The correct use of hot and cold therapies after an injury or sprain can contribute to a reduction in pain and swelling and aid in healing.
The incorrect use of heat and cold, however, can worsen an injury and hamper recovery. Both heat and cold affect nerves and muscles, might reduce your ability to perceive pain and recognize your limits.
Please use hot and cold therapies correctly and cautiously. Of course, cold and hot therapy should never be applied to anyone who cannot communicate due to age, disability or any other reason.
COLD THERAPY GUIDELINES
Apply cold therapy in the first 24-48 hours after an injury to prevent further damage to tissues. It can also be applied after 48 hours if inflammation persists. Repeated applications can be made throughout the day in increments of 10-15 minutes.
When a cooling agent, like an ice bag or a commercial cooling pack, is applied to the skin, blood vessels contract and blood flow to the area is reduced. The reduction in blood flow helps to reduce inflammation, swelling and pain. Pain is also reduced, or masked, by the numbing effect of cooling the skin.
Beware of frostbite when using cold therapy. Cold can also damage nerves if left in place too long. Check the area under treatment visually every 5 minutes.
Using a damp towel between the skin and the cold source can increase effectiveness of the therapy and reduce the risk of skin or nerve damage. If the initial redness or discomfort persists, discontinue treatment.
Immediately after an injury, when pain and swelling are at their peak, follow the P.R.I.C.E. guidelines: Protection, Rest, Ice, Compression, Elevation.
Cold therapy can also be used after exercise to ease muscle spasms or to diminish pain or swelling.
Cold therapy should NOT be used by those with:
• poor blood circulation
• Raynaud's disease (spasms of blood vessels)
• hypersensitivity to cold
• lack of sensitivity of the skin
• recent or severe skin inflammation or eczema
• skin that has an open or infected wound
HEAT THERAPY GUIDELINES
Heat therapy is often used during the chronic, or continuing, stage of an injury. It should not be used during the initial period after an injury when swelling is present and/or the skin is hot to the touch.
Hot packs, both dry and moist, do the opposite of cold packs. Hot packs aid in healing by dilating bood vessels and increasing blood flow to the affected area. This increased blood flow brings increased oxygen and nutrients to the cells in the area and carries away cell waste.
Hot packs can be applied for 15-20 minutes at a time.
Take care not to overdo heat therapy. Always check the area visually every 5 minutes. STOP if skin color or discomfort are abnormal.
Never lie on a heat source or sleep during heat therapy. Avoid burns by placing multiple layers of toweling between the heat source and your skin.
Heat therapy can also be used before exercise or physiotherapy to increase range of motion and flexibility and to reduce muscle tension. Heat therapy is also effective in the reduction of joint stiffness and in moderation reducing muscle spasms and tension.
Heat therapy is not recommended for those with:
• poor circulation
• poor skin sensitivity to heat
• areas of recent bleeding or severe bruising
Heat therapy should not be applied to areas:
• with open or infected wounds
• over a tumor
• over a tuberculosis lesion
• where swelling or severe inflammation exist
TALK TO A PHYSIOTHERAPIST
Please consult us if you have questions about your injury. We can advise you about the nature of your injury and whether hot or cold therapy are appropriate. Your condition might also benefit from one or more of the other forms of therapy at our disposal.
