Heat or Cold Therapy?

By Roger P. Smith, D.C.

Whether you are trying to just relax or perform self therapy, I suggest using cold therapy for an acute injury and heat therapy for a chronic injury. Unfortunately, most of us do not understand the difference between acute and chronic so we self treat with whatever feels good. Enhancing your body’s physiology or function with the proper use of cold therapy and heat therapy at the proper time can assist your body with healing and recovery.

Acute Injury: injury having severe onset and a short course, Dorland’s Medical Dictionary.

Chronic Injury: injury persisting for a long time, Dorland’s Medical Dictionary.

Cold therapy constricts blood flow to the muscle. As the muscle cools, the amount of blood in the muscle diminishes as the constriction process pushes it out. This is great to help reduce bruising, swelling, and discomfort. As the muscle warms and the blood vessels expand, new blood comes rushing in and cleans the debris left behind from the injury and stimulates the healing process. The more often this cycle is applied, the faster the body can recover from an acute muscle injury.

It is recommended that cold therapy is only applied for 10 minutes every hour. Using cold therapy for longer than 10 minutes at a time can actually have a negative effect on the body.

Moist heat is a great treatment tool for chronic muscle injuries. Moist heat applied to the injury area opens up the blood vessels allowing blood to flow more freely. Typically, chronic injuries have some sort of ischemia (lack of blood) associated with them. The ischemia is detrimental to healing and the moist heat helps reduce it. It is recommended that moist heat is applied for up to 20 minutes every hour. Always place a layer between the body and the moist heat to prevent trauma to the skin.

Think of this scenario, you burn your mouth on a hot cup of coffee (acute). Do you suck on an ice cube or drink more hot coffee? Ice reduces the inflammation to the burn and diminishes the nerve response allowing some sense of a good feeling. It’s a little different with a muscle injury in that the heat initially feels good even though it is adding inflammation and swelling. Then, once the heat is removed the injury site is typically more irritated than if you just left it alone. Ultimately, you are extending your symptoms and delaying the healing cycle when heat is applied to an acute injury. With a chronic injury, applying ice when heat is suggested can delay the therapeutic effects that heat offers.

Best rule of thumb. Keep it simple! Use heat therapy for long term (chronic) injuries. Use cold therapy for a recent (acute) injury. However, if you are injured it is always best to seek the advice of a medical professional before applying any hot and cold therapies.

Roger P. Smith, D.C.
www.drrogeraz.com

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