Applying hot and cold therapy to an injury is usually one of the easiest treatment options available. However, one of those may be better than the other, depending on the situation. Here’s a quick rundown so you know exactly what to do the next time you’ve got an ache or pain and can treat the injury or pain without making things any worse.

Hot and cold therapy: A starting guide

Even those of us who live in desert climates are not immune from the chill of winter weather. It can permeate your bones and drive you indoors for several months straight. It is completely normal to seek warmth as the days get shorter.

Hot and cold therapy has been a mainstay for treating minor sports injuries. The idea is that applying cold, or ice, to an injury immediately after it occurs can reduce swelling and inflammation. Then, once the initial healing has begun, heat can be applied to soothe soreness and restore a better range of motion.

In the winter months hot therapy can seem like more than just a helpful tip for sore and aching muscles. Who doesn’t want to curl up with a hot water bottle when the temperatures dip below freezing? However, there are some things to keep in mind when using hot therapy in cold weather.

To avoid unnecessary complications from the incorrect use of hot and cold therapy, here are a few things you should consider.

How to use cold therapy 

Use ice to reduce swelling and lessen pain and inflammation, for example, after an acute injury such as an ankle sprain. In some cases, cold therapy can be used to manage chronic injuries, such as shin splints, that reoccur with certain activities.

Ice actually causes your blood vessels to narrow, which helps to bring down swelling, but also minimizes pain and limits any bleeding that could be occurring internally in the injury area.

Methods of applying cold to an aching area include placing an ice pack on the sore area. Be sure to wrap the ice pack in a towel to avoid irritating your skin.

Wetting a towel with cold water and then placing ice inside to keep the cloth cold also makes an effective cold pack. Ice stuffed into a sealable, plastic bag and placed inside a towel could work, as could a frozen back of vegetables if you’re really in a pinch. You can also ice the area three times each day for 15 minutes. If you’ve just experienced an injury, ice every two or three hours for about three days.

How to use cold therapy safely

Believe it or not, there are wrong ways to ice an injury. Here are some tips for apply ice the right way to keep the pain and damage under control.

  • Apply an ice pack to the injury within 48 hours.
  • Never apply ice directly; if you don’t have a pack, wrap ice cubes in a thin towel.
  • Apply the ice pack for only 10 minutes at a time.
  • If using cold therapy for a chronic injury, always do so after the activity, never before.

How to use hot therapy

Applying heat to the body opens up the blood vessels and increases blood flow. This helps supply oxygen to painful areas including joints, muscles, ligaments, and tendons. Using heat can also reduce muscle spasms and improve range of motion issues. Heat is a great non-medical treatment for painful conditions or injuries.

Hot therapy is perfect for cold winter days and sore muscles. Winter sports, outdoor maintenance, and other activities can lead to pain and discomfort. Applying heat in the correct ways to these conditions will help speed recovery and provide comfort from the cold.

How to use hot therapy safely

It is important to know what to do when applying hot therapy and how to do it to avoid further injuries.

The heat source can be either dry or moist. Dry heat sources, such as an electric heating pad, may dry the skin while applying moist heat can get better penetration into the affected area. Electric heating pads, microwavable pads, hot water bottles, gel packs, warm towels, and hot water baths are all possible methods for applying hot therapy.

It is important to make sure the heat source is not too hot and can be maintained at a consistent temperature for as long as possible. You want to avoid burning or scalding. When using a dry heat source you may wish to place a towel between the pad and your skin to prevent burns or discomfort. Depending on your injury or condition, certain heat sources may be better suited for you. Your doctor or specialist can make recommendations.

Other helpful tips for safety when using hot therapy include:

  • Keep heat applications under 20 minutes unless otherwise directed.
  • Do not apply heat if there is swelling around the injury. Cold therapy should be applied first.
  • Patients with poor circulation or diabetes should avoid hot therapy.
  • Heat should never be used on open wounds or areas with stitches.
  • To avoid burns don’t give into temptation to lie down with an electric heating pad. Make sure you are able to stay awake and upright when using these devices.

Injuries or conditions that benefit from hot therapy

Some injuries or conditions that can benefit from the use of hot therapy include:

  • Sore muscles: If you’re been shoveling snow or putting up holiday decorations you may be feeling some tight, sore muscles in your shoulders or legs. This is the perfect opportunity to apply hot therapy. Use a hot water bottle or a heating pad to apply the heat directly to the area that is feeling the discomfort.
  • Menstrual cramps: Every woman knows that heat around the midsection during their period can help reduce cramping. Even a warm cat on your lap can feel comforting during this time of the month. Curl up in bed with a hot water bottle and get plenty of sleep to reduce the effects of menstrual cramps. Don’t use an electric heating pad while you’re sleeping.
  • Aches from the flu: If you still have a fever, hot therapy may not be the right choice but otherwise go ahead and add heat to your recovery regimen. This is a case when you may want to apply heat to your entire body. A hot bath, maybe scented with soothing oils or herbs, can help you relax and make it easier to get some much-needed sleep.
  • Comfort from the cold: There is absolutely nothing preventing you from using hot therapy as a respite from the cold weather. Staying indoors with a cup of hot tea can bring comfort on a cold winter’s night. Take a hot shower to get the blood flowing before wrapping yourself up in warm, fleecy pajamas.

Alternating hot and cold therapy 

Incorporating both hot and cold therapy into your self-care routine for pain could help you find the relief you’re looking for.

To try this method, apply heat for 15 minutes, wait several hours, and then apply cold for 15 minutes. You may even try alternating a cold bath with a hot bath for full-body submersion. Changing temperatures on your body so quickly may reduce any swelling and associated pain, however be careful not to shock your body with widely different temperatures.

Hot vs cold therapy safety 

Hot therapy should not be used when there is bleeding or inflammation. Because the heat opens up the blood vessels, this can cause increased bleeding and further complications.

When an injury is fresh or there is inflammation present you may wish to choose cold therapy as an alternative. Applying ice to an injury at this stage will reduce the swelling. A good rule of thumb is to use cold therapy for acute pain or new injuries. Use hot therapy for chronic pain or an injury that is more than a day old.

If the injury or pain persists after the use of hot therapy, you may also wish to speak with your physician or specialist to determine if there are any complications or issues that require a different approach or intervention.

There are many things to keep in mind when it comes to hot or cold therapy. Always make sure you follow your doctor’s instructions regarding the use of these techniques. Incorrect adherence can result in increased pain or complications from injuries. It is also important to follow the safety tips outlined here and not use either therapy if it is not the right solution for you.

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