When to Use Heat Therapy & Cold Therapy?

Confusion is common about whether heat or cold will give the best results for a sports-related or in-home injury, especially since both will help temporarily relieve pain. The use of heat or cold therapy depends on whether the pain is acute or chronic. A sprained ankle from a misstep on the stairs is an acute, sudden and painful injury. Recurring knee discomfort after every jogging session is considered chronic. Which should be used, moist heat or an ice pack, and when?

Cold Therapy

• Cold therapy should be the first choice for an acute injury like a sprained ankle. It helps limit or reduce swelling and inflammation and eases the pain. Combining cold therapy with ice and compression (wrapping the area) encourages a more dramatic drop in tissue swelling. Elevation also helps reduce swelling by '"raining" excess fluid from the area.

  Rather than chunky cubes, ice chips in a plastic bag and wrapped in a towel are most effective. It is not a good idea to apply straight ice because that can damage the skin. If crushed or chipped ice isn't available, a bag of frozen peas or corn kernels is a good alternative.

  The Sports Injury Bulletin (see References) suggests there is controversy about how long ice therapy should be used. Doctors have traditionally recommended as much as 30 minutes of icing at a time, but studies by the University of Brussels in Belgium indicate the best treatment is intervals of no more than 10 minutes, allowing skin temperature to return to normal in between. Ice therapy can be used on acute injuries several times a day for as many as three days.

Heat Therapy

• Moist heat therapy is recommended for chronic pain or discomfort such as sore, stiff muscles or spasms. Heat improves the flexibility of tendons and ligaments by relaxing the blood vessels and increasing the blood flow. The function of heat therapy that increases circulation and raises skin temperature is why it should not be used for acute sprain types of injuries or when there is inflammation of joints.

  Hot, wet towels laid over skin-protecting layers may be applied to an injury for 15 -- 20 minutes at a time. If you need to use heat therapy often, consider investing in athletic moist-heat packs or heating pads.

  Caution should always be used with heat therapy, making sure temperature is not great enough to burn or scald the skin. Heating pads should never be used for more than 20 minutes at a time or while sleeping.

Exercise Therapy

• Heat may increase the elasticity of muscles and joint connective tissues before exercising but should be avoided after a strenuous workout when cold ice therapy is the better choice.

Consult a Physician

• Because some injuries can be serious, you should see doctor if there is a possible bone fracture or if the injury does not improve, or gets worse, within 48 hours.