Both forms of treatment are very effective means of achieving pain relief. The decision to use Cold Therapy or Heat is dependent on many factors such as the type of injury, the symptoms being elicited by the body and how recently the injury occurred.

Cold (crushed ice, bag of frozen peas or gel ice pack) is generally applied to acute injuries immediately after and up to 3-5 days after trauma. The body’s initial reaction to soft tissue damage is to send blood rushing to the injured area. This reaction is an important one as it initiates the first stages of healing and clotting around the damaged tissue. The body struggles to regulate this early response and as a result excessive pain and swelling can ensue. Cold therapy pulls heat from the area, thus constricting blood vessels and reducing the swelling, Cold therapy stimulates the sensory nerve endings in the skin which send messages faster then that of the pain thereby helping to block the perception of pain.

The pain associated with traumatic injuries such as bruises, sprains and strains can all be alleviated by ice and is particularly affective when used in combination with R.I.C.E principles.

  1. Rest
  2. Ice
  3. Compression
  4. Elevation

Heat (hot packs, infrared heat) is applied to chronic injuries (on going conditions). Heat therapy causes dilation of the blood vessels, which improves circulation, bringing fresh blood to the injured area, helping the body to receive the ‘fuel’ and ‘building blocks’ required for tissue repair and remove unwanted waste (dead tissue). The use of heat can help to relax tight muscles and muscle spasms. When applied to peripheral joints of the body it can temporarily alleviate stiffness, thus reducing pain and making exercise and daily activities easier.

Cautionary Footnote!!!

When using either Heat or cold therapy ensure that it is within your sensory tolerance. Always wrap the source in a thin layer of toweling to avoid direct contact with the skin.  If you have sensory deficit through nerve injury or are on medications that affect your ability to detect temperature change then it is advised to exercise extreme caution or seek medical advice prior to application of these therapies. Never fall asleep whilst applying heat as your sensitivity to temperature variations becomes diminished.

This document is intended for general advice and is not intended to provide specific solutions to individual problems. Bad backs takes no responsibility for the individual’s interpretation and application of this advice.

Matt Baker BSc (HONS) MCSP PG Dip Erg (Physiotherapist)