Heat or Cold: The Great Debate

Mind detoxAt my practice, I often get asked which is better: heat or cold with regards to an injury.

Well, now the question is going to be answered.

First, let’s learn the difference between acute, sub-acute and chronic injuries.

Acute injuries are described as a trauma of rapid onset, rapid progression and brief duration. During this stage, inflammation or swelling is always present in soft tissue, thus causing pain and stiffness.

Chronic injuries are described as a condition that develops slowly, is persistent and long lasting. It can start off as an ache that can progressively become quite debilitating, lasting 3 months or more.

Sub-acute injuries are a midpoint between acute and chronic.

Inflammation is a protective response by the body to help initiate the healing process and remove the injurious stimuli. It usually appears within a few minutes or hours and ends upon the removal of the injurious stimuli. It is classified by pain, redness, immobility, swelling and heat. This is why ice is effective when recovering from acute injuries. Most people know to rest, ice, compress and elevate above the hearth is best remembered as the acronym R.I.C.E. It is recommended to use ice from the moment injury occurs up to 72 hours after injury. Ice is not recommended to people with circulatory conditions, sensory changes, or cold sensitivities.

During the sub-acute stage of injury a contrast between ice and heat is usually recommended. This involves using cold (such as applying a cold compress) for 3 minutes and then immediately using warm (such as a hot water bottle or warm bath) for 1 minute. The contrasting temperatures create a pumping action of constriction and dilation to help move inflammation out of the tissue. Contrast treatments are not recommended for people with decreased skin sensitivity to temperatures.

Heat is effective when trying to increase below dilation and blood flow to the skin and muscles below. It is also effective after treating trigger points. A reflex reaction of increased blood flow occurs in the opposite arm. Heat is applied generally from 10 – 20 minutes in a specific area, and care is taken not to burn the area. A general sense of sedation and relaxation occurs. Heat is not recommended for people with acutely inflamed joints, existing burns, hypersensitivity to heat, and circulatory pathologies.