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heat pack on shoulder

‘Should I use hot or cold therapy?’

ice pack on elbow joint- cold therapy

By rule of thumb always use cold therapy on achy joints – unless you are sure what is injured or have had professional advice. If you have back or neck pain which is achy, nagging or dull, then it is likely that it is caused by a degenerative process that creates heat itself. If the pain is sharp, knife-like and shooting, then structures such as discs may be involved. If the pain is hot and periodic (comes for a few weeks and disappears for a month or so) then this is likely to be an inflammatory process.

The discs between our vertebrae have a soft center with elastic rings around the outside, a bit like a soft-centered sweet surrounded by a chewy outer. This soft center is like petrol on a fire, when it comes in contact with the nervous system and creates heat and intense, sharp pain. Ask yourself, would you really want to put more heat into an already inflamed area? No! There… cold therapy it is then, the question is answered!

Study into effective pain treatment using cold therapy methods

Research into different therapy methods was been carried out at Cardiff University (circa 2000). They compared similar groups of patients of similar age, with similar low back pain and monitored their progression. One group used ice and another used nothing and compared how the patients recovered. The study found that those who used ice, even if they did not report a decrease in pain, healed more quickly.

So there are 3 reasons to use ice:-

1. Reduce and contain inflammation processes

2. Promote healing

3. Reduce pain

They also looked at the best way to use ice. They discovered that it had a greater effect if the area being treated had time to thaw a little within the treatment period. So the best way for low back pain is to use a bag of frozen small vegetables from the freezer, or treatment intended ice pack.

Method for using cold therapy:

  • Wrap ice, or a pack in a thin tea towel and place on the affected area for 10 mins
  • Remove for 10 mins and then replace
  • Remove and replace the ice pack another two times (so 3 times with ice on the area in one session).

Working this way equates to one dose. Repeat 3 – 4 times in the day.

For the neck and upper back do the same but for 5 mins each on and off. You need to adjust this a little if you are rather more solid but don’t exceed 20 mins.

COLD should NEVER be used over a pregnant tummy, front of a chest, or during a time when the patient has a chest infection on the upper back. If your surroundings are chilly, then make sure you are wrapped up warmly so as not to catch a chill. Elderly and frail patients should seek advice first.

HEAT does have its place. It is good to increase circulation. In cases where you have strained or sprained a joint eg a twisted ankle and there is almost instant swelling and or bruising (so long as you have not broken the underlying bone). Here you could use a heat pack in a similar way to using ice above, 5 mins on, 5 mins off and repeat two more times.

To speed the healing process you could do both HOT AND COLD. Instead of removing the heat and leaving the joint, replace it with an ice pack for the same pattern. ALWAYS end on cold though.

This advice should only be adopted for a short period of time whilst you seek professional advice.

If you are still not sure whether cold therapy or hot is best for you, then please contact us 01733 254239 or get in touch through our contact form.

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