Hot or Cold Compress, What to Use for Pain and Swelling


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Evidence Based - Facts Checked

Whenever we feel pain, our elders usually recommend using a hot or cold compress. You must have heard them quoting, “Hot and cold compress is important in managing pain due to musculoskeletal injuries"1Malanga GA, Yan N, Stark J(2015)  Source

But to understand when to use hot or cold compress procedure is a bit tricky as the reason of pain and the age of pain may differ. However, this question can be best answered if we can easily differentiate the types of injuries and the age of pain. So, let’s first understand what are the different types of pain that require heat or cold compress therapy .

Well! There are two types of pain. One is an acute pain, and the other is a chronic pain. An acute pain is a result of sudden trauma, which may include collision or fall. However, chronic pain is developed from an old injury, caused due to overuse of a body part.2Raffaeli, W., & Arnaudo, E. (2017, August 21) Source-PubMed    

If you are still not clear about what is included in acute pain and chronic pain, then let's try to dig into a bit more detail. 

ACUTE PAIN

Whenever you hurt yourself, the injured area becomes inflamed, and the patient experiences redness, swelling, and pain in the affected area. The pain caused by such injuries is termed as acute pain. This type of pain remains for a maximum of five to six months3Johnson, Q., Borsheski, R. R., & Reeves-Viets, J. L. (2013)   Source-PubMed. Physicians recommend using ice therapy in cases of acute pain.

How Does Cold Compress Help in Reducing Pain

Using ice on the affected part helps in narrowing the blood vessels, and thereby helps in reducing the blood flow to the affected area responsible for aggravating swelling and inflammation. Vasoconstriction (narrowing of blood vessels) decreases the metabolism in the affected area by controlling the blood flow.4Block, J. E. (2010, July 07)  Source-PubMed  

Examples Of Acute Pain Where Ice Therapy Will Work

  • Injury due to banging leg, knee, finger on a hard surface
  • Ankle Sprain
  • Pain in the knee due to sudden twisting of the leg
  • Elbow injury
  • Accidental contact of skin to a hot surface
  • Inflammation due to toothache

How Long Should Ice be Used to Reduce Swelling?

Whenever you apply ice on a swelling, remember to do so for 20 minutes at a time. Take a gap of one hour between each session . You can put ice in a sealed bag, in a towel/napkin, or put a wet towel in a freezer for 15-20 minutes and then apply it on the swelled area

Quick Note

Individuals having poor blood circulation, cardiovascular disease or inadequate sensory response to touch should prefer approaching a therapist rather than doing themselves as it will cause more damage than benefit. Further, if, after using a cold pack for 48 hours, doesn’t help you relieve your pain, please consult an Orthopedic Physician immediately.

How To Use Cold Compress?

Applying a cold compress within the first 48 hours of the injury helps in minimizing the swelling around the affected area and hence control the pain.5Block, J. E. (2010, July 07)  Source-PubMed. The cold therapy will numb the affected area and will thereby reduce the swelling and inflammation. Wrap ice/ice pack in a towel before applying over the skin for patients not comfortable with extremely cold temperatures.

Let’s learn, how to use a cold compress on the injured area to decrease swelling, inflammation, and pain:-

1

Apply ice pack on the swollen or inflamed area for 15-20 minutes, every 2 to 3 hours, for three days. It will reduce the pain considerably. Cold compresses are readily available in medical stores or online platforms.


Learn the Right Way of Using Ice Pack for Effective Results:-

2

Soaking a cloth in the cold, but not freezing water, can also show excellent results in reducing your pain.


Learn the Right Way to Do It:-

3

You can also massage the swollen or inflamed area with an ice cube or an ice pack in a circular manner or clockwise or anti-clockwise manner from 2 to 5 times in a day, for 5 to 7 minutes, which might reduce the pain. 

Learn the Right Way to Do It:-

Take a plastic disposable glass and fill it water. Refrigerate it and cut it's brim to have a portion of ice outside the glass, so that it can be applied on the affected area.


Now let us talk about chronic pain where hot compress can be used!!!

Chronic PAIN

A pain that is older than six months is termed as chronic pain. Heat therapy (warm compress) can be used for such pain or injuries. Heat therapy, such as using hot water bag, moist heat, hot showers, steam baths, saunas, hot baths, or using just a warm damp towel, can relieve muscle pain and loosen tightened muscles.6Malanga, G. A. (2014, December)  Source

How Does Hot Compress Help in Reducing Pain?

Exposing the affected area to high temperatures leads to vasodilation, which results in increased blood flow. This helps in healing the pain as the supply of nutrients and oxygen increase in the affected area.

Examples of Chronic Pain where Heat Therapy/Warm Compress Will Provide Relief

  • Pain due to arthritis
  • Pain due to fibromyalgia
  • Pain due to cancer
  • Pain due to tissue and ligament tear
  • Frequent headaches
  • Nerve damage
  • Lower back pain

Quick Note

Individuals having a poor sensory response to touch should prefer approaching a therapist rather than doing themselves as it will cause more damage than benefit. Further, avoid using hot compress in the following conditions and consider talking to your physician before using it:-


  • Open wounds
  • Hypertension
  • During pregnancy
  • Diabetes
  • Deep Vein Thrombosis
  • Dermatitis
  • Multiple Sclerosis
  • How Long Should Heat Therapy be Used to Reduce Swelling?

    It would be best if the heat therapy on a joint or muscle is done for 15 minutes at a time, and then a gap of an hour is taken. Remember not to leave heating pads for extended hours or while sleeping.

    How to Use Hot Compress?

    Following are some of the ways of deploying heat therapy on the affected area:-

    1

    Soak the affected area with the help of a hot bath, between 33 and 37.7 degrees Celsius or 92 and 100 degrees Fahrenheit. The hot water will provide heat therapy to the injured area.

    2

    Take warm water,  soak a towel in it and then apply it on the affected area. This will help in managing the pain and muscle tightness.

    Learn how to make Moist Heat Pack at Home to Relive Muscle Tightness Pain:-

    3

    Making use of safe heating devices on the injured area helps in providing heat therapy to the affected area in an efficient way . These products may include hot water bottles made of rubber or plastic, electrical heating pads, hot compressor, or heat wrap.

    Hot Water Bag - Its Use and How to Take Care of It

    4

    Making use of heated paraffin wax therapy7Sibtain, F., Khan, A., & Shakil-Ur-Rehman, S. (2013, April)  Source-PubMed  

    5

    Medications patches containing capsaicin, help in inducing heat in the applied area and hence provide relief from pain8Anand, P., & Bley, K. (2011, October)  Source-PubMed  

    Does Heat Make Inflammation Worse?

    The heat used on the affected region having swelling and inflammation may further aggravate the pain and prevent the muscles from healing. It can significantly make the condition worse. Heat and inflammation are predominantly a lousy combination. Inflammation and swelling are caused due to an increase in the blood flow in the affected area. Applying a hot compress on it shall further lead to vasodilation and cause the swelling to increase.




    Final Takeaway

    Ice compress application on the swelling and the inflamed area will constrict the blood vessels, decrease the metabolism of the cells, and decrease the pain in the tissue due to any injury. The ice will reduce swelling in 24 hours, and some doctors recommend not to use ice on swelling post 24 to 48 hours of the injury.

    Hot compress application on muscle stiffness or a pain older than six months will prove out to be effective. Although there have been studies conducted to alternate the ice compress and hot compress for chronic pain but there isn’t much evidence in the form of clinical studies available as literature9Kim, E., Choi, Y., Lim, C., Kim, K., & Lee, S. (2015, June 26)  Source-PubMed

    Hot or Cold Compress, Which one to Use in Pain

    This content is medically reviewed by Dr. Apoorv Dua (MS Ortho) and written by Puneet Utreja

    Last Medical Review Date - 24th September 2020


    References

    1. 1
      Malanga GA, Yan N, Stark J.
      Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury.
      Postgrad Med. 2015;127(1):57-65. Retrieved September 19, 2020, from https://doi.org/10.1080/00325481.2015.992719
    2. 2
      Raffaeli, W., & Arnaudo, E. (2017, August 21).
      Pain as a disease: An overview.
      Retrieved September 19, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573040/
    3. 3
      Johnson, Q., Borsheski, R. R., & Reeves-Viets, J. L. (2013).
      Pain management mini-series. Part I. A review of management of acute pain.
      Retrieved September 19, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179627/
    4. 4
      Block, J. E. (2010, July 07).
      Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: A narrative review.
      Retrieved September 19, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781860/
    5. 5
      Malanga, G. A. (2014, December).
      Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Research Gate.
      Retrieved September 19, 2020, from https://www.researchgate.net/publication/269767537_Mechanisms_and_efficacy_of_heat_and_cold_therapies_for_musculoskeletal_injury
    6. 6
      Sibtain, F., Khan, A., & Shakil-Ur-Rehman, S. (2013, April).
      Efficacy of Paraffin Wax Bath with and without Joint Mobilization Techniques in Rehabilitation of post-Traumatic stiff hand.
      Retrieved September 19, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809244/
    7. 7
      Anand, P., & Bley, K. (2011, October).
      Topical capsaicin for pain management: Therapeutic potential and mechanisms of action of the new high-concentration capsaicin 8% patch.
      Retrieved September 19, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169333/
    8. 8
      Kim, E., Choi, Y., Lim, C., Kim, K., & Lee, S. (2015, June 26).
      Effect of heating and cooling combination therapy on patients with chronic low back pain: Study protocol for a randomized controlled trial.
      Retrieved September 19, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494172/

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    This content is only for educational purpose and should not be considered as a substitute for your Physician's/Doctor's clinical judgement

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