Concordville Chiropractic, Dr. John A. Harris, Concordville, PA


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Heat or Cold?

written by, Dr. John A. Harris

     When you have a back injury people around you are usually full of advice. Common suggestions include, "put a cold pack on it," and "put heat on it." Since cold and heat have opposite effects on the body, what should you do?

     Cold and heat can have beneficial effects when you are experiencing back pain but, the choice of which one to use depends on two things - how long you have had the pain and how it happened. It is very important to use these therapies at their appropriate times or you may actually make your injury worse!


     When To Use: First 48-72 hours (acute stage of injury) after a sudden-onset injury.

     Effects: The effects of cold include a decrease in pain, decrease in muscle spasms, and the constriction of blood vessels decreasing blood flow and bleeding. This will decrease swelling and inflammation.

     How To Use: A simple cold pack from your freezer will work just fine. Be sure to put a towel between the cold pack and your skin as you can actually frost the skin with direct contact. Limit  use of cold to 10 minutes every waking hour.

     If you leave cold on for more than 15 minutes you may experience something called the "Hunting Response." This is an automatic reflex you can't control. This happens when your brain thinks the treated areas is starting to freeze, and increases the blood flow into the area to warm it back up (an example of the Hunting Response is when your ears "burn" and get red after you have been outside for awhile on a cold day). This can increase the swelling and edema, aggravating your condition.


     When To Use: Starting 48-72 hours after a sudden-onset injury and for chronic conditions.

     Effects: After 48-72 hours, in all but the very worst injuries, the acute stage is over and the injured area will not continue to swell. It is now when we want to increase blood flow into the injured area to bring oxygen and nutrients and remove waste. Heat has many beneficial effects including: stimulations of white blood cell production, prevention of excess adhesions and scar tissue, increase in metabolism and waste removal, and dilation of blood vessels for improved circulation speeding up the healing process.

     How To Use: There are many forms of heat therapies you can use - some MUCH better than others. The most common form of home heat is an electric dry heating pad. Although this is very convenient to use, dry heat does not penetrate deep enough to reach the deep muscles that support the spine. Because the heat is concentrated at the surface, there is the danger of actually burning the skin while not even treating the deeper injured area. I have seen many patients with blisters that have burnt their skin from using dry heating pads.

      A better choice for home heat is moist heat. Anything from a warm bath, electric moist heating pads, or a Jacuzzi hot bath can be used. Moist heat penetrates a little deeper than dry heat but is still considered "superficial" heat. Even infrared heat lamps are considered superficial heat. Unfortunately, many physical therapy offices and even some chiropractic offices use superficial heat as it is cheap.

     By far, the best choice for heat therapy is deep heat. This cannot be done at home as this requires specialized equipment including ULTRASOUND and SHORTWAVE DIATHERMY. These two therapies reach the deepest muscles of the spine and are much more beneficial than any superficial heat. I use both in my office with great success.

Health and Fitness Articles by John A. Harris, D.C.




Our goal here at Concordville Chiropractic is to provide you with the most modern, natural, and effective chiropractic care available, without the use of drugs or surgery and their accompanying side-effects.


Copyright 2017 Concordville Chiropractic, John A. Harris, D.C.