Heat or Cold?
written by, Dr. John
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
When To Use:
First 48-72 hours (acute stage of injury) after a sudden-onset injury.
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
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.
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
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.