Heat and Cold Therapy

heat-cold-therapyDuring a painful injury, it can be difficult to determine the use between ice and heat. The treatment will be advised according to the injury and the condition of the patient.






  • Decreases Pain
  • Increases Swelling
  • Decreases Stiffness
  • Increases Tissue Extensibility
  • Dilates Capillaries


  • Decreases Pain
  • Decreases Swelling
  • Increases Stiffness
  • Decreases Tissue Extensibility
  • Constricts Capillaries


Cold Therapy (Cryotherapy)

Cryotherapy (Cold, or Ice therapy) is applied during pain and acute injuries to help reduce muscle spasms or recent soft tissue injury in the body. In the early stages of the healing process, cryotherapy helps reduce swelling, pain, inflammation, and the progression of tissue damage. By applying the cold compress on the skin, the temperature decreases and thereby constricts the blood vessels.

According to the injury, the application of the cold pack will be advised for the first 24-48 hours. The ice pack should be wrapped in a towel or a thin damp cloth prior to placing the ice pack directly on the skin. The ice pack should be applied for 10-20 minutes at least three times a day, or once every hour if the pain is severe. Allow the therapy to numb the painful area and provide a cooling relief to the affected soft tissues. Do not keep the ice pack on the injured area for more than 20 minutes. To achieve optimal results, complete all four natural stages of sensation for cryotherapy:

  1. Uncomfortable sensation of cold
  2. Burning/Stinging Sensation
  3. Aching Sensation
  4. Numbness Sensation

Heat-Cold Contrast Therapy

The heat-cold contrast therapy consists of alternating applications of heat and cold. The use of moist heat followed by cold provides best results when pain is not the direct result of the actual injury or is not sustained for more than 48 hours. The physiological effects are cycles of vasodilation (brings nutrient-rich blood to surface areas) and vasoconstriction (driving blood to the body’s core), which create a pumping action to reduce swelling, reduce pain by reducing muscle spasms, and change the temperature.

The body’s pain receptors are sensitive to temperature change. This means cooler temperatures decrease the speed of nerve transmission, while warmer temperatures increase the speed of nerve transmission. In simple terms, the brain is momentarily distracted from sending or receiving pain messages through the use of contrasting temperatures.

As swelling cause’s pain and spasms, the range of motion can be limited. Contrast therapy can ease the pain and spasms, allowing an active, pain-free range of motion. This not only accelerates tissue repair and recovery, but also increases lymphatic drainage from the area and decreases the swelling.

It is important to use moist heat, not dry heat, to prevent dehydration of the soft tissue and any interference of the healing process. There are many varieties of moist heat, such as applying a hot moist pack, soaking in bath, applying a hot wet towel until its effective, and taking a hot shower. An example of dry heat is a dry heating pad.


  • ∙ Apply moist heat for 3-5 minutes, followed by an ice pack or cold water for 30-60 seconds.
  • ∙ Do not apply moist heat for more than 5 minutes and cold therapy for more than a minute.
  • ∙ Never apply heat without following up with ice therapy.
  • ∙ Depending on the condition, perform just one application, 1-3 times a day.
  • ∙ The human body has certain tolerance levels when it comes to temperature extremes; exceeding the recommended number of applications may cause damage to the skin and tissue.
  • ∙ To prevent harm, the cold water should remain between 50 and 60 ˚F and the hot water should remain between 100 and 105 degrees ˚F.
  • ∙ If the directions are not followed properly, temporary relief may be noticed, but the long-term effects may include a decrease in circulation and an increase in pain and swelling, which can increase pain and swelling later.
  • ∙ If any discomfort is noticed, immediately stop the therapy.

Cryotherapy and heat-cold contrast therapy are inexpensive and convenient forms of treatment that can be applied at home or in the office. However, please do not begin treatment without consulting your doctor.

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