One of the biggest and most important questions I regularly receive from many of my clients is, “What is better to use, heat or cold, to help when I’m in pain or when my muscles are tight?”
Knowing the difference between hot and cold therapy is vital in both the speed and effectiveness of healing your injury and managing your pain. Let’s talk about what some of the benefits and functions are of heat and cold as it relates to pain management.

One of the best examples is someone who comes to me for massage.

You’ve been really busy for the last couple of months and meaning to come in for a massage. You helped your brother move and the stress at work has been overwhelming, leaving you feeling pretty ragged and stiff. I do a body assessment and know you are carrying most of the stress and tension in your shoulders and back. You don’t have any inflammation, just tension in the muscles.

I put a heat pack on your back and shoulders to help the tissues relax, making them more pliable and easier for me to work on. I start with work on your legs, while the heat pack relaxes your back. I check in with you as I work to make sure it’s not too hot. When I’m finished working on your legs, I move to your back and begin massaging muscles that are warmed up, loosened and much easier to work with. Plus we’ve drawn new circulation to the area that promotes healing and the rebuilding of damaged tissue.

Normally I use a dry heat pack that covers most of the back and shoulders, but can also use a wet hot pack that penetrates deeper into the muscles (usually used on more serious chronic back pain).

The biggest benefits of using heat on muscles;
- to increase circulation to a specific area
- to loosen and relax tight muscles
- warm up what’s cold

We have many types of heat available to us; heat packs (grain, gel, cherry pits, etc), electric hot pads, warm cloths, paraffin baths, hot tubs and even a simple bath. Of course each has its own function and effectiveness,

But is heat always the best way to go? Not always!

Cold packs are best when you have an acute (fresh) injury, or if you are showing signs of swelling, inflammation or pain in a specific area.
Cold gets a bad rap because it’s not very comfortable, but it’s one of the best tools for pain management. If you have sore muscles, a cold pack to the area will reduce the swelling, reduce inflammation and dull or numb the pain. Plus, when the cold is removed and the tissue returns to normal temperature, it brings with it fresh circulation and promotes healing of the tissue. You must be cautious when using cold / ice pack in order to not freeze the skin. Short (2-5 minute) applications with ice direct on the skin, or Ice Therapy are very effective at reducing pain on very specific areas (hand, wrist, elbow, shoulder). Longer applications (15-25 minutes) of cold packs are also very effective, again being cautious to insulate the skin by wrapping the cold pack in a towel before application. Don’t forget, immersing your swollen joints in cool water, or using a cold wash cloth can still help your pain, especially if you find ice packs too uncomfortable.

Even a simple cool shower can be invigorating and be helpful with reducing your pain.

The key is to find what works best for you.

Whether its’ heat or cold, know that they can be used as effective tools in your pain management. Remember; Heat to loosen up tight muscles and increase circulation and Cold to reduce pain, inflammation and swelling.

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The System Includes:
a Self Assessment workbook, Manuals, Video and Audio instruction, Clear direction of how to assess your individual pain sources, the exercises and stretches to eliminate the pain. It’s a very powerful program and if you are suffering from Chronic Back Pain may hold the answers you are looking for.

Darren Hutchison
Registered Massage Therapist
Soul Vitality
Lethbridge, Alberta

PS. As a massage therapist I use my hands, wrists and joints everyday. I use ice on a regular basis for pain relief after a hard day at the office.

One weekend I was putting in a new fence at home and used a sledge hammer to pound 2 foot spikes into the ground. It left my hands bruised and tender. Thinking I’d be ok to work, I did massages the next day with my hands still injured and did I pay the price. My hands were inflamed, and I was in utter pain.

Taking some of my own advice; I filled a large metal pot with cold water, added ice and freezer packs (the ones from camping) to the water, and immersed my hands in the cold water. Over a period of about 90 minutes I would put my hands in the water until I couldn’t stand the cold anymore (about 3 minutes), remove my hands and dry them with a towel, let them warm up to room temperature (5 to 10 minutes) and then repeated the process.
Not only did the pain go away completely, but the bruising was gone and I was able to work the next day with no further trouble from my hands.

In most cases warmth may feel much better than cold, but in terms of effectiveness for pain management; you can’t go wrong by using cold for pain, swelling, inflammation, and the promotion of healthy tissue recovery.

Tags: Pain Management

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