Use of Cold and Heat Therapy in Injuries

Use of Cold and Heat in Injuries

Cold (Cryotherapy) Therapy

How does it work?

The effect of cold depends on the situation it is used in. In fresh (acute) injuries cryotherapy therapy helps to reduce swelling and pain. It reduces the potential for further injury to the damage tissue (reduces the metabolic rate and secondary injury). When used in chronic injuries it plays a role in relieving overuse pain.

When to use it?

Use it in Acute Injuries and Chronic Injuries. The situation and timing defers.

Acute Injuries.

Use it as soon as possible, ideally immediately after injury. Apply it using a part conforming pack.  Cheaper options include a bag of frozen peas or crushed ice in a plastic bag. Wrap this in a thin towel. The ‘Good Morning Towel’ is a good option. Custom made gel packs are also good but are relatively more expensive.

Chronic Injury/Pain.

Cryotherapy for chronic pain (eg backpain) is reserved for use after activity ( eg – pain after a long day at the office or discomfort after a workout ). Stiffness and discomfort after awaking from sleep usually requires the use of heat.

How do you use it?

Apply the pack over the area for 20 minutes. In acute injuries, cryotherapy is best repeated  every 2 hours for the first 24-48 hours.

Heat Therapy

How does it work?

Superficial heat increases flexibility of tendon and ligaments. It is also useful to reduce muscle spasm and stiffness. It does this by increasing blood flow and metabolism.

When to use it?

Acute Injuries

It is NEVER used immediately after injury. Use is initiated once the acute inflammation has subsided ( about 72 hours) and as a method to increase flexibility prior to rehabilitation exercises.

Chronic Pain

It is used to increase flexibility and reduce stiffness felt after a period of inactivity or prior to initiating exercise. After the exercise session a cold pack is used to reduce the metabolic rate of the tissue.

How do you use it?

Apply a warm pack (a moist towel is better than a dry one) is applied to the treated part. The usual time for application is 15-20 minutes. The temperature used is between 40 and 45 degrees Celsius.

Cautions:

1.     Always be mindful that both cold and warm can cause skin injury. Redness of skin, which is not blanching to pressure, should alert one to the possibility of skin vascular compromise.

2.     Use it with caution in patients with possible peripheral vascular disease ( eg – diabetics, Raynaud’s disease or cold initiated hematological issues)