Heat and Cold Therapy
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Heat and Cold Therapy
When to Use Heat vs. Cold
To determine if applying heat or cold is best, it is important to understand what exactly applying heat or cold accomplishes. Applying heat increases blood flow, turning the tissues pink or red reflecting the dilation of the superficial blood vessels and their increased flow. Increasing blood flow provides injured or inflamed tissues with more of the nutrients necessary for rebuilding or repairing damages. Along with increased blood flow, lymphatic drainage is also increased allowing for removal of toxins and cellular debris associated with injury and inflammation.
Heat also relaxes muscles, providing relief of painful muscle spasm. It is particularly beneficial to apply heat, especially in the form of a hot soak, prior to obtaining a massage to allow for a synergistic benefit from the two therapies. Actually, the same argument applies to a hot soak after a massage as well.
Because heat dilates blood vessels, if heat is applied to acutely injured tissues such as a swollen, freshly sprained ankle, it will trigger greater fluids loss from injured vessels in the area resulting in more severe swelling and bruising. Therefore it is counter-productive to apply heat to new injuries where blood vessels are damaged and leaking. After the first 48-72 hours, when an acute injury has stabilized with no further development of bruising or swelling, applying heat may appropriate.
As one would predict, applying cold to tissues has much the opposite effect of applying heat. The application of cold causes blood vessels to constrict, reducing blood flow and also reducing fluid leakage from acutely damaged or inflamed vessels, thereby reducing the bruising and swelling associated with an acute injury.
Applying cold also slows and impairs nerve conduction, resulting in reduced pain signal transmission from an area of injury. Thus applying cold to an injury may reduce pain and, similarly, applying cold to an area of injury such as an injured muscle prior to stretching that muscle may allow for less pain and greater tolerability for stretching that muscle.
When to Use Heat and Cold
Well, not at the same time. But when recovering from an acute injury, there is often a good argument for using both heat and cold intermittently in the course of a day. In the morning, for example, an injury that has stabilized from a few days of rest and elevation and is no longer showing worsening swelling or bruising would likely benefit from either warm compresses or warm soaks to facilitate the healing process. However, towards the end of the day when daily activities have resulted in increased pain or soreness, especially if accompanied by some increased swelling, it would be appropriate to apply cold to reverse the transient worsening symptoms. Understanding the mechanisms by which heat or cold applications affect tissues allows for more appropriate application of therapy.
Emphasis on Education
Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.
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