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Which therapy is better? Cold or Heat?

It is not appropriate to say one therapy is better than the other because both have their own uses and benefits. Mostly in some conditions we use cold therapy and in some conditions we use hot therapy but sometime both therapies are used at the same time depending upon the condition.

Cold therapy:

Ice or cold therapy is also called cryotherapy. It can help to reduce pain, swelling, inflammation and bleeding anywhere in the body.

How to apply cold therapy?

Cold therapy is used in the forms of ice packs, cold sprays, ice massage, cold bath, Full body ice therapy chamber, cryostretching (using cold during stretching to reduce muscle spasm) cryokinetics (the combination of ice therapy and active exercise used for ligament sprain).

Cold therapy should not be applied directly on the skin because it can damage the underlying tissues and skin. It is applied for 10 -15 min after injury or swelling as soon as possible. It should not be apply for more than 15 min.

When to use cold therapy:

  • Cold therapy as pain management:

Ice pack increases the blood circulation. It helps to reduce the pain and swelling in acute and chronic conditions.

  • Cold therapy in spasticity:

Ice pack applied for long duration reduces nerve activity and It helps to relax or reduce the muscle tension in spastic patients but if applied for short duration, it can increase the spasticity or increase the muscle tone.

  • Cold therapy in muscle spasm:

Ice pack in muscle spasm or in muscle guarding acts as a pain killer and protect from further injury of surrounding tissues.

  • For Sports injuries:

Cold spray helps to treat the soft tissue injuries in athletes and help them to continue the sports.

  • In reducing Fever:

Ice pack impact on the physiological function of the body and reduce the fever by lowering down the muscle temperature

  • Cold therapy in post surgical conditions:

Ice pack is very helpful in healing the acute post surgical conditions by reducing pain, swelling and edema.

  • Cold therapy stress benefits:

Stress induced on the body tissue by cold therapy stimulate the release of some hormones that help us to bear pain, hunger and fatigue.

  •  Cold therapy role in burning calories:

When we used cold therapy the body temperature reduces and after the removal of cold pack from the body, the body uses the energy to reheat. During this process body metabolism increase and calories burn.

In which conditions cold should not be applied:

 Cold therapy should be avoided in some conditions like heart problems, Respiratory problems,

Blood pressure issue, Paralysis attack, Cancer, In children, Blood disorders, Chronic stiff joints and muscles, Open wound, Vascular injury, Risk of cramping, Hypersensitivity of skin.

Heat therapy:

Heat therapy is used to relax the tight muscles. It increases the blood circulation of the area due to increase in temperature. Oxygen supply to that particular area increases that helps to heal the body structures. Heat therapy helps in decreasing pain and muscle tightness.

When to use heat therapy:

Heat therapy is used in relieving chronic pain, arthritic condition, and muscle spasm, to increase joint range of motion, decreasing contractures and in blood clot resolution.

In which conditions heat should not be applied:

In some conditions Heat therapy should be avoided like in pregnancy, heart problems, open wounds, vascular issues, blood pressure issues, blood clotting, acute injuries, impaired sensation and in severe arthritic conditions.

How to apply heat therapy:

Heat therapy is used in the forms of heating pads, hot water bottles, hot wet towels, and hot baths. For minor issues 15 to 20 minutes are enough but in some cases its duration increases up to 30 minutes.

 Myths about heat and cold therapy:

  • It is considered that heat therapy is better than cold therapy. But it is not true because heat or cold therapy applied according to condition of body. Usually we apply cold when injury is fresh and there is swelling on any area. Heat therapy is mostly applied in prolonged conditions like in the management of long-lasting pain.
  • Another myth is that cold therapy use is not appropriate for head injuries. But this is just a myth and like other acute conditions cold can be applied to head injuries if necessary.

NOTE: The information provided to you is solely for the information purposes. It is not for any legislation. Please consult an expert Physiotherapist /Physician/Consultant for your respective problem.

By Dr. Saba Saleem, PT

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