November 2009 Newsletter – Hot or Cold?
Happy November to everyone! It’s that time of year when the trees are dropping the last of their leaves, the turkeys are finding their way into the supermarkets, and the air is getting colder. And since cold is all around us, I thought I’d spend a little time talking about the cold… and the heat.
I’m often asked the question, “when something hurts, should one use heat or ice to make it feel better?” The answer, as you may already be guessing, is “it depends!” And as each individual case is different, the following information should not be taken as a specific prescription for the use of heat and cold, but rather, as a general guideline.
First, I’d like to address the use of heat and cold in response to a recent injury. The standard recommendation is to use cold for about the first two weeks following an injury. This cold causes a reflexive vaso-constriction of blood vessels to combat the effects of inflammation. Cold should be applied several times a day for 15 to 20 minutes, and no longer. If cold is applied for prolonged periods of time, cold-induced vaso-dilation can occur, which can result in increased inflammation. From two to four weeks following an injury, one is generally safe using either heat or cold to flush out inflammation and/or decrease pain, depending on which one they feel is more effective. After four weeks, the inflammatory phase of healing should be complete, and the general recommendation is to use heat to address any residual pain and/or inflammation.
Next, I’d like to talk about pain that’s been around for a long time or pain that may be associated with osteoarthritis (OA). If you read July’s newsletter, you should remember several of the clinical hallmarks that are often associated with OA:
- Age >50
- Morning stiffness less than 30 to 60 minutes
- A crunching sound associated with joint movement
- Bony enlargement
- Joint soreness, stiffness, or pain, followed by periods over overuse or inactivity. If some of the aforementioned hallmarks sound all too familiar, pain of that nature generally responds better to heat.
And lastly, whereas heat and cold are often very beneficial for reducing pain and/or inflammation, sometimes it takes a little more to get back on your feet following an injury. If you find that things don’t seem to be improving, don’t wait! Your physical therapist is the one to see to get you up and moving again!
Gobble Gobble,
Josiah Faville, DPT, Staff Physical Therapist @ TAI Valley South
November 2009 Newsletter – Hot or Cold?
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