Pain Management Education

Hot/Cold Therapy Education

The modalities of hot, cold and compression have a very appropriate role in the treatment of most injuries and chronic pain. The immediate result of almost all injuries involving the soft tissues (muscles tendons and ligaments) includes pain, possible bleeding, and a leakage of fluid from damaged tissues into the area. Afterwards, there is a migration of white pain management blood cells into the region of the injury. For this reason it is common to have inflammation, swelling and stiffness following an injury.   Cold and compression are medically recommended therapies for at least the first 72 hours after an injury to help reduce local pain and swelling. More importantly, by containing the severity of swelling, the application of cold and compression can have a significant impact on helping to promote healing and speed recovery from that injury.

Cold Therapy with Ice

Cold therapy with ice is the best immediate pain management treatment for acute pain and injuries because it reduces swelling and pain. Ice is a vaso-constrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site. Be careful not to apply an excessively cold product directly to the skin surface. At the very least, place a paper towel on the skin before applying cold and then wrap the cold product in place with an elastic bandage. Leave the cold product in place for approximately 15-25 minutes and elevate the involved joint or limb to about heart level if possible. Cold therapy can be applied every two hours during the initial 72 hours after an injury. If the injury is somewhat severe, the cold can be applied 2-3 times in a row for 15-20 minutes each with a 30-minute rest between applications. This type of pain management treatment can be repeated several times a day.

The best way to ice an injury is with a high quality ice pack that conforms to the body part being iced such as cold gel pack (link to ice gel pack) or by performing aqua therapy with the Vitalwrap system. Learn More

Many first-aid authorities recommend the simultaneous use of cold and compression therapy, often identified as R.I.C.E. therapy.
R = Rest. Avoid over-exertion or weight bearing on the injured body part.
I = Ice. Apply cold to the injury as described below.
C = Compression. Apply compression with an elastic bandage.
E = Elevation. Elevate the injured area above the level of the heart (about even with the lower portion of the breast) to help drain the area of excessive fluid accumulation.

Heat Therapy

Heat Therapy (hot compress, micro-waved gel pack, heating pad [link to moist /dry heating pad], etc.) promotes blood flow and enhances healing. Moist heat will penetrate more deeply than dry heat. Heat is generally used for chronic pain and injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. To aid recuperation from an injury, heat should only be used after swelling has subsided and after cold therapy has already been used. Because heat increases circulation and raises skin temperature, one should limit the application of heat to no more than 20 to 30 minutes at a time four times daily. To prevent burns use enough layers between your skin and the heating source.

People with nerve or circulatory problems (such as advanced diabetes) should not use heat unless otherwise prescribed by a physician. Do not apply heat to broken and/or sensitive skin. One should not sit, lean or bear weight on the hot compress.  For any injury consult your medical professional.