How heat and cold therapies work and which one is best for pain and inflammation

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How heat and cold therapies work and which one is best for pain and inflammation

Accidents happen. You slip, slide and sprain your ankle. You’re able to walk it off for the time being, but later that night your ankle is swollen and throbbing with pain.

Or, perhaps after a hard day’s work, you wake up with back or muscle pain that’s making it difficult to do even the simplest of tasks.

As we experience these injuries, we have learned that applying hot or cold compression to the injured part of our body helps to speed up the recovery process. 

But, do you know when to should use either a hot or cold gel pack for treating a particular kind of injury?

Complicated as it seems, there are basic principles to remember when dealing with these specific issues. We’ll walk you through the best times to use hot or cold therapy while on your road to recovery, as well as providing tips on how to best prepare and use hot and cold gel packs.

How Does Cold Therapy Work?

Cold temperature slows down blood flow and reduces swelling and pain. When applied to the injured area, a cold gel pack constricts blood vessels and reduces blood flow, limiting the amount of fluid around the injury. This is how swelling is reduced.

A low and chilly temperature also slows down the pain messages being transmitted to the brain. This provides a numbing and analgesic-like effect that decreases the pain and discomfort. 

Use the RICE method to reduce pain and swelling

At the onset of minor injuries, doctors recommend the rest, ice, compression and elevation (RICE) technique. This self-care method eases the pain, reduces the swelling and promotes healing. 

Here is how it works:

  • Rest – Experiencing pain is the body’s signal that something is wrong. Hence, you should stop any activity that could aggravate the injury. Avoid putting weight on the injured area for up to two days. 
  • Ice  To reduce pain and swelling, a cold gel pack should be applied exclusively to the affected area for 10 to 20 minutes. Do this every two to three hours for the first 48 hours following the injury. 

Tip: To avoid damaging the skin and tissues, ice should not be directly placed on the skin. For example, place a hand towel or elastic bandage over the injured area before applying an icy gel pack. Choose a multi-purpose and reusable gel pack that is convenient to use and can be placed on any part of your body.

  • Compression – Cold therapy works best with proper compression. Snugly wrapping the sore or injured area with an elastic bandage facilitates faster healing. These gel packs come with an elastic band that not only holds the packs in place but also provides proper compression. 

Tip: The compression should not be too tight because it will disrupt blood flow and might worsen the swelling. Loosen the bandage if you feel increased pain, numbness or tingling, as any of these could mean that the band is too tight. 

  • Elevation – To further reduce throbbing pain and swelling, keep the affected area above the level of your heart, whether sitting or lying down. 

Tip: You can use pillows to prop the injured or affected area.

Cold compression may be used for up to five days following the injury. If the affected area does not show any improvement or becomes worse within two or three days, book an appointment with your physician.

Things to consider with cold therapy

A cold pack’s potency in alleviating pain and swelling is widely accepted. However, there are few instances when it is better to avoid ice treatment. 

People with sensory disorders are discouraged from using both hot or cold therapy as they won’t be able to feel excessive temperature. Individuals with poor blood circulation and those suffering from stiff joints or muscles are advised to shun ice because it could further worsen their condition. 

When should I use a heated gel pack?

If cold therapy is best for recovery, then warm therapy helps us to get moving again. Applying heat from warm gel packs is best for treating muscle stiffness, cramping and chronic pain, and it also soothes sore muscles and increases flexibility. 

How does heat therapy work?

While cold is best for treating recent minor injuries, swelling and inflammation, heat therapy works best for tired and stiff muscles, chronic pain and stress.

Heat therapy, when applied to problem areas, helps increase blood flow and circulation, soothes tired muscles, improve mobility and heals damaged tissue. 

How to safely prepare a heated gel pack

Warm gel packs, as the term suggests, should not be scalding hot. To avoid causing burns to skin, use a mercury thermometer to check and maintain a temperature of 100 degrees Fahrenheit for babies, 105 for children and 120 for adults. For eye compresses, the temperature should be adjusted to 105 degrees Fahrenheit.

Reusable gel packs are easy to use and made to withstand contrasting temperatures. You only need a few minutes to prepare a heated gel pack:

  1. Set the microwave oven at a medium or medium-high temperature to heat the gel pack.
  2. After about 30 seconds, remove the pack using mitts or cover your hand with a towel to avoid burning yourself. 
  3. Check the temperature of the gel pack. It should be warm enough not to burn your skin when resting on you for a few minutes.
  4. If it’s not warm enough, reheat in the microwave in 10-second increments. 
  5. Insert the pack in the sleeve and place the gel pack on the affected area for 10 to 20 minutes. 

You can use boiling water if you don’t have a microwave oven. To do this, bring water to boil, turn off the stove, and then place the gel pack in boiling water for five to 10 minutes. Be sure to dry off excess water from the gel pack to avoid burning yourself.

Whether you’re using a hot or cold gel pack, do not place it directly on your skin as it could cause burns.   

Things to considering when using heat therapy

The use of a hot compress for pain relief has its limitations. For instance, it should not be used on an open and infected wound, or a bruised and swollen injury. 

Individuals with sensory issues caused by diabetes, heart conditions and multiple sclerosis are also discouraged from using heat therapy. 

Which type of therapy is better for treating back pain?

Whether it’s from intense manual labour or long hours in an office chair, back pains spares no one. The debate on whether to treat back pain with either hot or cold gel pack therapy creates uncertainty for us.

Heat compression is preferred for soothing back pain. Muscle tension is usually the culprit for back pain, and cold compression might offer no relief, especially if the inflamed tissues lie underneath. In most, if not all, cases of back pain, heat therapy is more effective. The soothing warmth from heat therapy helps alleviate the muscle tension in our backs and improves our mobility.

A team of researchers in 2006 discovered that patients with lower back pain, who exercised and used continuous low-level heat wrap therapy (CLHT), felt less pain compared to those who did not undergo the treatment.


The Verdict

Knowing when to use warm or cold therapy depends on your condition. In general, ice gel packs work best for inflammation and swelling, while warm gel packs are best administered to muscle and joint-related problems.

Below are some of the most common conditions that cause pain and swelling, and the more effective therapy for each:       

    • Arthritis – Heat works best to relieve pain caused by worn down cartilage in joints because it eases stiff joints and relaxes tight muscles. 
    • Gout  Ice can calm chronic and inflammatory arthritis flare-ups, and its numbing effect easing the pain. 
    • Headache – Both cold and heat therapies can do the job. Ice can numb the throbbing head pain, while heat relaxes painful head spasms. 
    • Strains – Alternating between heat and cold therapy can do wonders for pulled muscles or injured tendons. Ice numbs pain, eases swelling, redness and tenderness. Heat reduces inflammation and eases stiffness. 
    • Sprains – Heat is better in reducing inflammation and stiffness. 
    • Tendinitis – Acute joint and tendon irritation can be treated by contrasting temperatures. Ice eases the swelling and numbs pain while heat reduces inflammation and eases stiffness.

Contrast therapy – alternating between hot and cold packs 

In most conditions, alternately using both hot and cold therapy produces the most ideal results. Doctors recommend applying a cold compress for the first two days following a recent injury, and a hot compress thereafter. 

Heat therapy allows blood vessels to expand, increasing oxygen flow and blood circulation. Cold therapy does the opposite. Together, the two therapies allow for a synergistic action that contributes to faster healing.  

For instance, arthritic patients may use hot/warm compress to ease joint stiffness and apply cold compress for pain and swelling. Other conditions such as fibromyalgia and neck pain can benefit from alternately using hot and cold compress.

How do you know if it’s time to switch from hot to cold and vice versa? Allow for your skin to return to normal body temperature, or allow any colouration in your skin to recede, before switching treatments.    

We hope this article has cleared up any confusion you may have when deciding which type of treatment you should use for your injuries. Whatever situation you find yourself in, having a resilient and reusable hot and cold gel pack on hand will have you prepared for any pain and injury treatment!  

We at are committed to help you with your pain and inflammation management issues. 

If you have further questions or concerns, or just want to share something, you may reach out to us via this page.  


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