HOT AND COLD
One of the most common questions I get asked almost every day as an Osteopath is if its a good idea to put something hot or something cold on a painful area. This is not such an easy question to answer. Applying heat or cold to a sick patient is probably one of the oldest treatments known to mankind. For centuries people have used volcanic pools, Bath houses, Saunas, cold showers and Ice packs to make achy muscles feel better and to take away pain.
Pain in muscles can often come from over exercise or stress. A good long soak in a warm bath can help muscles to relax and soften which feels very nice. In general, sore and tight muscles at the end of a hard day, from driving, or using a computer will relax in warm water or the application of a hot water bottle.
However heat can make some conditions worse. When an area of the body becomes damaged, blood floods the tissues to provide oxygen and nutrients that allow it to repair. This is called inflammation. The affected area becomes warm, swollen and painful. In this case the treatment is to apply cold which reduces the inflammation. Ice packs act as a natural anti inflammatory. The cold causes blood vessels to narrow which removes the swelling. The cold also causes nerves to become less sensitive and acts as a painkiller.
Any time a joint is injured just remember RICE. This stands for Rest, Ice, Compression and Elevation. For example if you strain your ankle or knee you should take the weight off it, apply an ice pack for about 10 minutes at a time, put your leg up and wear a compressive bandage. This is a good example of where heat will actually make the problem worse because it increases the inflammation. For sharp low back pain the same is also true. Lie down, apply ice and wear a back support. Even if the Ice is not effective it will not make the problem worse.
Cold compress will also help tendon problems like Tennis elbow and Achilles tendinitis but these types of tendon conditions can take some weeks to improve even with therapy.
A mosquito bite can be quickly cured by applying heat from the back of a hot spoon (from hot water) onto the bite. This kills the proteins that make it itch. A bee sting or wasp sting on the other hand requires a cold compress to reduce the pain and inflammation.
Finally remember that everything in excess can be harmful. A hot pack should not be filled with boiling water. If its too hot for you to drink, its too hot to apply to your body. Similarly cold packs should be applied for 10 minutes 2 or 3 times an hour and always with a cloth on you to prevent damage to your skin.
