Home Care for Injuries: Apply Heat or Cold?

One of the most common questions patients ask regarding home care for injuries is whether to apply heat or cold. Hot and cold affect body tissues in different ways. They both affect circulation, muscle, and nerves. Let's look at what each does to your body to help you understand which may be better.

The application of HEAT causes:

• Circulation to increase in the area
• Muscles to soften in the area
• Sedates the nerves associated with the area

The application of COLD causes:

• Circulation to decrease in the area
• Muscles to fatigue then relax in the area
• Numbs the nerves associated with the area

To understand which is better for a particular injury, you need to keep in mind the age of the injury and the degree of inflammation of the tissues. Injuries are viewed as new or acute or old or chronic.

Acute or New Injuries

When you have a sprain or a strain, the first week to ten days are considered the acute stage. In this time, the body will suffer from inflammation, which causes a swelling in the damaged tissues. In fact, much of the pain a person feels is from the stretching of the tissues due to the swelling.

Swelling means that too much fluid (blood) is going to the injured tissues. If you apply heat, the injury will get worse because you are increasing the circulation to the injured area and therefore, the amount of fluid in the area. If you apply cold to the new injury, you will reduce the amount of blood flow thereby reducing the pain and swelling.

Chronic or Old Injuries

Nagging shoulders, aching backs and stiff necks that have been problems for weeks or months do better with the application of heat. In chronic problems, the pain is usually caused by spasms in the muscles and over-sensitivity of the nerves. Applying heat increases the circulation allowing a healing blood flow, softens the muscle spasm and sedates the over sensitive nerves.

Rules to using Hot and Cold

• When in doubt use cold. Cold rarely makes problems worse. Heat can make big problems out of small ones!
• Always wrap the cold pack (bag of ice, frozen peas, flexible cold pack) or the hot pack (heating pad, hot water bottle, flexible hot pack) in a cloth to protect your skin.
• Always apply hot or cold for 20-30 minutes, no more than three to four times per day.
• Never sleep on a heating pad.
• If chronic injuries are not improving, or a new injury is not improving in three or four days, make an appointment to get the injury evaluated.

If a sprain or strain is not significantly better within one week, then there is probably a misalignment of the joints preventing proper healing. The sooner an injury is treated the faster it heals.

Chiropractic care takes time because the tissues that are healing are bone, ligament, and nerves. While nerve tissue heals very quickly, bone and ligament are the densest and slowest-healing tissues in the body. In order for the subluxation to heal properly, first the bone must be in its correct position, and then the ligaments that support the vertebrae must heal. This process will vary depending on the history and age of the problem, compliance to the treatment plan,

the degree of spinal degeneration, and the attitude and responsibility of the patient.