When to use Cold or Hot fomentation?

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Almost all of us resort to using home remedies or self-medicate, in whatever way possible, for minor injuries or health problems. One of the most common self-help technique used at home is Ice pack or Hot water bottle or Heating pads.

People often wonder when to use Ice or Heat because they don’t know the rationale behind this application. If either of them is used when it is not supposed to be then it might worsen the situation. It is important to understand the principle behind the usage of Ice or Heat to be able to choose :

  • When to use Ice?
  • When to use Heat?
  • When you can use both?
  • What should be the duration and time gap between usage?

What does Ice do?

Ice constricts the blood vessels and hence the blood flow is reduced

What does heating do?

Heating dilates the blood vessels and hence the blood flow is increased

When to use Ice / Cold Therapy?

As the use of ice reduces the blood flow, it should be used in the first stage of an injury for the first 72 hours. When you are injured, there is inflammation, redness and swelling. More blood starts flowing towards the injured spot. There could be internal bleeding as well. If you apply heat at that time, the situation will get worse. In this situation, you need to use ice to reduce the blood flow, stop bleeding and reduce swelling. This applies to internal injuries also when the wound is not visible.

Even in case of a sharp pain/nerve pain in the lower back or any other area, it is better to use ice instead of heat, however, consult a doctor first in case of sharp pain.

Duration and Time gap to use Ice therapy

Ice can be used for upto 15-20 minutes and 3 to 4 times a day for the initial 72 hours after the Injury. 2 hours gap between the application is desirable.

As you start applying Ice, you might feel some burning sensation after a few minutes followed by numbness. This can be considered normal.

Don’t apply ice directly on the skin, use a thin cloth or towel instead. Ice must not be applied over the open wounds.

When to use Heat Therapy?

As heating dilates the blood vessels, it has a softening effect on the muscles, makes them more pliable and flexible. Therefore heat can be used for more chronic issues like chronic muscle stiffness, pain due to tiredness, muscle fatigue etc.

Heating can also be used as a follow-up action after the application of ice on the injury, once the inflammation and pain are reduced. Sometimes it might take a very long time for the inflammation to reduce, much more than 3-4 days. You should wait until then to apply heat. Normally you should look for signs like reduction in swelling, redness and pain to ensure reduction of inflammation. No need to rush into applying heat.

Some examples where heating can be used :

  • Tired upper back after working in Kitchen
  • Tired Lower back after driving
  • Muscles pain / fatigue after trekking (especially in calves, upper thighs)
  • Chronic fatigue in Cervical spine (Neck) due to excessive laptop usage / reading / writing
  • Fatigue due to playing musical instruments like Guitar, table, piano etc
  • Abdominal pain during periods

Types of heating: Heating can be in the form of a Hot water shower, sauna bath, dipping legs in hot water tub with rock salt, lying in warm water tub, wrapping hot towel or Ultrasonic therapy.

Duration and Time gap to use heat therapy

Heating can be used for 15 to 30 minutes, 2-3 times a day. Applying heat can be very relaxing and you might fall asleep. Always use a timer alarm to rule out any chances of falling asleep.

When to apply both Ice & Heat?

As mentioned above, Ice has to be used upto 72hrs after an injury. After you are sure that acute inflammation has reduced, you may switch to a combination of heat and Ice. You have to start with heating first as it will dilate the blood vessels and Ice will constrict it. 10mins of heating followed by 5-7 mins of Ice can help in stabilising the blood flow, increases the flow of fresh blood and expedite the healing process.

Caution: Heating or Ice should not be applied on open wounds, if you have diabetes, DVT, sclerosis or if you are prone to have frostbite. It is advisable to have expert advice rather than self-medicate

Disclaimer: This article does not encourage skipping a visit to your doctor or an expert when you have a situation that needs medical attention

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