When to use HEAT and COLD

Patients always seem to be confused when to use HEAT and COLD. The following should help you understand when to use either:

HEAT is used to help loosen up muscles and ligaments and increase blood flow to an injured area. For backs it is good to perform the exercises following the use of heat – hot shower, hot water bottle with a moist towel between you and it. Heat for 15 minutes and then do stretching exercises. Do not use heat for more than 20 minutes at a time. Do not use heat if there is pain radiation into either leg especially if the pain goes past the knee – read on to know why.

COLD is used to reduce swelling. For backs with radiating pain into the leg (e.g., sciatica), usually due to a nerve root which has been squeezed and is swollen. Icing for 20-30 minutes especially in the evening once or twice will help to reduce the swelling of the nerve roots causing the radiating pain. You can make an ice pack by using two veggie bags and a thick washcloth. Dampen and then fold the washcloth into an 1/8th and slip it into the 1st plastic bag, squeeze the air out and tie it off. Slip this into the 2nd bag and do the same. Make two and place flat into the freezer. These can be placed right over the area and the time it takes to thaw is the time needed to work.

When in doubt ICE!