Treating pain in the home

Almost everyone knows to use ice packs right after an injury to prevent swelling, but time and time again I see patients in my office who are unsure whether to use heat, cold, both heat and cold or neither. I’ll set it straight for you now so that when you find yourself injured or in pain, you know which option is most beneficial to you. At your fingertips are very helpful modalities to treat your injuries, aches and pains.

Acute injuries—those that occurred within a few minutes, days or even a few months—respond best with cryotherapy, which is the application of cold, to minimize swelling.

Cold is a natural anti-inflammatory. It causes your blood vessels to constrict, thereby shunting the extra fluid away to reduce swelling from the area. It also serves as an analgesic to numb the area as well as an aid to decrease muscle- guarding spasms so you feel less pain. So if you have a recent injury with throbbing pain, it is your body’s way of asking for ice!

You can buy gel ice packs that contour and conform to your body, or you can simply put ice in a plastic bag or even use your frozen veggies (there’s a good way to defrost your dinner!). Another option is an ‘ice-massage.’ 

To do this, fill a small paper cup 2/3 full of water, freeze it and when you need it, remove from freezer.  Tear off the top of the cup to expose the ice and you have a handle to grasp at the base of the cup. Begin massaging the ice on a localized area of pain. It will be uncomfortable; you will feel ice cold, burning, then numb within 3-5 minutes. This is a quick and effective method of cold application. In general, if you take anti-inflammatory medication and it relieves your pain, then cold will most likely help you (without any systemic side effects).

Chronic injuries—those that have occurred several months ago—may respond better to heat. The localized swelling is usually gone by now, yet pain and the secondary pain and muscle restrictions remain. Applying heat to the painful area dilates your blood vessels, bringing more oxygen-rich blood to the area to help promote healing. Heat also helps to relax tight muscles, alleviate spasm, increase range of motion, and ease pain and stiffness.

We all know how soothing a warm shower or bath is (whether you’re injured or not!) There are gel, sand or bead hot packs you can purchase that can be warmed in the microwave, or you can simply get into a warm bath or shower. Electric heat is also suitable, but moist heat tends to be more comfortable.

Sometimes the use of both heat and cold in cycles is best to promote circulation. For example, use heat 4 minutes, then ice 1 minute and continue this way for several cycles up to 30 minutes, ending with heat to act as a local fluid pump. Or as commonly done in my office, use heat before exercise to help loosen the muscles and to bring blood flow to the area; then use a cold pack after exercise to help calm any inflammation that may have been brought on by the activity.

In other instances, neither cold nor heat is beneficial. It is always best to respond to your body. If the use of either modality increases your baseline pain levels, then avoid it. If you have any underlying vascular problems (i.e. poor circulation/hypertension/ recent hemorrhage), specific temperature hypersensitivity conditions, neural dysfunction (i.e. poor sensation), malignancy, or infection you should check with a professional before using either modality.

Always be careful to apply heat or cold for only 10-30 minutes and to use protective layers (i.e. a towel or sheet) to avoid frost bite or burns. When using cold or heat (especially on children), make sure to check the skin every few minutes to make sure the temperatures are not too extreme.

The best part about the use of cold and heat for pain management is that it costs nearly nothing and it is readily available in our homes.


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