Cold therapy or Cryotherapy is the application of cold to tissues to achieve the result of vasoconstriction and decreased blood flow, and slowing of nerve conduction to an area. By decreasing the flow of blood to an area, the inflammatory response of an injury or irritation is decreased.
Although inflammation is a necessary part of the healing process, excessive inflammation puts pressure on the surrounding tissues which causes pain. So decreasing the inflammation, relieves the pain we experience. As well, when there is pressure on tissues from swelling and inflammation, it is more difficult for oxygen and good nutrition to get to the injured area, so healing is slowed.
By controlling the inflammation, the healing process is promoted and pain decreased. We all know the numbing effect of ice. This gives almost immediate pain relief in a hot, swollen, injured area. But, did you know that the slowing of nerve conduction which occurs with cold application helps to continue this decrease in pain sensation after the ice is no longer present?
Acute or very irritable injuries generally respond well to all aspects of the acronym R.I.C.E.: rest, ice, compression and elevation.
This form of treatment is very helpful in controlling inflammation and promoting the early stages of healing. This is usually the best course of action immediately following an injury and up to 72 hours after. Gentle movement and gradual resumption of activity can happen as the pain and swelling decrease. But, if you irritate the area again and the pain and swelling increase, continue to use cold therapy.
In physiotherapy and massage therapy, we use cold often after treatment as the tissues have been somewhat irritated by new exercises or by manual therapy. Cold helps to control the inflammatory process and keep the healing moving forward.
Remember, with any injury, if using the above method does not decrease your pain and inflammation, you should seek the medical advice of your physiotherapist or doctor as it could be something more serious.
Heat therapy or Thermotherapy is the application of heat to tissues to cause vasodilation of blood vessels to increase circulation and the extensibility of collagen fibers.
Increased circulation of blood brings oxygen and nutrients to an area and helps to flush out toxins. It also helps to decrease stiffness in joints and muscles which tends to make people feel more comfortable – decreasing pain for the short term.
If muscle soreness from a new or overdone activity is the main issue, heat can be helpful, especially in the form of a soak or sauna to release the toxic byproducts of exercise that can remain in the muscles.
Moist heat is often used in physiotherapy and massage therapy treatment near the beginning of treatment. It allows improved relaxation, and manual therapy is more comfortable and effective. Heat is produced actively during exercise, increasing blood flow. So it is used in treatment in the same way – at the beginning to increase circulation and elasticity of the tissues.
Mechanical heat, such as through Ultra Sound modalities, is very effective in specifically heating and breakdown of scar while allowing increased circulation and elasticity to an area, promoting healing. It is also very soothing.
Which to use when?
Although many people find heat more comfortable than cold, we advise patients that if you are not sure
which to use, try ice. It will generally help with any pain and inflammatory situation and not cause any harm. 10-20 minutes is enough depending on the
Heat, on the other hand, increases circulation so it can increase inflammation and cause more harm.
When applying either, check your skin regularly to ensure it is not freezing or burning. If you do not get improvement, seek professional help.