Hardly a day goes by that someone doesn’t ask me this simple question- Do I apply heat to my injury, or do I apply cold? The answer depends on who you ask. Chiropractors, many physicians and physical therapists for the most part prefer cold. Massotherapists and other natural healers feel heat is the best therapy. So who’s right?


Hot and cold therapy is one of the oldest and most valuable of therapies available and should not be overlooked as part of treatment for injury or ailment. The basics of anatomy and physiology shed light on why and how each work and when to use them. Cold forces blood circulation away from the skin and into deeper organs and tissues including injured joints and muscles bringing much needed nutrients for healing, relief from swelling, inflammation and pain. Opponents of cold therapy say you only numb the nerves temporarily and may starve the tissue of much needed circulation, and cause pain to return in a rebound effect to say nothing of the tight muscles and joints caused by too much cold.


Heat on the other hand allows for relaxation of the muscles and joints, relieves pain without rebound effects, helps the body shed toxins such as lactic acid through the skin and brings much needed circulation to the effected areas.


There is only one hard fast rule about hot versus cold and to when to apply it. The first 48 hours following a burse, break or any kind of blunt injury the application should be cold after which you may try heat. Cold is a very effective tool for managing pain, easily as strong prescription pain medication. 


For a sore back, stiff neck, and or otherwise cranky muscles and joints I tell my clients to use what feels good. Given that, I have found that for most of my clients if the complaint turns out to be one of neurological disorder such as a slipped or bulging disc, sciatic pain, diabetic involvement in the feet with numbness and tingling heat does not help nor does it feel good but cold does. If the complaint is one that arises from sore over used healthy muscles and tendons or involvement with arthritis or fibromyalgia cold is almost painful and heat works.


My advice, listen to your body and it will tell you which to use and when. There are some cautions to be aware of with both, with heat that’s obvious. Cold can be just as damaging numbing to the point that pain signals are ignored and further damage occurs without medical treatment. If you can’t decide which to use try both alternating from hot to cold every fifteen minutes. Till next time, Rebecca