In an interview with HT Lifestyle, Dr Praveen Tittal, director, orthopaedics at CK Birla Hospital, Gurugram shared when to use cold therapy and when to use heat to treat joint pain.
When to use heat therapy
Heat therapy (thermotherapy) dilates blood vessels to increase blood flow, providing tissues with oxygen and nutrients. It also relaxes constricted muscles and enhances joint movement.
1.
For stiff joints: Heat enhances blood flow, eases tight muscles, and enhances flexibility.
2.
For chronic pain: Is good for conditions such as osteoarthritis, where stiffness is a primary issue.
3.
Before exercise or stretching: Mild heat can warm muscles and joints up for activity.
Doctor's tip: Never apply heat immediately after an acute injury since it has the potential to increase swelling and inflammation. Apply a heating pad, warm cloth, or warm bath for 10-15 minutes. Make the temperature comfortable, not too hot to burn.
When to use ice therapy
Ice therapy (cryotherapy) contracts the blood vessels, decreases blood flow, and decreases inflammation. It also numbs painful tissues and retards nerve impulses, making it beneficial for acute pain.
1.
For new injuries: Ice works best within the initial 48 hours after injury such as a sprain, strain, or acute twist.
2.
For swelling and inflammation: Cold compresses minimize blood flow, thus limiting swelling and reducing inflammation.
3.
During flare-ups: Acute arthritis or gout/ rheumatoid flare-ups are eased by ice to soothe sudden pain.
Doctor's tip: Apply an ice pack in a thin towel for 10-15 minutes at a time. Do not apply directly to skin to avoid frostbite.
When to use both (alternating heat and ice)
- Post-exercise or rehabilitation: Ice is applied immediately after activity to reduce swelling, followed by heat subsequently to relax muscles.
- Chronic pain with intermittent swelling: Begin with ice to manage inflammation and then alternate to heat to relieve stiffness.
- Healing from specific surgeries or injuries: Alternating can accelerate healing, but only if a doctor authorises it.
