Pain Relief: When to Apply Hot or Cold?

Often when people are sore, injured or just plain stiff, they wonder what is the best remedy to apply: heat or ice? Get the scoop on one of my most frequently asked questions: “Should I apply a hot or cold?”

For millennia, people have instinctively been drawn to water, lakes and beaches to soothe the body and mind, and to relax. Hydrotherapy, as it is known, is using the healing nature of water, for therapy.

When to Apply Heat?

Modern comforts afford us opportunities of having hot showers or baths after a long day, reminiscent of using natural hot springs in our ancient past.

Hot packs and hydrotherapy such as warm showers, baths or hot springs are wonderful ways to reduce tension and stiffness in muscles, as well as purge the body of toxins through sweat glands and sinuses.

When to Apply Cold?

An interesting tradition in many northern cultures is to have the “Polar Bear Dip” whereby participants plunge themselves into frigid outdoor water on New Year’s Day. Cold hydrotherapy is not only stimulating to your body, but also acts as a natural pain reliever.

Cold Can Take the Pain Away

We have almost ten times the nerve receptors for cold stimuli as we do for hot in our body, and these cold-sensitive nerve receptors can override pain signals when they are stimulated.

If one part of your body feels warm to the touch in comparison to the corresponding opposite side, take measures to cool it down, achieving harmony.

So next time you knock your shin on the coffee table or your find forearm is sore from using the computer all day, check to see if the area is warm. If it is, this probably indicates inflammation, so apply a cold or ice pack to it.

What Are the Best Tools for the Job?

These applications are for small (local) areas of your body.

Hot Applications

• I recommend using a hot water bottle, or a “magic bag” warmed in the oven or microwave, both wrapped in a towel for insulation (to avoid burns). Leave the heat on for 10-15 minutes.
• If the heat isn’t getting through, remove the insulating towel.
• If it is too hot, then insulate with another towel.

Cold Applications

• I recommend ice cubes packed in a zip lock bag; the more, the better. Wet and wring out a facecloth (moisture transfers cold better), and place it over the inflamed area. Place the ice on the damp cloth and cover with a towel for insulation.
• You should aim to feel a progression of sensations to get the maximum effect. You may feel CBAN: Cold –> Burning –> Aching –> Numb
• It will always start with a cold feeling, but may skip one of the others. As soon as you feel the tissue being numb, though, take the cold off. You don’t need to develop frostbite on top of your tennis elbow!

Apply Treatments in Sets of Three

For any local application, you should do a series of three applications in a row; with 20 minutes break in between:

1. Apply Hot or Cold
2. 20 minute break
3. Apply Hot or Cold
4. 20 minute break
5. Apply Hot or Cold