Should I use HOT or COLD?
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by Jeffrey S. Malka, M.D., F.A.C.S., F.A.A.O.S.
People so frequently misuse one or the other that I thought it would be helpful to explain what each does and when it is best to use one or the other and even situations when both may work.
Blood supply to the area:
Heat brings more blood to the area it is applied to. Cold reduces blood to the area it is applied to.
Think of frost bite. Frost bite occurs if the weather is so cold that the blood is so reduced that there no longer is enough blood going to the exposed area to keep it warm
and alive. That body part then dies and is said to be frost bitten.
Feeling
On a cold day, not only are your nose and lips cold but they are numb. That is because cold numbs the area and reduces feeling in it. This is very useful when an area of your body is in pain. Applying cold to that painful area will numb it and help with the pain, sometimes as well as many pain medications and without having to swallow drugs. However don't freeze the skin!
Muscle spasm
Heat reduces muscle spasm and therefore is useful in situations where muscles are tight such as a stiff neck or back.
Specific conditions
Muscle ache after exercise
During excessive exercise beyond what one is accustomed to comfortably do, muscles can get sore. All athletes are familiar with this type of muscle ache. When a muscle works chemicals side products are produced that need to be eliminated. These chemicals need blood to be eliminated and cause pain till then. If the exercise is very intense, there may not be enough blood flow to eliminate all the chemicals during the exercise. It is these accumulated chemicals that cause this type of muscle ache. Over the next few hours these chemicals are gradually eliminated through the blood and the muscles are no longer sore.
Since it is blood supply that helps eliminate the chemicals that cause the pain, it makes sense to use heat to help sore muscles after exercise. Add to that the effect heat has in relaxing tight muscles and a hot bath (or any form of heat) makes great sense here. In fact it is from this use of heat that heat became so popular.
Injury
When an injury occurs, tissues are damaged and bleeding occurs. Here, heat would increase blood flow and increase the bleeding. Not the thing to do!
Instead cold will reduce blood flow to the area and therefore reduce bleeding which is good. Also as you recall, cold numbs the area it is applied to which in the case of an injury is an added benefit.
Inflammation
Inflammation (tendonitis, bursitis, etc.) means that more blood is going to an area as a reaction to some problem there. That is why an inflamed area of skin is red and painful. Applying heat to an inflamed area will send more blood to the area making it even more inflamed. Cold on the other hand will reduce the blood and numb the pain. So, in case of inflammation, cold is the way to go.
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