Hot and cold therapy for pain relief is possible due to extremely different mechanisms, which are important to understand so you know when to use the right treatment. You sprained your ankle jogging, have a migraine, or are bothered by a carpal tunnel injury. Which respond to heat therapy—and which to cold therapy? For a muscle sprain injury, it is important to ice the affected area immediately after the sprain occurred as this will reduce swelling. However, applying heat is beneficial beginning 24-48 hours following a sprain in order to decrease stiffness. Meanwhile, a cold compress is best for most headache occurrences or to relieve wrist ache due to carpal tunnel syndrome.
According to the National Institute of Arthritis and Musculoskeletal Diseases of the National Institutes of Health, a sprain that has just occurred should be treated with an ice pack for 20 minutes at a time at intervals of four to eight times daily. Because The Core Products Vinyl Cold Corpack offers up to 30 minutes of cold therapy (and it can be stored in a freezer), it is an excellent product to include in your emergency first aid stock at home or in the workplace. Meanwhile the Core Products Breathable Hot and Cold Wrap (with hook and loop closure straps) comes with a double layer pocket that provides more temperature protection for sensitive skin.
Heat increases blood flow to the area upon which it is applied, reduces muscle spasms, and aids in resolving inflammation—while cold provides pain relief by numbing, reducing swelling and reducing bleeding (per the University of Chicago Medical Center’s website).
The New York Times reported on July 23, 2013 in an article entitled, “After a Sprain, Don’t Just Walk it Off” that an estimated 28,000 ankle injuries occur daily in the United States. Most of these occur during sporting and fitness activities, but high heels are also a risk factor. The World Health Organization reported that an estimated 47 percent of the global population suffered a headache at least once in the past year—and migraines accounted for 1.3 percent of productive years lost due to disability. Meanwhile, carpal tunnel syndrome affects between 2.7 to 5.8 percent of the population in the U.S. (according to a report by Kim Edward et al in American Family Physician).
In sprains, there is often bleeding beneath the skin (epidermis) due to the rupture of underlying blood vessels. This is what causes the bruising that appears on the skin surface. The application of cold for pain relief will usually halt this bleeding. As the bruised area heals, the discoloration usually changes from purple or black to a yellowish hue. During the healing process, the sprained area can become stiff due to immobility. The application of heat can reduce muscle stiffness so that the affected part can be exercised without pain to increase flexibility.
For individuals who spend a high proportion of their work-day at a computer keyboard or in construction tasks, the repetitive motion can lead to carpal tunnel syndrome—pressure on the median nerve passing through the wrist. Typically, a wrist brace is worn by sufferers to reduce further injury. The swelling that occurs can be relieved by the application of a cold compress for pain relief such as the Core Product Reflex Wrist with Dual Comfort Pack. Its open palm design includes an adjustable thumb strap, and it also has a “frost-free” surface to protect the skin.
The treatment of migraines—and whether to apply cold or heat—is more controversial than that for sprains and carpal tunnel syndrome. Unlike other types of headaches (i.e., tension-related or due to a head cold), migraine headaches occur due to the activation of a mechanism deep in the brain. This leads to the release of pain-producing inflammatory substances around the nerves and blood vessels. While some blood vessels constrict, others dilate—causing the throbbing pain typically experienced by afflicted individuals. The application of cold numbs the area, while heat increases blood flow. Therefore, some people with migraines prefer the application of heat to cold for headache pain relief.
Besides the application of hot or cold compresses to the head, pharmaceutical agents are often used. For mild migraines, aspirin or nonsteroidal anti-inflammatory drugs (e.g., ibuprofen) are frequently prescribed. In other cases, Triptans may be prescribed; these constrict blood vessels and block neural pain pathways. Glucocorticoids (e.g., Prednisone) are sometimes prescribed for pain relief, but can cause mental status changes in some people.
Hot and cold pain relief occurs due to extremely different mechanisms. Alternating heat with cold can also be helpful if applied properly, and using the appropriate method is crucial to speeding up the process of healing.