Treating pain, should you use heat or cold?

Back when I used to work in an acupuncture clinic in Japan I saw many patients who believed all pains would be relieved if they warmed up the area only to find out that their pain got even worse. The truth is that it is very important to distinguish how you got your pain or injury and that way determine if it’s better to warm up the area or to cool it down. If not, you could cause yourself even more damage.

Cooling down (Cold therapy)

Cooling down is used on sudden injuries and it’s also used on inflammations. Cold treatment help reduce the inflammation that usually occurs after injuries.
Some examples of sudden injuries would be, sprained ankles, pulled muscles, strained back, etc. You can know that it’s a sudden injury because you will experience sudden sharp pain immediately after the injury occurs.
You could be doing some sport and suddenly fell and twisted your ankle, or lifting a heavy object and suddenly felt a sharp pain on your back, running without stretching first and suddenly felt a sharp pain on your leg muscles. 
Usually these types of sudden injuries will lead to inflammation of the area, you can tell if there is inflammation because the area might feel warm and tender to the touch, look swollen and red, and also you will feel acute pain in the area. 
When there is inflammation, the worst thing you can do is warm up the area because it’s like putting coal to the fire, the swelling will get worse. That is why in these cases is best to cool down. Use ice or cold packs, a bag of frozen veggies to cool down the area for about 10-15 minutes, and do it daily for at least 3 days or until you notice the swelling has gone down. 
When you suddenly injure yourself its always best to see a doctor first to get properly checked, however, in such case that you cannot see a doctor for some reason then the next best thing to do is RICE (Rest, Ice, Compress, Elevate).
Rest: Do not put weight and effort on the injured area.
Ice: use ice or cool compresses to cool off the area for 10-15 minutes 3 or more times a day for at least 3 days or until the swelling is reduced.
Compress: Use bandages to wrap the injured area in order to decrease swelling.
Elevate: Swelling and inflammation are caused by too much blood accumulating in the injured area, so try to elevate above heart level in order to reduce some of the blood flow.
If after 3 days of doing this you see no improvement in the area at all you should definitely see a doctor.

Heating Up (Heat therapy)

Heating a sore area helps to increase blood flow and relax muscles in the area, therefore, is used on chronic pains, period pains, and even on injuries but only after the swelling has gone down.
You can use heat therapy on pains that are chronic such as arthritis pain, stiff neck and shoulders, chronic back pains, tension type headaches or you can even use heat to relax muscles before doing exercise.
You can easily do heat therapy on yourself by applying a hot towel, heat pack or a hot water bottle wherever you feel pain. Hot showers and hot spas are also really effective. 
I think heat therapy is more effective when I combine it with stretches, exercise massage and acupuncture. 


Multilingual acupuncturist travelling the world