New Research: Use Hot or Cold for Healing Injuries?

Our Awesome Acupuncturist
Our Awesome Acupuncturist at 70.

New research reveals some answers to the old question which remedy to apply when treating our injuries and ailments, heat or cold?

Massage therapists and other therapeutic bodyworkers don’t always agree. Even physicians, chiropractors, and acupuncturists don’t always agree.

Whitney Lowe, Licensed Massage Therapist, author, educator, and premier authority on pain and injury treatment with massage therapy, has just recently posted an article on this dilemma in the November edition of Massage Today, a popular monthly magazine published by MPA Media for massage therapists and other professional bodyworkers.

Often we as bodyworkers raise questions while attending Continuing Education courses and other professional meetings regarding the latest techniques and theories that can help in providing optimal patient/client care. The case for cold vs heat has always been a point for debate among massage therapists and the use of ice has recently come under scrutiny by a number of authors, according to Whitney. Yet in my discussions with various healthcare practitioners through the years, their answer to the heat vs ice query has overwhelmingly been ice. There you have it. But why?

As Whitney states in his publication, cold applications are most commonly used for the healing process of acute (24-48 hours) soft tissue injuries. Cold applications reduce inflammation and can help relieve pain. Our group of seasoned therapists have become comfortable with this treatment plan and see the benefits first-hand, however we and our patients, with regard to specific on-going injuries, have questioned at what point the use of heat might be a better option.

My thought, based on my training and my experiences over the past fifteen years, is that ice works well up to 48 hours, depending on the nature of the injury, of course. Then, the use of heat therapy or a combination of ice and heat has worked well for most.

I remember many years ago when my awesome Acupuncturist recommended to me that I apply heat for a week old TMJ problem. After applying heat I thought I was going to die!  I went back to ice to relieve the pain, but was that the best solution? Probably not.

Here’s why. The initial ice treatments (also called Cryotherapy) were appropriate and did help relieve my pain, along with OTC anti-inflammatory medication ( I am not a pill person…) but after the 24-48 hour cut-off, heat most likely would have helped the healing process by bringing blood flow to the tissues. Heat will not diminish pain like ice and heat is contra-indicated for many patient conditions and diseases, but in my case continuing with heat applications (even though it hurt during the application) would have been the best choice.

The Massage Magazine article states further: “New research indicates the standard guidelines for hot/cold therapy may need to be reconsidered.” In a nutshell, the article shares the argument that with the use of ice, blood flow is decreased and that vasoconstriction with cold applications is more pronounced in some regions of the body, such as the feet and hands. “The effect of reducing circulation is a physiological effect of ice that may not be desirable.” Other points worth considering are Whitney’s statements that “tissue healing is enhanced by chemical mediators carried through the blood stream and reducing their movement may interfere with the tissue healing response.” Additionally, he shares a valid concern that cold applications slow down lymphatic drainage and may have another detrimental effect on the tissue repair process as a result.

Makes perfect sense to me, I think…but I have heard through the grapevine that additional research is on the horizon.

Hot or cold for injuries may stay a dilemma in treating injuries but HEAT, is the ONLY treatment plan for cooking your Turkey. Happy Thanksgiving, everyone!