Heat Therapy: When & when not to use it.

Heat therapy, it’s so commonly used in the self management of pain. But are you using it for the right thing? And do you know when NOT to use it?

The application of heat has many effects including:

  • Improved elasticity of soft tissue
  • Increased blood flow
  • Increase local metabolic and enzymatic activity leading to increased white blood cells and decreased metabolic waste.
  • Subjective relaxation
  • Mild pain reduction

Negative effects of heat therapy include:

  • Increases in local oedema (swelling)
  • Increased local inflammation
  • Increase localised bleeding

When not to use heat therapy:

  • Acute injuries
  • In those with haemorrhage or bleeding disorders
  • In those with poor thermal regulation
  • In those with peripheral vascular disease – In those with lack of awareness of pain or sensory loss (eg. Diabetic neuropathy)

There are varying opinions and research on the effectiveness of heat therapy, the general rule is that you should never use one therapy on its own; use with exercise, manual therapy and/or in conjunction with cold therapy to achieve greatest benefits.

Personally I suggest using heat for:

  • Chronic pain (pain > 12 weeks)
  • Muscular spasms or contractions
  • In conjunction with ice/cold to treat muscular strains or ligamentous injuries
  • To promote relaxation

Scholten, P., Stanos, S. P., Rivers, W. E., Prather, H., & Press, J. (2018). Physical Medicine and Rehabilitation Approaches to Pain Management. In Essentials of Pain Medicine (Fourth Edition) (pp. 531-538).

Self management not getting you the results you need?

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Angus Gould Osteopathy

103 Goods Station Road

Tunbridge Wells


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