Every day, patients ask me “What’s better, heat or cold?”, to which I ask them “Which do you find feels better?”.  Almost every time their response correlated with the theoretical clinical choice.

Cold Therapy

Cold therapy increased vasoconstriction of the local blood vessels (decreased size of the blood vessels).  It decreases inflammation, edema, cellular metabolism and nutrition. Cold therapy also decreases muscle tone

Who would benefit from cold therapy? Cold therapy is best used in the acute phase of an injury.   This is when inflammation and edema are the greatest.

Heat Therapy

Heat therapy increases the local temperature of a tissue, which increased vasodilatation (increased size of blood vessels).  This is true only of more superficial structures in the body as deeper structures are insulated from this effect.  Heat also permits muscle relaxation, decreased sensitivity to nerve endings if the heat is mild, increased cell permeability and metabolism and possibly edema.

So who would benefit from these effects?  Patients who are passed the acute phase of injury.  In this stage of healing, tissue healing is promoted by increasing circulation and nutrients to the area.

These are not hard and fast rules to heat and cold therapy and your condition may not react in the same way.  For further information health care provider regarding heat or cold therapy for your specific condition.

Dr. Justin Arseneau, DC

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