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


The Osteoarthritis Society of Canada predicts that within the next generation one person will be diagnosed with osteoarthritis (OA) every 60 seconds. OA is a painful condition caused by a gradual loss of cartilage and inflammation in the joint. There are over 100 types of arthritis and OA is the most common. 1 in 10 Canadians are affected by OA. It is the leading cause of pain and disability worldwide. It affects predominantly the knees, hips, hands and spine and common symptoms include pain and stiffness in these joints. The prevalence of OA increases with age, and factors such as lifestyle, work and family history can contribute to this condition. What can you expect to determine a diagnosis of osteoarthritis? OA requires a combination of patient history, discussion of symptoms, manual examination and diagnostic imaging. The combination of imaging and a diagnostic examination leads to a better understanding of the patients symptoms. Based on the examination findings and your symptoms, your chiropractor will work with you to determine an appropriate course of treatment. How can we treat OA? Because OA is a multifactoral condition, a combination of treatments modalities and techniques is generally required to adequately treat it that is tailored to the patients specific condition. It is important to work with your healthcare provider to create an effective and acceptable long-term plan for managing with arthritis. Exercise has been proven to be beneficial and leads to an increase in quality of life of OA patients. This includes specific aquatic, stretching, aerobic and resistance exercises that are beneficial and effective for this condition. Spinal adjustments (SMT) have also been shown to be beneficial. Patients who undergo SMT report positive results, including pain relief and increased function. Acupuncture has also been show to be beneficial in controlling the symptoms of OA. Education and support is a major component of arthritis treatment. By learning more about arthritis you can better participate in your own care. It is important to discuss OA treatment options, the effects of OA on daily activities, and the strategies for coping with limitations imposed by OA with your chiropractor. Other treatments that are effective include weight loss, orthoses, certain assistive devices, heat and cold therapies and TENS treatment. There are many treatment options for OA patients and a customized balance of treatment options is generally required for maximum benefit. Patient commitment is a crucial component to establish an effective treatment plan. A working relationship between your chiropractor and other health care providers is also beneficial. Your healthcare provider is the best source of information for questions and concerns related to OA. Dr. Justin Arseneau, DC