14th Jun 2016

Posted by Sara Zuboff on

Hot Therapy vs. Cold Therapy Infographic



Heat and cold therapy are two of the most popular therapeutic modalities in rehabilitation and with good reason. Both can be applied in many different ways across a diverse population of injuries and chronic problems. The differences in temperature makes these modalities effective and appropriate for rehabilitation for distinct reasons. Our intention is to explore the uses of both heat and cold therapy in rehabilitation.

Heat and Cold therapy have long been utilized not only by patients for home-use, but rehabilitative practitioners: such as doctors, chiropractors, physical therapists, occupational therapists and alternative medicine practitioners. From the moment of injury to the cessation of a rehabilitation program, heat and cold therapy have a useful place in most therapeutic plans, depending on the desired outcome of treatment.

Further, heat and cold therapy can be considered for longtime use in pain management for chronic conditions. Minimal side effects and lowering the need for oral pain medication make heat and cold therapy a good addition to treating chronic conditions both in a clinic or at home for patient use.

Hot Therapy vs. Cold Therapy Infographic

What is Heat Therapy?

Heat therapy, sometimes called thermotherapy, is the use of heat in the form of hot packsultrasound, heating pad, etc. in order to reduce pain, decrease stiffness and increase range of motion.

How Heat Therapy Works:

Heat when applied to an injured area creates higher tissue temperatures. This produces the effect of vasodilation (widening of blood vessels) which increases the supply of oxygen and nutrients at the injured site and helps the elimination of carbon dioxide and metabolic waste

Heat is most often used after the swelling of an acute injury has decreased or during triggered pain cycles of chronic conditions such as arthritis or fibromyalgia. In rehabilitation, heat can also be used before therapeutic exercise in order to loosen tight tissues and relax the injured area. The same can be said for those who wish to loosen muscles before participating in exercise or physical activity. Heat is effective in releasing stiff muscles 20 minutes before physical activity.

The Use of Heat in Rehabilitation

Heat is effective in treating soft tissue injuries in addition to chronic pain injuries. Some of the issues heat is used to address in physical therapy are:

  • Sprains & Strains
  • Carpal Tunnel
  • Arthritis
  • Fibromyalgia
  • Multiple Sclerosis

  • There are many different ways to apply heat in rehabilitation. Some of the most common tools to deliver heat therapy are:
    • Hot packs: Hot packs used in physical therapy come in different shapes and sizes to address issues in most parts of the body. Reusable, these hot packs deliver moist heat that is able to penetrate deep in the muscles to reduce pain and muscle tension.
    • Paraffin Wax: Paraffin heat therapy is commonly used on the hands, arms, feet and ankles soothing the pain associated with arthritis, carpal tunnel and sports injuries.
    • Therapeutic Whirlpools: Whirlpool therapy has the option to deliver both heat and cold therapy and can be used in both therapeutic and sports training settings.
    • Ultrasound Therapy Machines: Therapeutic ultrasound is used in physical therapy create a deep heat effect for pain relief, decreasing muscle spasms and increasing muscle relaxation. Ultrasound is beneficial in treating soft tissue injuries and chronic inflammation problems like bursitis.

    What is Cold Therapy?

    Cold therapy is applied to injured or acute pain areas in order to immediately reduce pain and inflammation. Ice is the most effective modality within the first 48 hours after an injury, such as ankle sprain, in order to lower swelling and pain. Ice is an important element of first aid: Rest-Ice-Compression-Elevation.

    How Cold Therapy Works

    Cold therapy works by immediately slowing down blood flow to the site of the injury which immediately reduces pain and lowers swelling in the area. This slowing of the circulation not only reduces inflammation and pain but can also lower the incidence of muscle spasms.

    Cold therapy is most often used with acute pain or immediately after an injury. In rehabilitation, ice can be used immediately after therapeutic exercise in order to reduce any pain or swelling that may be caused by using the injured muscles and tissues. Ice can also be combined with other modalities, such as compression, in order to effectively reduce pain and inflammation more efficiently.

    The Use of Cold Therapy in Rehabilitation

    Cold therapy is ideal to use with acute injuries, but also with chronic problems that cause acute pain. Some of the physical injuries and ailments cold therapy is effective in helping are:

  • Sprains, Strains & Fractures
  • Bursitis
  • Carpal Tunnel
  • Arthritis
  • Fibromyalgia
  • Some of the most common ways to apply ice therapy in physical therapy are:

    Ice Packs: Ice packs are designed to deliver cold therapy to specific areas of the body. Ice therapy wraps are held in place by two straps and are able to deliver cold therapy deeper into the tissues and last longer than typical ice gel or ice packs.

    • Cold Compression Devices: Similar to ice therapy wraps, the wraps used in cold compression therapy are designed to be held in place and can address all areas of the body. Cold compression devices are extremely effective in immediate pain and inflammation relief, because they deliver compression in addition to cold therapy to the injured area.
    • Whirlpool Therapy: When used with cool or cold water, whirlpool therapy is beneficial for treating athletic injuries due to its analgesic and antispasmodic effects. Further, contrast therapy is also effective, because the vasodilation and vasoconstriction caused by the heat and cold creates a pumping action that greatly reduces swelling.
    • Cold Laser: Cold Laser Therapy can be used in diverse rehabilitative settings because it’s been proven to increase cellular energy. This effect accelerates self-healing and reduces the amount of down time a patient might experience because of an injury.

    Every year, 9 million Americans use physical therapy services to treat chronic injuries and conditions. In physical therapy, the immediate goals are to decrease pain and increase function. In order to achieve these goals in a safe manner with decreased down time it is important to utilize modalities that address these issues with minimal contraindications or side effects. Heat and cold therapy are two modalities that fit this bill.

    Further, heat and cold therapy is safe enough (as long as safety measures are followed) for patients to use at home to address minor injuries and pain associated with their chronic conditions. This diversity and applicable uses, make heat and cold therapy powerhouse modalities in the rehabilitation field.