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Heat or Cold?


Many people are unsure whether to use hot or cold packs to the area when they are suffering from back or neck pain. In the past, traditional wisdom was to apply heat to relax and soothe the muscles. This is not necessarily the best way to treat most back or neck pain, particularly if it is acute.

In acute back strain or neck pain, and in many cases of chronic spinal problems, the involved joints are inflamed. This means there is heat and swelling in the associated tissues. Application of heat will relax the muscles but it increases the swelling and inflammation in the joint. As a result, although the heat feels good at the time, the joints will stiffen up even more afterwards.

A back strain or sprain should be approached in the same way as a sprained ankle. Ice not only decreases the swelling in the affected tissues, but it causes a reflex closing of the blood vessels, followed shortly by an automatic opening of the vessels, resulting in an increase in circulation to the affected area. This alternating increase and decrease in blood flow can help to flush out toxins.

When using cold therapy, the best results can be obtained with a flexible gel pack or even a package of frozen peas, since this will mold itself to the shape of the painful area. For back problems, 10 to 15 minutes will produce good results. The maximum amount of time recommended is 20 minutes. This can be repeated as often as every hour. For neck pain, 5 minutes is sufficient due to the decreased tissue mass.

So - called "heat" or "cold" rubs produce the sensation of heat by increasing or decreasing circulation to the skin. In doing so, they act as a counter - irritant. Their main value may be in the massage required to apply them, and to the fact that they mask the pain with a different kind of sensation.

For chronic pain, alternating heat with ice often helps to reduce swelling in the tissues and increase circulation to promote healing. If using alternate heat and cold, always end with cold. In chronic back problems the use of a heating pad can produce additional problems. The heat is often applied for too long a time and at too high a temperature as the skin becomes desensitized. This can result in a slow burn to the skin and a permanent mottled discoloration.

The use of cold to reduce swelling and inflammation can make correction of the problem much easier when consulting your chiropractor. In both acute and chronic pain, ice applied after the initial adjustments often promotes faster healing.

Remember that cold is used as first aid and as an adjunct to the healing process. Spinal pain is a signal from your body that something is wrong. Consult this office as soon as possible to determine the cause of pain and the best means for eliminating it.

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