Cold vs. Heat

I often get asked the question during a massage treatment, do I use cold or heat for this?  In order to answer that question, we must first consider what types of situations that cold or heat would be used.

Cold or Cryotherapy

Cold therapy is used primarily when there is inflammation in an area.  The cold helps to suppress the pain and also to reduce swelling in the tissues by causing a decrease in blood flow.  After an acute injury, usually within 24-48 hours, cold is used.  If you are sore and tender after a massage, cold can help to reduce this tenderness. Massage therapists will sometimes use ice during a treatment while performing frictions to breakdown scar tissue.  Ice packs are the most common form of cold therapy but you could also use a cold compress, a bag of frozen peas, or submerse the body part in an ice bath.  Cold therapy is very effective at lessening the pain associated with menstrual cramps.  A typical application of cold would be 20 minutes on, 20 minutes off, and so on as often as needed.  Always be sure to wrap the ice pack in a cloth so it is not touching your skin directly to avoid frostbite.


Heat therapy is used to loosen up tight or stiff muscles, increase blood flow to an area, and decrease pain.  You should never apply heat to an acute injury (within 48 hours) as it will increase the bleeding and swelling.  Heat therapy would be typically used when a more chronic or long standing condition is present.  There are many forms of heat therapy including hot water bottles, wheat bags, warm compresses, thermophores (electric moist-heat pad), or hot baths.  An application of heat would be anywhere from 10 to 30 minutes, depending on the type of application being used.  Sometimes massage therapists will apply heat to a patient prior to treatment to help to soften the tissue and to increase relaxation.

No matter which form you use, hydrotherapy can be a very effective way of reducing pain and tenderness.


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