After an injury, when should hot or cold treatment be applied?

Applying either hot or cold treatment to an injury can help by reducing pain and promoting better recovery. However, it has to be applied properly, since the wrong treatment can be counterproductive.

"To answer this question, the first thing to consider is the type of injury and its severity," explains Pere Palmada. Whether to apply hot or cold treatment depends on the type of injury, its severity and the time elapsed since it happened. As well as these therapies, exercise, painkillers or anti-inflammatories can be taken. The latter options, however, should be recommended by a professional, depending on the features of the injury.

“We use cold treatment or cryotherapy when there is inflammation,” says Pere Palmada. This is usually seen in recent injuries such as knocks, falls or sprains. Cold should be applied for as long as there is acute inflammation (up to a maximum of 72 hours after the injury), with no more than 20 minutes every 2 hours.

Cold reduces inflammation and pain and promotes recovery. "It can also help in post-sports recovery," he states; with cryotherapy often being used after a period of intense physical exercise to improve recovery. Cold, however, should not be applied to open wounds, directly on the skin or before performing physical activity or exercise.

"Heat is applied in chronic or muscular processes or those at an advanced state and always after the initial inflammation stage," explains Pere Palmada; adding, "If heat is applied too early to an injury, it can lead to inflammation.” Some long-standing processes which may use heat are those to relieve pain in the lower back or neck, for example.

Heat has a sedative and relaxing effect that helps reduce pain. As with cold, it should not be applied for more than 20 minutes every two hours and never directly on the skin. Finally, an important factor that determines the effectiveness of these therapies is the patient's tolerance and perception of cold and heat.

INFORMATION DOCUMENTED BY:

Pere Palmada, sports physiotherapist at the Sports Medicine Unit of the Clínic Barcelona hospital and Hospital Sant Joan de Déu.