When to Use Hot or Cold Therapy? – Dr. Soothe

When to Use Hot or Cold Therapy?

Many people use hot or cold therapy when it feels best to them, however, doctors provide guidelines on when thermal therapy should be used.


For many people, heat therapy works best when combined with other treatment modalities, such as physical therapy and exercise. Relative to most medical treatments available, heat therapy is appealing to many people because it is a non-invasive and non-pharmaceutical form of lower back pain relief.

  • Heat therapy dilates the blood vessels of the muscles surrounding the lumbar spine. This process increases the flow of oxygen and nutrients to the muscles, helping to heal the damaged tissue.
  • Heat stimulates the sensory receptors in the skin, which means that applying heat to the lower back will decrease transmissions of pain signals to the brain and partially relieve the discomfort.
  • Heat application facilitates stretching the soft tissues around the spine, including muscles, connective tissue, and adhesions. Consequently, with heat therapy, there will be a decrease in stiffness as well as injury, with an increase in flexibility and overall feeling of comfort. Flexibility is very important for a healthy back.


Cold makes the veins in the tissues contract, reducing circulation. Once the cold is removed, the veins overcompensate and dilate and blood rushes into the area. The infusion of blood in the area brings with it the necessary nutrients to help the injured back muscles, ligaments, and tendons to heal.

  • Cold application slows the inflammation and swelling that occurs after injury or aggravation. Most back pain is accompanied by some type of inflammation, and addressing the inflammation helps reduce pain.
  • Direct cold numbs sore tissues (providing pain relief similar to a local anesthetic)
  • Direct cold application slows the nerve impulses in the area, which interrupts the pain-spasm reaction between the nerves
  • Cold decreases tissue damage
  • Direct cold pressure adds the beneficial effects of gentle manipulation of the soft tissues

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