The Hot Topic of Heat as an Analgesic

There have been several commercials in the media recently, advocating heat as a source of back pain relief. One such ad depicts a man giving a presentation to a group when a voice says, “Do you feel like this?”, then immediately a dude with a 2-by-4 steps into the picture and whacks the poor guy on the back. The message concludes with the man smiling with relief while pointing to a heat-generating stick-on pad that has eased his troubles.

While heat applications can be a source of pain relief, it can also lead to a worsening of your overall condition that caused the pain. Wait, What? Yes, I said it: applying heat will ruin your day after a NEW INJURY (notice lettering in all caps).
To test out this concept–try a little experiment:
1. Have someone (who you lost a bet to) help you sprain both ankles, or help you tear your hamstrings (or do it yourself—I don’t care).
2. Scream for an indeterminate period (then go to #3)
3. Apply moist hot packs to the right side as often as possible.
4. To the left side apply cold packs 20 minutes every three hours
5. Observe the amount of swelling to each side
6. Document which side hurts worse

What’s that? This study has already been done? Well, yes, kinda, but without the premeditated violence. There are several scientific studies which have compared heat and ice as therapeutic applications. The conclusions are somewhat muddled as to the effectiveness of ice application to new musculoskeletal injuries. What is very conclusive, however, is the PAIN-INTENSIFYING, MUSCLE SPASM INDUCING effects of HEAT application to musculoskeletal and ligamentous NEW INJURIES (sprain/strains). 

Here’s why: When muscle, tendon, ligamentous and/or fascial fibers become damaged or torn they (the damaged fiber cells) attract white blood cells which then start to release inflammatory substances (histamines, cytokines, substance P, among other stuff) which bind to pain-sensitive nerve endings & muscle tissue & Voila: pain, swelling, redness, spasm & loss of function to the area. When heat is applied, (hot pack, sitting in a Jacuzzi, etc.) to a newly injured area, your brain senses the increased temperature & automatically sends more inflammation-producing white blood cells which will markedly up the intensity of your swelling, pain, & muscle spasm which were already present.

In other words, if you want more muscle spasms & pain (than you already have) immediately after you hurt your back–just put heat on it.
When is it OK to apply heat? Answer: When your injured area isn’t in the acute state anymore.
How do I know when it’s not acute? When the area is no longer hot, swollen or tender to the touch.
With chronic pain, heat (especially moist heat) can be a cheap but effective remedy for muscular pain & tightness.
Stay tuned for further topics on injury recovery, prevention & the Fit Life.

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