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How to use HEAT therapy

Not just for snuggling next to.

Sore back? Achy muscles? Stiff neck? … just cold?

Or maybe you just need to relax after a long week of putting in work. Either way, you want to feel better NOW.

Well, here is something that might relax those muscles and ease that pain. Best of all, it’s drug free, costs about nothing, almost infinitely re-usable, and can be started right away!


First of all, if you are confused with whether or not you should be using heat or ice, check out this article: Ice or Heat?

Why heat?

Also known as ‘thermotherapy’ in the therapy world (to make us feel smart for using nothing more than a hot pack), heat therapy a classic treatment for any sort of ailment. These days, we know it doesn’t have magical healing properties. Still, it sure feels nice to be warm, which is sometimes all you want when you feel sick.

What it does seem to be good for is aches, pains, and sore / stiff muscles.

How does it work?

Relaxing muscles: By increasing the temperature, heat seems to improve blood flow (via ‘vasodialation’; widening blood vessels) and increase tissue extensibility (stretchiness) 1, 2. By doing this, it’s supposed to relax muscle tone and spasms, which improves mobility.

Pain: When heat is applied to a painful area, it may decrease pain by offering a competing stimulus to the nerves in that area, effectively blocking out the perception of pain in that area. This ‘blocking out’ is known as the gate-theory of pain 3, and may be a good explanation of what’s happening in this situation. However it works, there is some good evidence that pain is good for stubborn pain 4. Pain can be confusing, so check out the pain section of this site if this is a problem for you.

What can I use heat for?

Heat therapy is most often used for:

  • Chronic injuries, especially:
    Low Back Pain.
    Neck Pain.
  • ‘Muscular’ type pain.
  • Joint and muscle stiffness.

Want a little more detail?

Heat is for discomfort. Although that is an ambiguous answer, it pretty much covers it. Of course, discomfort can come from an inflamed (where ice is recommended) injury too, but not always.

Discomfort usually means an achy type pain, and that stiff feeling at your joints or muscles. In joints it may feel like tight pressure, in muscles it may feel more like stiffness, as if you needed a massage or stretch, only with more pain. Either way, heat feels great and gives a temporary increase in range of motion, giving you a window of opportunity to get some early mobilization.

Chronic injuries are usually treated with heat. This is when an injury is a few weeks old and beyond. Inflammation should be under control by now, and pain has more to do with the nervous system, muscles stiffness, and a lack of mobility. Heat can help with each of these things, and from my experience, people usually prefer heat anyway.

Again, read the article: Ice or Heat? if you are still confused.

How do I use heat therapy?

Quick and easy.

Find a hot pack that fits the area you want to heat. Magic bags are popular and convenient for smaller areas like the neck, and can easily wrap around elbows, knees, and ankles. Some ice packs can also be microwaved, but then it takes a while to make cold again.

For larger areas of the body, it might be convenient to invest in a larger heat pack, like the thera-therm. These larger electric heating pads are especially good for low back pain. Careful with the ones that do not automatically shut off. People can fall asleep with a hot pack on, possibly leading to burns.

For larger areas.

You want a temperature of around 40° Celsius. If you don’t want to actually measure it, just make sure it’s not too hot to feel uncomfortable. You want a goldilocks-type “just right”. Interestingly, it takes 40° Celsius to heat tissues 2-4cm deep by only about 2-5°. But even a 1° increase in temperature can cause a 10-15% increase in tissue metabolism! Neat stuff.

It’s a good idea to use a couple layers of towel to keep the temperature in a safe range, especially with electric heat packs that can keep increasing in temperature.

Apply the hot pack for 15-45 minutes. About 30 minutes will usually do the trick heating up the tissues. It’s best to stop and repeat every two hours, so your tissues can return to normal temperatures.

Are there any safety concerns?

Of course!

Possible side effects can include:

If you use heat too long or too hot, you put yourself at risk of:

  • BURNS!

Contraindications huh? (no, I didn’t mean to say contradictions)

In plain English, these are warnings. Don’t use heat or ice in these cases. If you’re not sure, check with your doctor. read: disclaimer!

  • Check for red flags
  • Decreased sensation
  • On open wounds
  • Acute inflammation or hemorrhage
  • Bleeding disorder
  • Known malignancy (tumor)
  • Full body heat (like a tub) when one has conditions affecting core temperature like: Multiple Sclerosis., Adrenal Suppression, Pregnancy, and Lupis.

That’s it!

You’re ready to use heat! Now go try it. For more advice on how to treat your injury, be sure to go through the injury section of this site.

Good luck!

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    3 Responses to How to use HEAT therapy

    1. MARIA ROSA says:

      I have RSD 2 yeaes ago, this therapy es good for persons with rsd?

      • Tony Ingram says:

        Hi Maria!
        Reflex sympathetic dystrophy (RSD), a.k.a. complex regional pain syndrome (CRPS), is often treated with ‘contrasting’. This is done by switching between heat and ice for about 10-20 minutes each, repeating a 2-4 times. I’m not sure how effective it is though; I couldn’t find much research on it when I searched. But it’s worth a shot!

        Something that may be more worth a try is ‘graded motor imagery’, which has been shown to be effective by a few studies now. It’s something I am planning on writing about eventually, but in the mean time, try to find a Physical Therapist who can provide this treatment for you.

        Best of luck!

    2. Enozia Vakil says:

      Do using heat therapy wraps work as well?

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