Frequently Asked Questions

Please Note! This information is not intended as a substitute for professional medical treatment or consultation. Always consult with your physician in the event of a serious injury or whenever using cold or hot therapy for a medical condition.

Cold & Hot Therapy

When should I apply heat? When should I apply cold? More detailed information and answers will follow in this FAQ discussion. But a quick guide line?

Use......Moist heat therapy for chronic pain
Use......Cold therapy during the first 48 hours of acute pain and
sometimes alternate with moist heat for chronic pain.

What should I do when I suffer an acute injury?

A common recommendation for all first aid and acute injuries is known as the R.I.C.E. method of acute injury treatment. Rest, Ice, Compression and Elevation. When you are hurt or are in pain: R.I.C.E. is the key to the four basic methods of speeding injury recovery and reducing pain:

Rest: Resting is important immediately after the injury for two reasons: First, rest is vital to protect the injured muscle, tendon, ligament or other tissue from further injury. Second, your body needs to rest so it has the energy it needs to heal itself most effectively.

Ice: This is the best method for soft-tissue injuries. Cold can provide short-term pain relief. It aids in reducing swelling, bleeding, spasms and pain. Apply as soon as possible after an injury has occurred and continue for 48 to 72 hrs. Most doctors recommend 20 minutes of cold therapy followed by 20 to 60 minutes off.

Compression: For a severe injury, immediate compression (pressure) is important to decrease bleeding and keep fluids from pooling in the area. Compression should be continued throughout the day and removed at night.

Elevation: Elevating the injured area above the heart helps reduce internal bleeding and swelling.

The Polar non-toxic Soft-Ice® system of packs and compression wraps provide a comfortable, convenient and effective method of implementing a R.I.C.E. regimen. Our patented packs stay soft and flexible even right out of the freezer; this provides greater contact, heat transfer and comfort than ice or cheaper cold packs. Go to our cold therapy and cold compression wrap products section.

After 24 to 48 hours of R.I.C.E., many injuries will begin to heal. If your pain or swelling does not decrease after 48 hours, consult your primary care physician or go to the emergency room, depending upon the severity of your symptoms.

Once the healing process has begun, very light massage may improve the function of forming scar tissue, cut healing time and reduce the possibility of injury reoccurrence.

When should I use Soft-Ice® cold therapy?

Using cold therapy to treat injuries is one of the oldest methods of pain control. Cold therapy is an easy self care technique that is proven to be safe and effective at reducing swelling, relieving pain and decreasing muscle spasms. Often people who use cold therapy require much less pain relief medication. 
Cold therapy or Cyrotherapy is usually recommended as soon as possible after an injury has occurred and continued for 48 to 72 hrs. Most doctors recommend 20 minutes of cold therapy followed by 20 to 60 minutes off.
Some chronic injuries can also benefit from icing; but always ice after using the affected muscle or joint, never before.

What conditions can benefit from cold therapy?

Sprains

Strains

Muscle spasms

Whiplash

Insect bites

Contusions

Dislocation

Subluxations

Arthritis

Headaches and Migraines

Hematoma (acute)

Bursitis

Tendonitis

Post Surgery

Myofascial disorders- muscle spasm, muscle tension, muscle soreness

How should cold therapy be used?

Place Soft-Ice® on the injured area using a thin cloth or any of our compression wraps to help protect from freezer burn or frostbite. Use Soft-Ice® for twenty minute intervals, followed by 20 to 60 min off. (See your doctor for exact recommendations) This will help to relieve pain, reduce swelling, and increase circulation. The skin temperature should always be allowed to return to normal between applications.  Ice packs should not be left on the skin for too long, especially if the area has little fat (i.e. the toes). The cold can eventually stop blood flow altogether, causing frostbite. 

How does cold therapy work?

After an injury, blood vessels that deliver oxygen and nutrients to cells are damaged. The cells around the injury increase their metabolism in an effort to consume more oxygen. When all of the oxygen is used up, the cells die. Also, the damaged blood vessels cannot remove waste. Blood cells and fluid seep into spaces around the muscle, resulting in swelling and bruising. When ice is applied, it lowers the temperature of the damaged tissue through heat exchange and constricts local blood vessels. This slows metabolism and the consumption of oxygen, therefore reducing the rate of cell damage and decreasing fluid build-up. Ice can also numb nerve endings. This stops the transfer of impulses to the brain that register as pain. Cold or ice should never to applied directly to the skin. A barrier, such as a towel or compression wrap should be placed between the cold pack and the skin's surface to prevent skin and nerve damage.

How long does Soft-Ice® packs stay cold?

Ice therapy requires that as much heat is drawn from the effected area within the first twenty minutes as possible. Soft-Ice® optimizes cold therapy for 20 minutes and are designed to stay soft and flexible.

How long will the packs last? 

Soft-Ice is non-toxic and is designed to transfer heat with no chemical reactions. The pack can be reused over and over again and will last a long time.

Why not just use an ice bag or a bag of peas?

That certainly is an option and these methods will work, however there are disadvantages. Both ice bags and frozen peas can be messy; they freeze hard and crunchy which does not allow close contact with the skin, maximum heat transfer and comfortable therapy. Ice bags and frozen peas are also less environmentally sound as reusable cold packs and they do not provide compression.

When you are in serious pain, you want a quick, clean solution that is reusable and will provide you consistent relief of your pain!

What precautions should you take when using cold packs?

Prolonged, direct contact with cold can damage skin and nerves so always use a cloth or Polar compression wrap between the pack and the skin.  Hot or cold therapy should not be used on people who have circulatory problems, who are unconscious, who cannot feel or respond to cold (e.g. in paralysis) or who are allergic to cold (some people develop skin reactions).

What should I do if I suffer a chronic pain?

Heat or Moist Heat Therapy should be used for chronic conditions such as muscle discomfort, stiffness and many more. Applying heat to an area effectively opens up the blood vessels allowing blood to flow freely to the affected area. This increases circulation, delivering an increased supply of oxygen and nutrients and removing waste from sore, fatigued and injured muscles. Moist heat therapy can be effective in treating back pain caused by muscle strains and spasms. Arthritic and thematic pain is often temporarily relieved with the use of moist heat. Apply the Thera-Temp® moist heat pack to the injured area for twenty minutes, repeating as needed.

Cold therapy can also be effective with chronic pain. Many doctors recommend alternating these therapies with minimum 20 minute intervals: 20 minutes of heat, 20 minutes off, 20 minutes of cold, 20 minutes off.

When should I use heat therapy?

Heat or Moist Heat Therapy should be used for chronic conditions such as muscle discomfort, stiffness and many other chronic conditions. An example would be, for some people, nothing soothes a sore back like a hot pack. In a 2002 study published in the journal Spine, investigators at the University of Medicine and Dentistry of New Jersey found that the continuous application of low level heat eased low back pain better than two common over-the-counter painkillers.

Heat therapy can also be used before exercise to increase the flexibility of joints and to increase blood flow.  (You should not use heat therapy after exercise.)  Because heat therapy increases circulation and increases the skin temperature, it should not be used when there is any swelling or inflammation.  See our microwaveable moist heat wraps.

How should you use heat?

The best way to apply moist heat or heat is to alternate 20 minutes of heat therapy with a 20 minute break. Repeat this process for 3-4 times daily until stiffness and soreness decreases. It is important when using heat therapeutically, to always have enough barrier between the skin surface and the heat pack to protect the skin.

What is the difference between moist and dry heat?

Moist and dry heat are the most common therapeutic treatments for superficial heat therapy. However, moist heat is more effective than dry heat in providing deeper penetration of the tissue at the same temperatures. Moist heat also has additional capacity to change the tissue temperature rapidly and obtain more vigorous response from temperature receptors. Patients often report greater relief of symptoms from moist heat.

How do moist and dry heat compare? 

Comparison of moist and dry heat therapy indicates that the advantages of moist heat over dry heat are:

Moist heat is more effective than dry heat in deeper tissue heating

Moist heat penetrates more than dry heat at the same temperature

Moist heat has additional capacity to change the tissue temperature rapidly and obtain more vigorous response from temperature receptors

Patients often report greater relief of symptoms from moist heat

Moist heat is preferred over dry heat as a treatment or component of the treatment for the following conditions: 

Pain, stiffness and secondary muscle spasm in chronic arthritis

Acute temporomandibular joint closed lock condition

Pain and muscle spasm on posterior neck and back in patients with ankylosing spondolytis

What precautions should you take when using heat packs?

Most therapists and doctors advise not to use heat right after an injury, as this will have the opposite effect of ice. Heat increases blood flow and relaxes muscles. Its good for easing tight muscles, but will only increase the pain and swelling of an injury by accelerating metabolism.

Hot or cold therapy should not be used on people who have circulatory problems, who are unconscious, who cannot feel or respond to cold (e.g. in paralysis) or who are allergic to cold (some people develop skin reactions).

Take care not to burn or damage the skin. Use extra caution if diabetic.

Place a soft towel or cloth between the heating pack and the skin.

Take care when using a heat pack if you are taking medicines that make you sleepy or if the area being treated is numb.

Limit the heat therapy to ten or fifteen minutes at a time. Try ten minutes every one to two hours.

Wait at least twenty-four hours before applying heat to skin that has been bruised, cut or used for an injection or subjected to any "invasive" procedure. NOTE: Heat can increase bleeding.

Important: If the area is sore from overuse or inflamed, use Cold, NOT Heat!

I get terrible migraines, can your products help?

Ice therapy has been proven to help reduce migraine headache pain. Some people also find temporary relief with our Thera-Temp® moist heat packs. We recommend our Soft-Ice® wraps: HB for the head, NC as a neck collar, and MHC as a moist heat collar.  See our Headache and Migraine Relief products: Active Headache Therapy                                                                                                        Headache Therapy Kit

I have arthritis, what would you suggest?

Subacute and Chronic Arthritic Conditions: Superficial heat applications are valuable in relieving pain, stiffness, and secondary muscle spasm in conditions such as chronic arthritis. Ice therapy, in some people, helps relieve the pain.

From Arthritis Today, July-Aug 2000, “Drug-Free, All Natural Power Over Pain” pages 35-38 “Packin’ Heat - Just about everybody can use a quick fix for pain now and then.  Experts told us that applications of warm, moist heat may do the trick.”

From Arthritis Today, July-Aug 2000, “Drug-Free, All Natural Power Over Pain” pages 35-38 “Give it the Cold Shoulder - If swollen, inflamed joints are making life miserable, then just chill out, experts say.  Applying something cold to those angry spots can decrease pain and swelling by restricting the blood vessels and preventing fluids from leaking into the surrounding tissues.”

From The Johns Hopkins White Papers Arthritis (1995 P.9) “Warm compresses may relieve pain and ease stiffness by relaxing muscles. Heat treatments may also improve subsequent ability to exercise. In some people, however, application of cold packs or ‘crushed ice’ provides better relief of pain, especially when pain and inflammation follow activity.  Warm compresses or ice should be applied for no longer than 20 minutes. Ice should be wrapped in a towel and removed when the area becomes numb.

From The Johns Hopkins White Papers Arthritis- Treatment of Bursitis (1995 P.47, 48) “A suspected case of bursitis can safely be treated at home. Apply ice packs to the affected area for 20 minutes every hour or two to help reduce pain and swelling. After 48 hours, use heat to stimulate blood flow and help ease the pain.

Can hot and cold therapy be effective for repetitive strain injuries such as Carpal Tunnel Syndrome, Trigger Finger, Tennis Elbow, and etc.?

From Postgraduate Medicine (Oct. 1997) Repetitive Strain Injury. The Goff Group “Use of ice packs, massage, NSAIDs, or topical pain relief agent is often helpful. See our Roller Ice cold therapy massage  products for cold & hot massage therapy.

From Prime Care (June 1994) Department of Family and Community Medicine, College of Medicine, U of Arizona Tucson “Most occupational muscloskeletal disorders respond to conservative measures such as ice or heat.”

From American Family Physician (Feb. 1992) Occupational Repetitive Strain Injury University of Alberta, Edmonton “Common injuries involving the elbow, wrist and hand include epicondylitis, carpal tunnel syndrome and ulnar nerve entrapment. Conservative treatment consisting of rest, application of ice or heat and anti-inflammatory drugs is usually effective.”

Caution

Hot or cold therapy should not be used on people who have circulatory problems, who are unconscious, who cannot feel or respond to cold (e.g. in paralysis) or who are allergic to cold (some people develop skin reactions). Applying ice for too long can cause problems and delay the healing process. Always apply ice in a safe and controlled manner. Never apply ice if you have a sensation loss. Always consult with your physician in the event of a serious injury or whenever using cold or hot therapy for a medical condition.

Be Prepared

Always keep a Soft-Ice® pack and compression wrap on hand – preferably one in the freezer ready to go.  You never know when you may have to ice down an injury!  Flexible-when-frozen Soft-Ice® cold & hot packs are ideal for this application.

References:                                                                          (Partial Listing)

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Chung, S. C., Kim, H. S.: The Effect of the stabilization splint on the TMJ closed lock. Cranio. 11 (2): 95-101, 1993.

Tepperman, P. S., Devlin, M.: Therapeutic Heat and Cold. A practitioner's guide. Postgraduate Medicine. 73 (1): 69-76, 1983.

Lindsey, B.: Patient Care Guidelines.: Cold and heat application in musculoskeletal injury. J. Emergency Nursing. 16 (1): 54-56, 1990.

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Johns Hopkins Medical Institutions. Baltimore, MD. White Papers. 1995.

The Power of Ice, Louise Roach

Pain and Inflammation. The Merck Manual. http://www.merck.com/mmhe/sec01/ch007/ch007b.html

Questions and Answers About Sprains and Strains. National Institute of Arthritis and Musculoskeletal and Skin Disorders. National Institutes of Health. http://www.niams.nih.gov/hi/topics/strain_sprain/strain_sprain.htm#strain_h

Use Heat and Cold. Arthritis Foundation. http://www.arthritis.org/conditions/pain_center/heat_cold.asp

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Low back pain. Tips on Pain Relief and Prevention. American Academy of Family Physicians. http://familydoctor.org/117.xml

Nadler, Scott F. DO, et al. Continuous Low-Level Heat Wrap Therapy Provides More Efficacy Than Ibuprofen and Acetaminophen for Acute Low Back Pain. Spine. 27(10):1012-1017, May 15, 2002

First Aid Guide. Mayo Clinic. http://www.mayoclinic.com/findinformation/firstaidandselfcare/index.cfm

Neck Sprain. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=141&topcategory=Neck

Ankle Sprains: Healing and Preventing Injury. American Academy of Family Physicians. http://familydoctor.org/x2683.xml

Handout on Health: Sports Injuries. National Institute of Arthritis and Musculoskeletal and Skin Disorders. National Institutes of Health. http://www.niams.nih.gov/hi/topics/sports_injuries/SportsInjuries.htm

Swelling. Medical Encyclopedia. MedlinePlus. U.S. National Library of Medicine and the National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm

Why Should I Use Ice on an Injury? Wallops Flight Facility. NASA. http://rehabworks.ksc.nasa.gov/education/pamphlets/heatice.pdf

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