Heat or Cold for Pain?

People with pain often ask me whether they should be applying heat or cold. In Chinese medicine neither is universally appropriate and there are times when the incorrect treatment can even be detrimental. The basic idea is to choose whatever will neutralize your symptoms.

Fire and Ice

1. Warm cold pain. Cold pain is subjectively cold in nature, is generally aggravated by cold weather, and improves with the application of heat. Since cold contracts, this type of pain is more likely to be cramping or spastic in nature than hot pain. Circulation may be inhibited so there may be swelling, but there will definitely not be any redness, and the tissue will be cold to the touch.
2. Cool hot pain. Hot pain is subjectively burning in nature, is generally aggravated by hot weather, and improves with the application of cold. Hot conditions correspond with the western medical definition of inflammation in that symptoms include pain, swelling, redness, and tissues that are hot to the touch.
3. Swelling does not necessarily indicate inflammation. Please note that pain and swelling can occur when there is an accumulation of stagnant fluids, as seen in edema. Signs of heat must be present as well to indicate inflammation and the application of cold. Since cold contracts, inhibiting circulation, applying cold to edema will further constrict circulation, aggravating symptoms.
4. Never use ice! Chinese medicine considers ice to be too extreme, especially when it is used to numb pain. The numbness that ice induces is an early warning sign of frostbite and indicates that the tissues are being damaged. Though it is good to cool hot pain, the recommendation is to use a cold compress, a cloth that has been run under cold water and rung out, instead of ice. Using ice on cold pain can be especially detrimental, temporarily numbing it but ultimately prolonging recovery time.
5. Not sure? Go with what feels good. If you have either a preference or an aversion to using either heat or cold, go with it! Listen to your body, it is wise and knows what it needs.
"Nancy is very down to earth and incredibly warm. I appreciate all her knowledge and abilities to help me understand my body. Thank you very much for all that you do!" ~Virginia Pitts
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