Cold Or Heat? What To Apply For Each Injury Or Pain?

In the case of a painful kick to the shin while playing football, for example, the ideal is to elevate the leg, apply a tight bandage, apply a bag of cold gel and secure it with a light bandage, says the vice president of the German Society for Sports Medicine and Prevention.

Cold reduces inflammation and pain

Inflammation occurs when small blood vessels are damaged. Cold causes these vessels to contract and close more quickly. It also inhibits the transmission of pain signals to the brain. This means that the injury no longer hurts as much.

German orthopaedic surgeon and accident specialist Thomas Gottfried advises using cold for all acute injuries, even bruises and fractures, but never for open wounds.

How to avoid frostbite

However, care must be taken when using cold. If certain precautions are not taken, frostbite can occur on the skin. “There are two perceptible reactions to cold,” explains Gottfried.

First, there is some pain caused by the cold, which is normal and is not a reason to stop the treatment, he explains. “Then there is an accustoming effect, followed by a second pain caused by the cold. In this case, you have to be careful and stop the cold to avoid frostbite,” says the specialist from the German Society of Orthopaedics and Orthopaedic Surgery.

According to him, this second pain caused by the cold is a sign that the body temperature is dropping and that can lead to dangerous terrain.

Gottfried points out that if you work with cold compresses or cold water jets, there is usually no risk. However, in the case of ice packs or granulated ice, he recommends not using them for more than 30 minutes and taking a break.

“If the ice packs are very cold, it is advisable to place a towel on the skin to avoid damaging it. In these cases, cold should be applied for 15 to 20 minutes,” he adds.

“Another option is to repeatedly rub an ice cube over the injured area,” says Axel Klein. This means that the body is not permanently exposed to the cold, but still has a pain-relieving effect.

Klein also recommends cooling the affected area for a maximum of two days. “By the third day at the latest, the metabolism must be stimulated so that the tissues are properly irrigated,” he explains. Excessive cold is not good for this.

Given these guidelines, you can safely apply cold at home without the help of a doctor. However, there are some exceptions. “You should be careful with certain illnesses, such as circulatory disorders or sensitivity to cold,” says Thomas Gottfried.

The same applies to sensitivity disorders, as this causes the warning mechanisms to be deactivated. “These people often do not perceive the pain caused by the cold,” he says.

Heat opens the vessels

Applying heat, such as with seed bags, hot water bottles, or infrared lamps, may help relieve pain, but not for acute injuries.

“Heat softens the tissues,” explains Gottfried. This is helpful in the case of overworked muscles, such as muscle soreness. “It is also useful in the case of tissue adhesions or scarring. It can be helpful in all cases where there are changes in the tissues,” he points out.

Heat dilates blood vessels, which improves blood circulation. It also has a pain-relieving effect. “That is why heat is also used to relieve menstrual pain or chronic inflammation,” says Gottfried.

Red spots and pain are warning signs

In principle, it is not dangerous for red spots to form on the skin due to heat. The problem is if, in addition to the spots, there is pain, since according to the expert, this can lead to a first-degree burn.

Although these types of burns are reversible and heal without leaving any traces, it is always important to keep in mind that pain, combined with red spots on the skin, should be taken as a warning sign.

Axel Klein also advises being aware of your perception when applying heat. “It should be a pleasant warmth,” says the orthopaedic and sports medicine specialist. In his opinion, moderation is the best approach.

On the other hand, it is recommended to use the seed bags or infrared lamps several times a day instead of using them once a day for a long time.

“You should also be careful with recent infections,” says Thomas Gottfried. “The heat can put too much strain on the body,” he explains.