Heat Or Ice – Thermotherapy For Everybody

IIYou’ve put in a good day chopping wood and carrying water. Now your shoulders are sore, your back wants to secede from the union, and your dogs are barking. You’ve done something to your left knee and it’s larger than it should be. Heat and ice both seem like a good idea – but which helps with which?

Thermotherapy – the application of different temperatures, either hot or cold – is as old as the first hominid sticking sore feet in a creek, or turning his aching back to the fire. Both are excellent remedies when used properly; both, when used improperly, can do more harm than good. Fortunately the rules for when to use which are simple and easy.


Heat brings several forms of relief to bear on fatigued, overused tissues. It opens up blood vessels under the skin, bringing a rush of nutrients to the area and whisking away the metabolic waste products of honest hard work. It sedates and relaxes the nervous system, allowing tight muscles to let go. Use heat on areas that are tired, exercise-sore, tight, or stressed.

Do not use heat on areas that are injured, torn, swollen, hot, or have open wounds. The additional blood, opening of capillaries, and increased activity caused by heat would be counter-productive and possibly painful.


Ice is Nature’s anti-inflammatory. The application of cold penetrates much deeper than heat. It physically freezes out pain signals along nerve pathways, decreases swelling, and stops the processes of inflammation that cause more swelling and nerve pain. Use cold on injuries, hot and swollen areas, strains, and sprains.

Do not use ice on fragile tissues, or on areas of poor circulation or decreased sensation. Do not use ice for longer than fifteen minutes every hour to avoid actually freezing anything. That would be bad.

Remember! If you need to use ice, then you also need to show your injury to a doctor.

The best ways to apply heat are: a hot water bottle, electric heating pad, a microwave beanbag, a sauna, and my personal favourite – a hot spring.bagby hot springs

The best ways to use cold are: ice cubes in a plastic bag, a basin of cold water with ice cubes in it, or a first-aid freezer pack. Frozen veggies, although popular and convenient, don’t work too well for serious thermotherapy.

Heat and cold are two of the most basic tools in the home health cornucopia. Used properly, according to simple rules, they are invaluable in helping us help ourselves – just like our ancestors have been doing since time began.


Massage Therapy Case Study: The Case Of The Shifty Spine

beautiful nude spineBilly sure had us puzzled. I was working in a clinic with two other massage therapists, a naturopath, and a chiropractor, and he’d seen us all. Billy had a peculiar problem – he was shifted to the left, and couldn’t get back.

Billy was healthy – early twenties, easygoing, a lanky six feet and slightly more proportioned to the trunk than the legs. Billy was strong from his work as a labourer, no previous health problems. He simply woke up one morning and found himself standing crooked. He had no pain of any kind, but his entire upper body shifted to the left at L4, just above his hips. “I feel like I’m always walking in circles,” he said.

The Amazing Adaptive Spine

Lots of people stand with their shoulders lateral to their hips, for many reasons – a short leg, a torqued pelvis, a locked facet joint, compressed ribs, to name just a few. Almost all of these produce subtle but characteristic changes in the amazingly adaptive architecture of the spine. Each vertebral block will sit a little bit sideways, and twist a little bit to the outside of the resulting curve, all the way up the column until the offending misalignment is as neutralized as it can be – until the head is once again being carried as level as possible. Almost nobody is without some level of lateral correction in their spinal column, and it is a testament to the adaptability of the human form that so few of us even notice.

Lateral spinal correction is supposed to be a gentle, gradual thing; Billy’s was like one block – L4 – was trying to divorce L5 and move out. His lumbar paraspinal muscles, quadratus lumborum, and erector spinae were in solid spasm all around the area. I spent three sessions using thorough neuromuscular massage to remove all the tightness, and sure enough Billy would be straight again when he stood up. For about a second and a half. Then clunk, he’d be crooked again.

The Answer

Two months after Billy finished with all of us he came back for a visit, walking normally. Detailed scans had finally revealed the culprit – a chunk of the L4-5 disk had broken off and was floating inside his spinal column. Disks have few sensory nerve fibers, thus the lack of pain, but his spine couldn’t tolerate the wandering invader. A good surgeon plucked it out, and Billy was immediately fine.

Published in: on September 15, 2013 at 4:22 pm  Leave a Comment  
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