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  • Cheryl Cunningham

When and how to apply heat to aid healing!



Why is heat so soothing and what are the effects?


1. Psychological effects

Heat makes us feel relaxed and comforted. We learn from a young age that a warm bath or hot water bottle can make a tummy ache feel better. Research has shown that some of the positive effects of heat are as a result of activity in the brain, rather than from the local effect on the tissues (Davis et al., 1998; Yasui et al., 2010).


2. Decreased muscle tightness and trigger point activity

Heat seems to have a direct effect on reducing tight muscles, which is often the primary cause of common pain conditions. Tight muscles often contain trigger points, which are points in the muscle which cause pain in a particular pattern. It seems that heat application may reduce the firing rate of muscle spindle cells, which reduces muscle tightness and pain.


3. Increased circulation and reduction of rehabilitation time

The local increase in circulation caused by the application of heat is thought to be beneficial in healing soft tissue injuries. Bringing fresh blood and nutrients to the area helps maintain the optimum health of the tissues and aids the injury repair process. A 1% increase in temperature results in a 10-15% increase in local tissue metabolism (Nadler et al., 2004).


4. Increased pliability of fascia

Applying heat helps to improve the elasticity of the fascia, which is a type of soft connective tissue running throughout the body. Therefore stretching techniques are much more effective if heat is applied beforehand (Klinger, 2012). Hot yoga uses this result to good effect.


5. Decreased perception of pain

Heat can help to decrease the perception of pain and enables us to feel in control of our pain responses, and feel comforted.



When and how to apply heat?

The most effective heat therapy products are the ones that can maintain their heat. You should not have your heat source hot to the point of burning the skin, instead the temperature should be warm. The desired effect is for the heat to penetrate down into the muscles. Simply increasing the temperature of the skin will do little to decrease discomfort.


In many instances, the longer the heat is applied, the better. However, the duration that one needs to apply the heat is based on the type of and/or magnitude of the injury. For very minor back tension, short amounts of heat therapy may be sufficient (such as 15 to 20 minutes). For more intense injuries, longer sessions of heat may be more beneficial (such as 30 minutes to 2 hours, or more).



When NOT to apply heat

Heat should not be used on an area if there is swelling or bruising. Heat should not be used if you have heart disease or high blood pressure, unless advised by your GP. Heat application is also not suitable in the following cases:

  • Acute inflammation or trauma

  • Bleeding disorders

  • Dermatitis

  • Deep vein thrombosis

  • Diabetes

  • Oedema

  • Impaired sensation (neuropathy)

  • Infection

  • Local malignancy

  • Open wounds

  • Peripheral vascular disease

  • Severe cognitive impairment



The most effective dry and moist heat options to use at home:

There are many different ways that heat can be applied to the body. A specific type of heat therapy may feel better for one person than for another, and it may require some experimentation to figure out which one works best for you.


Dry heat, such as electric heating pads draw out moisture from the body and may leave the skin dehydrated. However, some people feel that dry heat is the easiest to apply and feels the best.

- Hot water bottle - tends to stay warm for 20 to 30 minutes

- Electric heating pad - maintains a constant level of heat as long as it is plugged in

- Heated gel packs - may be microwaved, or sometimes heated in water, and tend to

stay warm for about 30 minutes. Certain types of gel packs provide moist heat, which

some people prefer

- Sauna - home sauna units are available and can be very helpful when used on a regular

basis

Moist heat, such as hot baths, steamed towels or moist heating packs can aid in the penetration of heat into the muscles, and some people feel that moist heat provides better pain relief.

- Heat wraps - wrap around the back or limb and may be worn against the skin under

clothing, providing convenience and several hours of low level heat

- Hot bath or hot tub - tend to stimulate general feelings of comfort and relaxation that

may help reduce muscle spasm and pain. A whirlpool jet directed at a sore area of

the body may provide the added benefit of a light massage

- Steam room - a unit can be purchased for home use on a regular basis


If applying a heat source directly to the body, it is important to use enough insulation between the heat source and the skin to avoid overheating or burning the skin.



So why not try your treatment with heat!


Hot Stone Massage/Sports Massage

All of the moist heat benefits for the whole body in a relaxing treatment.


Warm Bamboo Massage All of the dry heat benefits for the back and legs in a relaxing treatment.


If you are unsure if a treatment with heat is suitable for you, then please get in touch.

References: spine-health.com; Massage Fusion by Fairweather/Mari

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