Heat vs. Cold

Physiological Effects of Superficial Heat

• Increase in tissue temperature, local metabolism and blood flow
• Analgesia and sedation (relaxation)
• Increased nerve conduction velocity
• Increase in O2 and nutrient supply at cellular level
• Decrease muscle spasms and pain

Indications of Superficial Heat:

• Before active exercises
• Before stretching or passive range of motion
• In conjunction with massage, ultrasound or traction to achieve maximum relaxation and warm local superficial tissues
• Muscle spasms
• Prior to joint mobilizations

Contraindications:

• Local infection present
• Some dermatologic conditions
• Feverish conditions

Precautions:

• Be aware of any deficits in sensation
• Very old/young or mentally incapacitated patients

Physiological Effects of Cold

• Reduce tissue temperature and local vasoconstriction
• Decrease inflammatory process and metabolism
• Diminish the effects of central and peripheral nerve disorders
• Decrease extensibility of non-elastic tissues

Indications of Cold:

• Reduction of acute pain and swelling
• Reduction of spasms and spasticity
• Facilitation of motor responses

Contraindications of Cold:

• Frostbite to the area
• Raynaud's disease or other circulatory compromises

Precautions:

• If stretching is required after cold therapy
• Same precautions that apply to heat