Treating Injuries After The First 3 Days
Safely Applying Heat

72 hours (three days) after an injury the peak of inflammation has usually passed and ice is usually not as helpful as heat. Applying heat now will reduce the stiffness in injured areas as well reduce the pain.

Physiology of Heat - Heat accelerates chemical reactions. About 72 hours after injury heating inflamed tissue can help accelerate the healing process. Heat dilates blood vessels, increasing the blood flow in that region. This helps flush inflammation out of the area as well as increasing the delivery of healing nutrients to the injury. When heat is applied to the skin it evaporates moisture in the skin. This evaporation is the bodies way of controlling it's temperature and protecting itself from heat injury. When available moisture in the skin is exhausted the body is less able to protect itself and may suffer a burn. "Moist" heat is therefore less drying on the skin allowing for longer and deeper heating with less chance of a skin burn than "dry" types of heating pads. Heat causes the body to try to cool the heated area back to normal body temperature. This flushes blood through the area and helps to remove inflammation. Heat should be used for 5 - 15 minutes, removed, and applied again if needed no more often than once an hour. Using heat too frequently does not allow skin moisture to return to normal levels and may result in a burn. Individuals with dry skin will burn more easily and should use caution with heat.

How to prepare heat - Dry heating pads are effective, safe and the least expensive. Follow the above procedures. Moist heating pads are available from pharmacy and surgical supply stores. Thermophores draw moisture from the air. Other types require your moistening a sponge liner. Hydrocollator packs require your heating them in a pot of water to 160 degrees and then either placing them in a special cover or wrapping them in about eight layers of colorfast Turkish towels. The differences in these methods are those of convenience and cost. While we use Hydrocollator packs in the office, I feel that the Thermophore or less expensive wet electric pads are much easier for home use with very acceptable results.

How to apply heat - For pain radiating from the spine down the arm or leg apply hot pack close to the spine laying lengthwise in the direction the pain travels. For local non - radiating joint pain, such as tennis elbow or a sprained ankle, apply the heat directly to the joint wrapped around it as much as possible. Hold the hot pack in place with an Ace bandage or wrap with a towel.

Cautions with heat- The skin can be burned with extreme heat. Do not apply heat too often, generally only once an hour. Some individuals with certain circulatory abnormalities should avoid the use of heat. Consult your doctor first.

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