Can heat compress be used during the remission period of chronic pain?

There is no one-size-fits-all answer to this question. Hot compresses can be used during the remission period of most chronic strain-type pains, and can also help reduce the frequency of attacks. However, for a few special types of chronic pain, the more they are applied, the worse they may become.

I have met many old patients who have suffered from lumbar protrusion for five or six years. During the remission period, there was no obvious pain, but the waist became stiff and stiff after sitting for a long time. I used a hot water bottle at about 42 degrees for 15 minutes every day before going to bed. The tightness in the waist dissipated very quickly. Even bending down to pick up things the next day was much easier. The frequency of attacks was also half lower than before without hot compress. The principle is not complicated at all. Hot compresses are like "heating and thawing" stiff local tissues. The expanded blood vessels can bring more nutrients and transport away the accumulated inflammatory metabolic waste faster. Muscles and fascia are softened, which naturally makes it less likely to compress nerves and induce pain. For problems such as cervical spondylosis, lumbar muscle strain, and old cold legs, anyone who has tried hot compresses during the remission period will understand the comfort of hot compresses.

But if you think that any chronic pain can be solved by hot compress, it is really easy to get into trouble. A young man who had suffered from gout for 4 years came to the outpatient clinic before. His ankle had just entered the remission period less than a week ago. He thought of applying a moxibustion pack to activate the joints, but the result was that his ankle became red, swollen and painful the same night after the application, and he had an acute attack.

In fact, doctors in different departments have slightly different judgments on this issue. Most rehabilitation departments will recommend that chronic pain patients without acute redness, swelling, heat and pain use appropriate hot compresses during the remission period. The effect of relaxing muscles is milder than many external plasters.； However, doctors in rheumatology and pain departments often say one more thing - if it is gout, postherpetic neuralgia, or joint pain associated with lupus erythematosus, do not apply heat casually even during the remission period. The former will accelerate the dissolution of uric acid crystals and irritate the soft tissue. The latter has high nerve sensitivity, and warm stimulation may aggravate the symptoms of neuralgia.

It is easy for everyone to judge by themselves. If your chronic pain usually attacks soreness, stiffness, and weight, and is aggravated by blowing cold wind or catching a cold. During the remission period, there will be no redness, swelling, or pain when touching the skin. Just apply it with confidence. The temperature should be controlled at 40-45 degrees. Put a thin towel on it and don’t burn the skin directly. 15-20 minutes each time is just right. But if the pain feels like pins and needles or burning, or the pain is worse after trying hot compress before, don’t join in the fun. It is safer to switch to gentle activities such as mild stretching and slow walking. By the way, don’t adjust the temperature too high in pursuit of the effect. I have previously encountered patients who suffered superficial second-degree burns from applying warm compresses to their babies. The purpose of hot compresses is to make them feel warm and comfortable. It’s not true that hotter is better.