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

Hot compresses can be used during the remission period of most chronic pains. Only a few special cases need to be avoided. The core reasons are related to the working principle of hot compresses and the onset characteristics of different chronic pains.

A while ago, I met a programmer who had suffered from lumbar muscle strain for 3 years. His waist was always stiff and sore when he was not having an attack. He had always heard people say that he should not apply it casually when he was in pain for fear of aggravating the inflammation. Until the last rehabilitation evaluation, we told him that he could use moderate heat compresses during the remission period. When he went back to get off work every day, he applied a hot water bag at about 42 degrees to his waist for 15 minutes. After applying it for more than half a month, he said that the feeling of muscle tightness had disappeared by half, and the frequency of back pain attacks had dropped a lot in the past two months. In fact, the principle is not complicated. A hot compress of the appropriate temperature can penetrate 2-3 cm under the skin. When the tight muscles and fascia are exposed to warm heat, they can slowly soften like a frozen rubber band placed next to a stove in winter. Local blood circulation can increase by about 30%. Those accumulated in the muscles can The lactic acid and inflammatory metabolic waste in the muscle fascia can be taken out by the blood faster, and will not remain there to stifle and cause pain. For pain caused by chronic strains such as myofasciitis, lumbar muscle strain, old cold legs, and frozen shoulder, the benefits of hot compress during the remission period are very clear.

Speaking of this, some people may ask, I also have chronic pain, why do I feel uncomfortable when I apply it? This is also the core reason for the controversy over this issue. It is true that not everyone is suitable for hot compress during the remission period. For example, for patients with rheumatoid arthritis, if the joints are still slightly red and swollen during the remission period, some people will feel comfortable after the stiffness subsides, while others will feel bloated after the local edema worsens. There is no unified standard answer. We generally recommend patients to try applying on a small area for 5 minutes, and then continue if there is no discomfort, and stop if there is any discomfort. There are also neuropathic chronic pains such as post-herpetic pain. The nerves of many patients are particularly sensitive to temperature stimulation. Even warm hot compresses may trigger a tingling sensation. There is no need to apply hard compresses in this case.

There are also some situations where hot compresses must be avoided, even during the remission period. For example, if the painful area happens to have infectious skin lesions such as skin ulcers, eczema, or erysipelas, hot compresses will dilate blood vessels and help pathogenic bacteria spread, which in turn aggravates the problem. In addition, I would like to remind everyone that the hotter the hot compress, the better. It is enough to control the temperature at 40-45 degrees, and apply it for 15-20 minutes each time. There was an old man who suffered from cold legs before. He fell asleep with a hot water bag in the winter, and a shallow second-degree blister appeared on his leg. Instead, it hurt for several days. It was completely unnecessary. If you are really not sure whether you can apply it, it is safest to see a rehabilitation doctor for evaluation. You don’t have to worry about the various opinions on the Internet.