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

The vast majority of patients with chronic strain pain can use hot compresses during the remission period, but this conclusion does not apply to all types of chronic pain. In clinical practice, there are indeed cases of some people experiencing discomfort after hot compresses during the remission period.

I have been in a sports rehabilitation studio for more than four years, and the most common patients I encounter are those with neck and shoulder fasciitis, lumbar muscle strain, and mild lumbar protrusion caused by sitting for a long time. Many old members regard hot compress as a standard for daily stability maintenance. Last week, an aunt who has suffered from lumbar muscle strain for three years came for a follow-up consultation and said that she has been using a hot water bag at about 42 degrees for 15 minutes every night after taking a bath for the past six months. She used to have two or three pains every month, but the pain has only happened once in the past three months, and the degree is much lighter. In fact, the principle is not difficult to understand. Pain caused by chronic strain is mostly related to long-term muscle tension and local inflammatory metabolic factors that cannot be discharged. Hot compress is equivalent to "warming" the muscles that have been tight for a long time. The warmth penetrates into the muscle layer along the skin, and the tight muscle fibers slowly stretch. As the blood flow speeds up, the accumulated metabolic waste can be taken away faster, and the dull soreness can be relieved quickly.

But don’t think of hot compresses as a “panacea” for the remission phase. Last year, I met a young man suffering from rheumatoid arthritis. His joint swelling had just gone through the acute phase, and he felt that he was in the remission phase. He applied a coarse salt bag at home for almost half an hour, but the joints became red and swollen that night, and he went to the emergency room overnight in pain. For this type of autoimmune joint pain, even in the remission period, the joint synovium itself is in a highly sensitive state. Warm stimulation will increase synovial congestion, which is equivalent to "adding fuel to the fire" to the already unstable joints. There are also patients with peripheral neuropathy caused by diabetes. Their skin's perception of temperature is slow. Even during the remission period, it is not recommended to use hot compresses. If the temperature is not controlled well and you get burned, your recovery will be much slower than that of ordinary people.

If you are not sure whether you can apply it in your situation, you can do a small test first: put a hot water bag or heating patch on an uncomfortable position with a thin towel and try it for three to five minutes. After taking it off, if you feel that the area is relaxed and there is no pain or hot discomfort, you can apply it regularly, and control it for 10 to 20 minutes each time. The temperature should not exceed 45 degrees.； If you still feel pain or swelling after applying it, don't force it. Just ask a doctor to confirm the type of pain you have and then choose a care method. Oh, by the way, there is a little misunderstanding that needs to be mentioned. If the chronic pain that was originally stable suddenly worsens, it is not in the remission period. Don’t apply heat immediately. The more serious thing is to first check whether there are new strains, joint dislocations and other problems.