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

Hot compress can be used in most cases during the remission period of chronic pain, but it is not suitable for all types. It must be judged based on the cause of the pain and the current local condition.

For chronic muscle strain, the remission period of lumbar disc herniation, and the stable period of degenerative knee arthritis, which are the most common pains we usually have, the effect of hot compress is actually very direct - just like heating a blocked small water pipe. Once the blood vessels expand, the local circulation starts, the lactic acid and inflammatory metabolic waste that have accumulated for a long time can be taken away faster, and the tight muscles and tendons will relax accordingly. The discomfort of soreness, stiffness, and heaviness will naturally be relieved. I met an accountant in the recovery room before. She suffered from chronic neck and shoulder strain for almost five years. She used to have pain that made it difficult to lift her arms. After entering the remission period, she used a hot water bag at about 42 degrees to compress her shoulders and neck for 20 minutes every day when she got home from get off work. She occasionally mixed it with gentle massage. The dizziness she often suffered from before was much less. She said it was more practical than the hundreds of massagers she bought before.

But this cannot be said too fully. There are indeed many clinical situations that are not suitable for hot compresses, and not everyone feels comfortable after applying them. For example, for patients with a history of gout, even if they enter the chronic pain remission period, if there are still obvious local urate crystal depositions, blind hot compresses will change the osmotic pressure of the local tissue, making the crystals more likely to dissolve and spread, stimulating surrounding tissues and aggravating inflammation. This was the case for a young man in his 20s. The pain was not much after the gout attack. He thought that applying it would heal quickly, but the next day his feet were so swollen that he couldn't even put on slippers. There are also neuropathic chronic pains such as post-herpetic neuralgia. The damaged nerves themselves are particularly sensitive. The temperature stimulation of hot compresses can easily induce burning and tingling sensations, which are not as comfortable as normal temperature or slightly cool wet compresses. Currently, there are many relevant studies to support this conclusion, which is indeed different from the traditional belief that hot compresses are omnipotent.

If you really want to apply it, you have to pay attention to the method. Don’t be too high. 40-45 degrees is just right. It feels warm to the touch without burning the skin. Applying it for 15-20 minutes each time is enough. Applying it for too long will easily aggravate local edema. If the pain becomes more obvious after application, or the skin becomes red and itchy, stop immediately and don’t force it. If you are not sure, ask the doctor first if the type of pain is suitable for you. It is better than trying blindly.