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

Hot compresses can be used during the remission period of most chronic pain, but there are only a few special circumstances that should be avoided.

I have been in the pain department for almost eight years, and I have encountered too many patients struggling with this problem. The one who impressed me the most is Aunt Zhang, an old patient with lumbar disc herniation who came to me for follow-up consultation in the past two years. She has a medical history of more than 3 years. She usually has no pain during the remission period, but her waist will become stiff and heavy after sitting or bending for a long time. She prepares a coarse salt hot compress pack at home, and applies it for 20 minutes every time she feels uncomfortable. After a few minutes, you will feel more relaxed after getting up and turning it around twice. This is actually the underlying logic of hot compresses: warm heat can soften locally tightened muscles and fascia, and at the same time expand blood vessels to speed up circulation. Those metabolic wastes accumulated in local areas that can easily cause soreness and swelling can be metabolized faster with the blood flow, which is equivalent to "loosening the soil" of stiff soft tissues. The comfort is real.

But if you think that you can apply it casually for all chronic pain relief periods, it is easy to get into trouble. Now the industry has different suggestions for some types of chronic pain. For example, for patients with chronic pain related to autoimmunity, such as rheumatoid arthritis and ankylosing spondylitis, if they have just entered the remission period within a week from the acute attack, many doctors do not recommend immediate hot compresses. I have met a rheumatoid patient in his 20s before who had knee pain for almost half a week. The month had just subsided, and I heard someone said that hot compresses can prevent recurrence. I applied a hot water bag for half an hour that night, but my knee swelled again the next day. This is because the core of this kind of pain is aseptic inflammation. When it is first stabilized, hot compresses may increase the activity of local inflammatory factors, which makes it easy to rebound.

There are also several types of situations in which you should not apply blindly even if there is no pain at all. For example, chronic pain caused by diabetic peripheral neuropathy. The patient has poor skin sensitivity and is easily burned even if the temperature is not high. There are also chronic pain areas that happen to have unhealed skin lesions and eczema. Hot compresses can easily aggravate skin problems.

In fact, if ordinary people are not sure whether they can apply it, there is no need to go to the hospital. When you try it for the first time, apply it with a warm towel for 5 minutes. If there is no tingling, itching, or swelling, then extend it to 15-20 minutes. The temperature should be controlled at around 40 degrees. It feels warm to the touch without burning the face. There is no need to go for the redness of the skin, which may easily outweigh the gain.