Trading Heat Therapy for Pain Medicine

Using heat therapy for pain conditions is a safe, effective non-drug option.

Non-pharmacological treatments for musculoskeletal disorders are becoming more and more popular in light of the CDC’s guidelines for opioid prescriptions. Now more than ever, healthcare providers are turning to alternatives like heat therapy for pain control.

Using Heat Therapy for Pain Management

Opioids are commonly prescribed by physicians to treat chronic pain; however, use of these drugs has serious risks including opioid drug disorder. Therefore, the CDC is bringing awareness among healthcare professionals and the general public regarding non-pharmacological measures available to treat chronic pain. Heat therapy (also called thermotherapy) is an option that has been proven effective in the treatment of acute and chronic pain, stiffness, as well as inflammation. Heat therapy is utilized in a variety of forms:

• Hot packs
• Sand packs
• Electric heating pads
• Hot bath/whirlpool baths
• Paraffin baths
• Heat wraps
• Hot patches
• Saunas
• Lamps

Heat can also be compounded with other treatments such as ultrasound, electrical stimulation, and interferential current. A licensed therapist is capable to use these modalities as a treatment intervention.

Heat therapy aids in the treatment of:

• Muscle or ligament sprains/strains
• Arthritis (OA/RA)
• Post-surgical pain

• Acute and chronic pain conditions
• Inflammation
• Muscle spasm
• Joint stiffness
• Edema
• Stress

Heat does heat therapy for pain relief work?

Heat therapy improves muscle flexibility, increases the range of motion of joints, and provides local relaxation. But, how exactly does it work? Although the type of heat therapy makes a difference (heating pad, whirlpool, etc.), the basic premise is that heat therapy increases the blood supply to the specific area of application. The increase in blood circulation is brought about by changing the temperature at a cellular level. Even a minor change of temperature (5 degrees C) can bring some significant changes in physiological functions (i.e. nerve conduction). This improves tissue healing, removes inflammatory irritants, and ultimately, reduces the pain.

How long do the therapeutic effects last?

The analgesic effects from heat therapy are temporary. The results do not last for more than a few minutes to several hours. If the purpose of the heat therapy is to reduce pain and improve muscle flexibility, range of motion or mobilization should be performed immediately after the application.

Heat Therapy Settings

The settings will differ based on the type of heat therapy as well as the manufacturer.

• Hot packs are usually kept between 70 to 80 degrees Celsius. They are applied for approximately 20 to 30 minutes. After the application, a skin check of the area is performed for safety.
• Whirlpool baths maintain a similar temperature to hot packs.
• Readily available heat patches, wraps, or electric heating pads have automatic settings, but allow the user the control to adjust the heat to the desired temperature. Heat tolerance is different for each person. Older adults, children, and females usually feel heat at lower temperatures compared to adult males or those who are heavy built.

Contraindications to Heat Therapy

Therapists should avoid the use of heat therapy in patients with the following conditions:

• Open wound or active bleeding
• Cancer
• Metal implantation
• Active infection (i.e. cellulitis)
• Pacemaker
• DVT
• Sensory changes
• Circulatory problems
• Pregnancy
• Cardiac insufficiency
• Impaired cognition