Warm and cold fun

Head hurts – we apply a cool compress. Stomach hurts – we put a warm hot water bottle. The XNUMXth century methods really work. The modest arsenal of measures in this case is an advantage, not a disadvantage.

When we bruise ourselves as a result of an impact, we instinctively reach for the ice. When we complain of abdominal pain, we automatically reach for the hot water bottle. If we have a cold, the first thing we think about is warming tea with raspberry juice and a warm duvet. On the other hand, when the body temperature rises significantly as a result of an illness, we use a cool bath to cool it down. Examples could be multiplied for a long time. It is true that many ailments are treated intuitively with heat or cold. And it is with great success.

Thermotherapy, as this form of treatment should be generally defined, consists in providing or – on the contrary – receiving thermal energy from the body. In the first case, it is about thermotherapy, in the second – about cold therapy, more and more often referred to as cryotherapy. There are many methods of therapeutic energy transfer from tissues. They differ not only in the way it is taken or delivered, but also in the intensity at the place of application, the time of action, and the response from the organism.

Leather like an antenna


Our skin plays an extremely important role in heat and cold therapy, as it receives and processes the energy that affects it. Therefore, it acts as an antenna for the central nervous system, which receives information about all changes in the external environment.

How does this happen? There are receptors in the skin that are receivers of a specific form of energy. Under its influence, they are stimulated. Thanks to the centripetal nerves, this information is transmitted to the central nervous system, and then, via the centrifugal nerves, impulses are sent to the executive organs, or effectors (muscles, glands). The stimulation of skin receptors may cause a reflex reaction not only in the skin, but also in internal organs as a result of skin-visceral reflexes.

By acting with heat


Thermotherapy is the transfer of heat from bodies that are heated to overheat the body locally or generally (we laymen would say “heating”, but specialists use the term “overheating”). As the tissue temperature increases, blood and lymph vessels in them expand, which increases blood flow. The primary purpose of heat is to relieve pain and reduce surface tension. However, it should be remembered that thermal stimuli exceeding the tolerance limits may damage the skin and cause burns. When the treatments are applied on a large area of ​​the body (for a sufficiently long period of time), the effect of heat will be stronger as the amount of energy absorbed is greater. Then a general reaction develops, characterized by an increase in body temperature. But here too, beware – excessive overall overheating can be dangerous. It activates the thermoregulation mechanism related to sweat production, i.e. the excretion of large amounts of water, sodium chloride and other minerals, which can lead to dehydration. The simplest procedures performed at home are the use of hot water bottles, electric pillows or bags with hot sand. The heat from them penetrates into the body quite shallow, thus not giving too much overheating effects. In physiotherapy offices, gel therapy, paraffin, warm peloids, sauna or warm hydrotherapy (baths, wraps, wraps) are used, but also infrared radiation, ultra sounds and high-frequency electric field. Unfortunately, the list of contraindications to the use of thermotherapy is long. It is not recommended for in arterial hypertension, circulatory failure, after a heart attack, in atherosclerotic hardening of the arteries, diseases of the central nervous system, diabetes, hyperthyroidism or cancer.

When we cool down


Therapy with cold, on the other hand, consists in lowering the temperature of tissues locally or cooling down the body in general. Gentle methods use the temperature from neutral to the body to + 15 ° C (baths). Intensive, on the other hand, already use temperatures much lower – from 0 ° C to –130 ° C. The duration of the procedure is also important. The entire mechanism of action depends on these two variables. In the case of short-term therapy, vasoconstriction occurs initially, and after its completion – diastole. On the other hand, prolonged exposure to cold causes a permanent cooling of the tissues combined with a slower metabolism and blood flow and a reduction in the excitability of nerve fibers. The effect is a reduction in pain and swelling (short duration of action) and inhibition of inflammation (longer duration of action). The simplest method of applying cold is to use ice – massaging it, rubbing it, making compresses and using cold hydrotherapy. You can also use cooling sprays. In physiotherapy, easily evaporating liquid substances, cold dressings and peloids, cryogel, cooling gas (nitrogen) and cold air (including systemic cryotherapy) and thermoelectric cooling are used. Low temperature is also used in surgery for the controlled destruction of pathologically changed tissues. Since freezing them causes the blockage of nerve endings, these treatments are painless and generally bloodless. Cold treatment is not for everyone. It should not be used in inflammatory conditions, in chronic diseases, hypersensitivity to cold, inflammation of the urinary bladder and renal pelvis, vasculitis, severe heart diseases, frostbite and states of exhaustion.

When choosing the type of therapy and its dosage, the nature of the disease, the general condition of the patient and any comorbidities should be taken into account.

Specialists advise


For fever and colds

Bow. med. Mariola Malicka, specialist in internal diseases, Damian Medical Center in Warsaw:

– The increase in temperature shows the fight against the disease. It is a physiological defensive reflex of the body, although not always well tolerated. The rule is: If a patient is tolerating a fever well and has never had a tendency to febrile seizures before, then there is no need to kill it. However, if the fever persists for a long time or exceeds 38,5 ° C, it must be reduced by administering an antipyretic drug. You can also apply cold compresses to the calves and forehead, or bathe the patient in water 1-1,5 ° C lower than his body temperature. There is still Grandma’s way – linden tea with raspberry juice that has a diaphoretic effect. In the case of colds, it is recommended to act with heat – warming up in bed, drinking hot drinks, e.g. herbal teas, which are diaphoretic. This is to prevent dehydration of the body, which interferes with the functioning of the thermoregulatory center, and to allow perspiration and hence heat dissipation. Sweat evaporates from the skin and reduces the temperature.

For frostbite and cold


Medicine. honey Mariola Malicka:

– Frostbite is local tissue damage caused by the action of cold. Blood circulation is increased to provide as much heat as possible to the chilled parts. The victim must be warmly dressed and wrapped in several blankets. Defrosted areas should be heated, but gradually. You can immerse them in water, but with a maximum temperature of 40-42 ° C. To replenish your energy deficiency, you should drink something very hot and sweet.

For neurological pains


Maria Magdalena Wysocka-Bąkowska, MD, PhD, specialist in neurology and migrenology, ENEL-MED Medical Center, member of the Polish Headache Society and European Headache Federation:

– A headache can have many different causes. With symptoms of a cold, a very warm bath or a hot compress bring great relief. They improve blood supply, circulation, relax muscles, calm down and improve well-being. However, in the case of toothache and its radiation to the head, a cold compress on the painful and swollen area will bring more relief. Local cooling of the tissues helps to reduce blood circulation and swelling, reduces inflammation and secondary pain stimulation, and reduces the area of ​​inflammation. Local heating may be beneficial in the presence of sinusitis. A traumatic bruise or contusion on the head will become less painful and will be better absorbed if you quickly apply a cold ice pack. Strong cooling, and even local “freezing”, is sometimes used to relieve pain and in rehabilitation of cervical headaches related to excessive tension or contracture of muscles in the paraspinal area and near the neck. Cryotherapy is used in the treatment of radicular pains in the lumbosacral spine resulting from degenerative changes. In migraine headaches, patients have been successfully using local head cooling for years: a cold compress or a cool bandage often brings relief. Warming up is avoided in the case of a headache accompanied by a pressure surge, so as not to aggravate hyperemia, but in people with a tendency to constrict blood vessels, bluish limbs, hands and feet, heating and warmth are more beneficial, and cold, on the contrary – can aggravate the symptoms of the disease and pain.

For pains in the digestive system


Prof. Krzysztof Celiński, gastroenterologist, Department and Clinic of Gastroenterology, Medical University of Lublin, expert of the “Zentiva – we change habits” program.

– We must be very careful when treating abdominal pain on our own. The use of heat or cold treatment when we do not know the cause of the pain may be dangerous to your health. Heat has a diastolic effect on blood vessels, increases cellular metabolism, and also increases inflammation. If the cause of the pain is a duodenal or stomach ulcer, warm compresses may accelerate and intensify the bleeding or lead to ulcer hemorrhage. Thermotherapy, i.e. heat treatment, is used in abdominal pain resulting from abdominal vasoconstriction (abdominal angina), in spasmodic conditions of the large intestine, chronic inflammation of the gallbladder and biliary tract, kidney stones, and the syndrome of symptoms related to premenstrual tension. Cold has the opposite effect, leads to vasoconstriction, reduces cellular metabolism, inhibits inflammation and reduces swelling. The use of a cold stimulus has a beneficial effect in acute cholecystitis and biliary tract inflammation and appendicitis. The elimination and reduction of abdominal pain with heat or cold should not be used without medical supervision. Warm or cold compresses can only be part of the therapy prescribed by a specialist, after the exact cause of the pain has been determined.

For toothache


Bow. stom. Agnieszka Sicińska, medical director of CS Eurodental:

– Cold therapy is only applicable to the treatment of inflammation. Cold compresses reduce pressure within the tooth chamber, relieving pain, and also reducing the activity of bacteria. In addition, cold reduces swelling, but only after surgery – reduces bleeding, which reduces the risk of complications. In other cases, there is only a cold calculation of when to go to the dentist in order to suffer as little as possible afterwards.

For leg pain


Bow. med. Anna Senderska, family medicine specialist, ENEL-MED Medical Center:

– Pain in lower limbs (their heaviness, swelling, stretching, pulling, cramps) is associated with impaired venous circulation, it can also be an occasional symptom, e.g. when we are forced to stand for a long time. One of the ways to deal with this ailment at home is to use cold or heat in the form of water baths. A cold shower of calves brings a definite relief, which pumps blood from dilated veins by stimulating the muscles and small vessels to contract. Alternately pouring hot and cold water on the legs also brings very good results – it stimulates the vessels to expand and contract, which in total allows for the reduction of swelling and thus brings significant relief. We know the famous Kneipp hydrotherapy, which also used this method on swollen and sore legs. Lower limb pain can also be caused by inflammation of the joints, ligaments or tendons. Here the situation becomes a bit more complicated, because we use cold in acute pain conditions caused by inflammation, trauma or overload. However, in chronic ailments, heat gives a definite improvement. However, it happens that I advise patients at the beginning of therapy to observe what brings them greater relief – warmth or cold.

For joint pain


Ewa Kazana, MA in rehabilitation, Bielański Hospital in Warsaw:

– Physiotherapeutic treatments using cold have gained immense popularity in the last few years. Undoubtedly, they show a strong analgesic, anti-inflammatory and anti-swelling effect. Thus, they enable rehabilitation. Cold is used in diseases of the musculoskeletal system – bruises, hematomas, soft tissue injuries (immediately after the injury), edema after fractures and sprains in the early period, but also in acute tendinitis, joint capsules and muscles, as well as joint contractures. Cryotherapy is also used in rheumatic diseases, incl. in the exacerbation of rheumatoid arthritis and in acute pain conditions in osteoarthritis.

Source: Let’s live longer

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