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Leaflet: The Use of Heat and Cold

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The Use of Heat and Cold

Both heat and cold can be used to relieve pain and in some circumstances help to reduce swelling. This leaflet aims to help you decide whether to try heat or cold and teach you how they can be
applied safely.

Take care both heat and cold can burn!

Do not use heat or cold:

  • If you have poor circulation and are prone to ulcers.
  • If you suffer from Raynauds Disease or vasculitis.
  • If the area to be treated has reduced sensation or feels numb.


  • Do not use cold over the left shoulder if you have a heart problem.
  • Cold can aggravate nerve pain.
  • Do not use heat over hot, swollen joints.
  • Do not fall asleep whilst using heat or cold.


When to use heat

  • When pain is widespread, as larger areas can be treated with a bath or shower.
  • When joints or muscles are stiff or aching.
  • Can be used before exercising in order to relax muscles.

How does heat help?

  • Reduces pain by making the nerve endings less sensitive and reducing muscle spasm.
  • Can increase joint movement by reducing muscle spasm.

How to use heat

  • Wrap hot water bottle, gel or wheat pack in 2-3 layers of towel (electric pads are already covered but you may want to use a towel as well).
  • Position yourself comfortably and ensure the area to be treated is supported.
  • Mould the heat pad around the affected area and leave in place for 20 to 30 minutes.
  • Check the skin after a few minutes to ensure the skin is not burning (it is normal for the skin to turn pink but should not be bright red or mottled).

Methods of using heat

Hot water bottle

This is a relatively cheap and easy way to use heat. The hot water bottle should only be half filled so that it can be moulded to the area to be treated.

Gel packs

These can usually be heated in the microwave or in a saucepan of boiling water. Ensure you have read instructions fully before use.Available from large chemists.

Wheat packs

Similar to gel packs and are heated in the microwave. Available from some health food shops.

Electric pads

These vary in size from a small pad to a whole blanket. Convenient and easy to use.

Heat lamp

No more effective than other forms of heat but bulky and can be cumbersome to use.


When to use cold

  • When pain is restricted to a small area e.g. one joint to be treated at a time.
  • When a joint is hot and swollen.
  • Recent rather than long-standing, aching pain.
  • After excess exercise.

How does cold help?

  • Reduces pain by numbing the area and stimulating the body’s natural painkillers.
  • Reduces swelling by increasing the circulation.

How to use frozen peas or gel packs

  • Wrap peas or gel pack in a damp towel to make a cold pack.
  • Position yourself comfortably and ensure the area to be treated is supported.
  • Mould the cold pack around the affected area.
  • Check the skin after a few minutes to ensure the skin is not burning. (It is normal for the skin to go pink but should not look mottled).
  • Leave the cold pack in place for 20 to 30 minutes.
  • Place peas or gel pack back in the freezer for next time.

Methods of using cold

Bag of frozen peas

This is the cheapest and usually most convenient way to use cold as it moulds well around the area to be treated. Boiled rice can be frozen for smaller areas to be treated, such as finger joints.

Gel packs

These are just as effective as frozen peas but more hardwearing, therefore may be worth investing in for longer term use. N.B. Some gel packs can be used for heat and cold – check instructions.

Ice cube massage

A single ice cube can be held in a cloth or piece of kitchen towel and circled over a small area such as a finger joint for 5 to 10 minutes.

Cold soak with a bowl or flannel

This will not be as effective as the above methods but may be useful when away from home or when time is limited.

Cooling sprays

Cooling is very rapid but does not last very long. Always follow instructions on the can.


  • Clearly label the bag of peas as they should not be eaten after being defrosted and refrozen.
  • Heat and cold can be used up to twice an hour if you are benefitting from it.
  • If you are unsure about whether or how to use heat or cold, consult your physiotherapist or doctor.



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