Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury

  title={Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury},
  author={Gerard A. Malanga and Ning Yan and Jill Stark},
  journal={Postgraduate Medicine},
  pages={57 - 65}
Abstract Nonpharmacological treatment strategies for acute musculoskeletal injury revolve around pain reduction and promotion of healing in order to facilitate a return to normal function and activity. Heat and cold therapy modalities are often used to facilitate this outcome despite prevalent confusion about which modality (heat vs cold) to use and when to use it. Most recommendations for the use of heat and cold therapy are based on empirical experience, with limited evidence to support the… 
Electrical Oxygen-compressed Cold Application Cuff on Pain among Patients with Musculoskeletal Disorders
The scientific basis for thermal-based therapeutic modalities, both alone and in conjunction with soft-tissue massage and compression, will be discussed and the advantages of the effective device for the treatment and prevention of pain among patients with musculoskeletal disorders will be considered.
A Role for Superficial Heat Therapy in the Management of Non-Specific, Mild-to-Moderate Low Back Pain in Current Clinical Practice: A Narrative Review
This review demonstrates that continuous, low-level heat therapy provides pain relief, improves muscular strength, and increases flexibility, and this effective, safe, easy-to-use, and cost-effective non-pharmacological pain relief option is relevant for the management of non-specific mild or moderate low back pain in current clinical practice.
Effect of Oxygen Compressed Cold Application VS Conventional Cold Application Level of Pain among Patients Musculoskeletal Disorders: A Randomized Control Trial
This study proves that the oxygen compressed cold application was found to effective as the conventional cold application in level of pain among patients with musculoskeletal disorders.
The use of contrast therapy in soft tissue injury management and post-exercise recovery: a scoping review
There remains a significant lack of research surrounding the efficacy of contrast therapy for soft tissue injury management and the use of alternative modalities, and the evidence is less clear regarding the influence on physiological measures and performance.
Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials.
  • Yutan Wang, Sijun Li, Yuxia Ma
  • Medicine
    Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine
  • 2021
The Effect of Cold Compress 15 Minutes on Delayed Onset Muscle Soreness
The conclusion of this study is that a cold compress with a duration of 15 minutes has a significant effect on reducing DOMS pain.
Continuous Low Level Heat Wraps; Faster Healing and Pain Relief during Rehabilitation for Back, Knee and Neck Injuries
Continuous heat wraps were used to reduce pain before home exercise programs to see if this would increase compliance and healing during a 2 week therapy intervention.
Modification of therapeutic temperature range in cryotherapy could improve clinical efficacy in tension type headache.
Rather than focusing on lowering the skin temperature indefinitely, optimizing tolerability by targeting the temperature at the upper therapeutic range could be more effective in cold modality application.
Cryotherapy: not as cool as it seems
The novel results supported the hypothesis that following prolonged exercise where glycogen is depleted, muscle warming would increase the rate of muscle recovery and glycogen resynthesis, while muscle cooling would hinder these processes.


The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner.
Clinicians treating patients with musculoskeletal injuries and those with rheumatoid arthritis should be aware of current research findings regarding these modalities, because their choice of modality may affect the ultimate outcome of the patient being treated.
Evaluation and treatment of acute low back pain.
There is good evidence for the effectiveness of acetaminophen, nonsteroidal anti-inflammatory drugs, skeletal muscle relaxants, heat therapy, physical therapy, and advice to stay active, and recommendations for effective treatments.
Heat or cold packs for neck and back strain: a randomized controlled trial of efficacy.
  • G. Garra, A. Singer, H. Thode
  • Medicine
    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
  • 2010
The addition of a 30-minute topical application of a heating pad or cold pack to ibuprofen therapy for the treatment of acute neck or back strain results in a mild yet similar improvement in the pain severity, suggesting it is possible that pain relief is mainly the result of ibup rofen therapy.
Treating acute low back pain with continuous low-level heat wrap therapy and/or exercise: a randomized controlled trial.
  • J. Mayer, L. Ralph, V. Mooney
  • Medicine, Psychology
    The spine journal : official journal of the North American Spine Society
  • 2005
Cryotherapy in sports medicine
Cryotherapy appears to be effective and harmless and few complications or side‐effects after the use of cold therapy are reported, however, prolonged application at very low temperatures should be avoided as this may cause serious side-effects, such as frost‐bite and nerve injuries.
Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis.
Superficial heat or cold for low back pain.
There is moderate evidence in a small number of trials that heat wrap therapy provides a small short-term reduction in pain and disability in a population with a mix of acute and sub-acute low-back pain, and that the addition of exercise further reduces pain and improves function.
Continuous low-level heatwrap therapy for treating acute nonspecific low back pain.
Continuous low-level heatwrap therapy was shown to provide significant therapeutic benefits when compared with placebo during both the treatment and follow-up period of acute, nonspecific LBP.
Impact of Continuous Low Level Heatwrap Therapy in Acute Low Back Pain Patients: Subjective and Objective Measurements
Objective measures (EEG) are obtained that suggest an acute therapeutic relaxation on the basis of the central nervous system effects accompanying the reported significant pain relief in LBP-patients.
The Use of Ice in the Treatment of Acute Soft-Tissue Injury
There was little evidence to suggest that the addition of ice to compression had any significant effect, but this was restricted to treatment of hospital inpatients and there was no evidence of an optimal mode or duration of treatment.