Can hot 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 also a few special cases where it is not suitable. It is impossible to directly give a conclusion of "100% OK" or "Absolutely not possible".

I have met many old patients with lumbar protrusion and cervical spondylosis in the clinic. During the normal remission period, there is no sharp pain, but local stiffness and soreness when sitting for a long time or when the weather changes. When I go home, I take a warm water bag or a warm baby wrapped in a towel and apply it for 20 minutes. When I come back for a follow-up visit next time, they report that the whole body feels relaxed after applying it, and the frequency of attacks is much lower. This is actually easy to understand. Most of the chronic pain remission period does not have the redness, swelling, heat and pain of the acute attack period. Local muscles and fascia are often in a state of tension and stiffness. The warm feeling of hot compress can quickly "knead" the tight soft tissue. It can also speed up local circulation and take away the accumulated metabolic waste faster. It is equivalent to giving the uncomfortable area a gentle spa. As long as the temperature is appropriate, there will be basically no side effects.

However, in the past two years, many colleagues in the pain department have suggested that some patients with neuropathic pain should not use hot compresses casually even during the remission period. An aunt who suffered from post-herpetic neuralgia came for a follow-up consultation before. She said that she only had a slight tingling sensation occasionally. Her neighbor said that hot compresses can nourish the nerves, so she used a baking lamp at home to bake for 40 minutes. That night, the pain kept her awake all night, and she couldn't bear even the clothes rubbing against her skin. This is because the peripheral nerves of these patients have been damaged and their sensitivity to temperature is several times higher than that of ordinary people. Even a temperature that is not hot to the touch may stimulate nerves that have been abnormally discharged, causing acute pain instead of causing more harm than good.

In fact, ordinary patients don’t have to worry too much about whether they can apply it. They can just do a small test at home: take a warm towel with a temperature of about 40 degrees and apply it on the uncomfortable position for three to five minutes. If the stiffness and soreness are relieved after applying it and the whole person feels comfortable, then they can use hot compress as a daily maintenance method. Just control it for 15-20 minutes each time. Don’t be too hot. Every year, many people think that "the hotter, the better" and suffer from low-temperature burns. If you still feel tingling, numbness, or discomfort after applying it, don't apply it hard. Instead, use gentle stretching or gentle massage to achieve better results. In addition, I would like to mention that no matter how comfortable you are with hot compress, if there is a local rash or ulcer, do not use hot compress even during the remission period to avoid infection.