Can heat compress be used during the remission period of chronic pain? Why?

Most of the chronic pain relief period can be treated with hot compress, but there are also cases where it is not suitable and cannot be generalized.

I have been in the rehabilitation department for almost six years and have met many patients who ask this question. Last month, I saw a sister who had been suffering from chronic lumbar muscle strain for three years. During the normal remission period, her waist was stiff and sore, especially after sitting for a long time. I had always heard people say that hot compresses were an "IQ tax". Last time I came for a review, I asked her to try using a hot water bottle wrapped in a thin towel for 15 minutes every day. Last week, I came for a review and said that the stiffness in the morning that had troubled her for a long time has basically disappeared, and the soreness and swelling after sitting for a long time have been reduced by most.

In fact, the principle is not difficult to understand. In the remission period of chronic pain, there is generally no redness, swelling, heat and pain as in the acute attack period. Most of the local muscles and fascia are in a state of tension and spasm, and a lot of inflammatory metabolic waste is accumulated in the local area and cannot be discharged. Hot compresses are like warming frozen plasticine or delivering hot water to a blocked water pipe. After local blood vessels are expanded, the blood flow speed increases, the accumulated metabolic waste can be taken away with the circulation, and the tight soft tissues will slowly relax. The discomfort of soreness and stiffness will naturally be relieved a lot.

However, it is true that not everyone is effective after applying it, and some even get worse the more you apply it. There was an old man who suffered from post-herpetic neuralgia. The pain lasted for almost eight months. He heard from his neighbor that hot compresses were helpful, so he used a hot towel to apply it to the painful area when he got home. As a result, the pain kept him awake all night, and he grinned from the pain when he came to the doctor. His type of chronic pain is neuropathic. The damaged nerves themselves are in an extremely sensitive state. A slight temperature stimulus will induce abnormal discharges. The original intention is to relieve the discomfort, but instead it adds additional stimulation to the damaged nerves. There are also patients with diabetic peripheral neuropathy whose ability to perceive temperature has declined. Sometimes they feel that the temperature is just right when they touch it, but in fact it is already so high that it will burn their skin. It is not recommended to apply heat on your own.

As for how to judge whether you can apply it, you don’t have to worry too much. If your pain during the remission period is mainly soreness and stiffness, and the painful area feels cool to the touch, without any signs of redness, swelling or heat, and you feel comfortable after applying it, then you can keep applying it. The temperature should be controlled at about 40 degrees. Don’t put the hot water bottle or patch directly on the skin. Apply it for 10 to 20 minutes each time. If you fall asleep and forget to remove it, it is easy to suffer from low-temperature burns. If your pain is like pinpricks or electric discharges, hurts even with the slightest touch, or you have a problem with decreased sensation. If you are not sure, ask your doctor first. Don’t blindly follow the trend and cause problems.