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

There is currently no unified clinical standard answer to this question. Whether it can be applied and whether it is useful after application depends entirely on the cause of your chronic pain and your current local condition. The application varies greatly in different situations.

I have come into contact with many patients with chronic myofasciitis and lumbar muscle strain. When they are in the remission period, there is neither redness nor sharp pain in the local area, but they will become stiff and have a faint sense of soreness after sitting for a long time or catching cold. At this time, proper heat application can basically make them feel better. The principle is simple. Chronic Muscle strains are mostly caused by long-term local tightness and poor circulation. Metabolized inflammatory factors are piled up in the muscles and cannot be discharged. Hot compresses are like thawing hard frozen dough. They can relax spasmodic muscle fibers, expand local blood vessels, speed up circulation, and take out the accumulated metabolic waste. The feeling of soreness, swelling, and stiffness will naturally disappear. The 32-year-old programmer who came to my rehabilitation studio last week is a typical example. He suffered from lumbar muscle strain for almost 3 years. As long as he doesn't sit for a long time, he has almost no pain. However, when he gets up in the morning and gets off work, his waist is as hard as a board. I asked him to wrap a thin towel with a hot water bottle at about 40 degrees Celsius and apply it on his waist for 15 minutes after taking a bath every night. After a week, he came back for a follow-up consultation. He said that the stiffness of his waist was 80% better, and even the pain that he occasionally felt when he stood up no longer recurred.

However, many clinicians do not recommend blindly using hot compresses for all chronic pain relief periods. This is not unreasonable. A 56-year-old aunt with post-herpetic neuralgia came to me before and said that her neighbor said that hot compresses can relieve pain. She used a baby warmer at home for two days, but the pain was so painful that she could not sleep all night. Her type of chronic pain is neuropathic. The nerves themselves have been damaged, and the stimulation of temperature will induce abnormal nerve discharges. Originally, there was only occasional tingling during the remission period, but the hot compress directly aroused the pain. There are also autoimmune chronic pains such as rheumatoid arthritis and ankylosing spondylitis. Even if they are in remission, blind hot compresses may expand local blood vessels and make it easier for immune cells to gather in the joints. This may induce repeated inflammation, which is not worth the gain.

In fact, you can easily judge whether it can be applied at home. As long as the painful area is not hot, red or swollen when you touch it, the pain will feel sore, swollen, and stiff, not pinprick-like or electric discharge-like pain. It will be aggravated by colds, and you will feel comfortable if you rub it. It is basically chronic pain originating from muscle fascia. You can apply it with confidence during the remission period. Be careful not to make the temperature too hot and do not apply it for more than 20 minutes to avoid low-temperature burns. If it feels swollen or the pain is throbbing like pin pricks, it’s best to ask your attending doctor or rehabilitation therapist first. Don’t just try it on your own. After all, the causes of pain vary from person to person, and a method that works for someone else may not work for you.