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 only a few special cases that require caution or even prohibition. When we talk about this in the rehabilitation circle, there is never a one-size-fits-all standard answer.

When I was helping at a community rehabilitation center, I met many old acquaintances who suffered from lumbar protrusion and neck and shoulder strain. Let me just say that 52-year-old Aunt Zhang had a lumbar disc herniation for almost 6 years. During the acute attack, the pain was so painful that she had to put on shoes. At that time, let alone hot compresses, no one would touch her. When she entered the remission period, her waist became stiff and heavy after sitting for half an hour after shopping for groceries every day. She liked to wrap a charged hot water bottle in a thin towel and apply it on her waist. After twenty minutes, she took it off. Her entire waist became much more relaxed, and most of the pulling sensation in her crotch disappeared. This kind of chronic pain caused by long-term strain and muscle tension does not show obvious redness, swelling or heat during the remission period. Hot compress is equivalent to "loosening" the tight muscle fascia. Warm stimulation will accelerate local blood circulation and take away the accumulated inflammatory factors and other pain-causing substances. Muscles that have been stiff for a long time will soften and the uncomfortable feeling will naturally become lighter. Just like hardened dough, it will become much smoother after being warmed for a while and then kneaded.

However, it is not applicable to all situations. Last month, I met a 28-year-old young man with chronic gouty arthritis. He had been suffering from ankle pain for less than half a year. He had just entered the remission period two weeks ago. He was thinking about using hot compresses to activate the blood vessels in his lower joints. However, after applying it for half an hour, his ankles were so swollen that night that he could not even put on shoes. When he went to check, he found that his uric acid had not been controlled, and there were many urate crystals deposited in the joints. In addition, people with diabetic peripheral neuropathy and localized skin hypoesthesia should not apply heat even if they are in the remission period of chronic pain. Such people are not sensitive to temperature and can easily feel the temperature is not high when touched. In fact, the skin may become reddened or even blistered without even realizing it.

In fact, if you are really not sure whether you can apply it, don't worry about it. First adjust the temperature to about 40 to 45 degrees, and apply it for three to five minutes across a thin towel. If you don't feel pain or the heat becomes worse, you can continue to apply it for up to twenty minutes at a time. Don't apply it all day long, otherwise it may cause edema in the local tissue and increase the discomfort. If the pain becomes more obvious after applying it, stop immediately. If you are really unsure, ask a rehabilitation therapist or doctor. It is better than trying blindly on your own.