Heat Or Cold For Hand Pain

Chapters

• 0:00 Meet Carl And Today’s Focus
• 0:17 Inflammation Basics Explained
• 1:49 Morning Heat For Stiff Joints
• 3:14 Midday Cold To Shrink Swelling
• 5:06 Practical Cold Options And Limits
• 6:21 Weather Exceptions And Heat Limits
• 7:34 The Heat Trap And How To Avoid It

Transcript

SPEAKER_00: 0:01

Welcome back to the Hand to Shoulder Solution where pain meets its match. I'm your host, Carl Petito. I'm an occupational therapist and a board certified hand therapist. I specialize in rehabilitating orthopedic conditions that affect the fingertips through the shoulder. I want to talk about heat versus cold. There's a very clear, uh, understandable mechanical reasoning to why and when to use the appropriate technique. And you know, I'm a realist, it should be very, it should be practical, it should be easy to quick and easy to do. So what I would like to do is explain the basic understanding of when and how to best use heat and cold and why. So let's talk about inflammation. So let's say something is painful, it's red, hot, and swollen, it's inflamed and irritated. And in general, when you put heat on that, heat expands. So heat will increase the pain, the inflammation, the redness, the irritation. But when is inflammation at its lowest point? It's at its lowest point first thing in the morning. Why is that? Because we're sleeping all night, so all night you're sleeping and it's resting. So if anything, stiffness is going to be a little greater in the morning, but your inflammation will be down. So resist the urge to get up in the morning and just force it to start moving. Let's take the example of arthritis and the wrist and hand. So itis means inflammation, arthral means joint. So arthritis, inflammation of the joints, pain, stiffness. So in the morning, it's been resting all evening, it's going to be more stiff. So resist the urge to force it to get moving and just try to get it going. Let it wake up naturally. If you enjoy a cup of coffee in the morning or as you're waking up and you're relaxing for a moment, what I like is an electric heating pad that has a thermostat. So you can adjust it. It should be on the lowest setting, wrapped around your affected joints for 10 to 15 minutes, maximum 15 minutes. And that will open up the blood vessels. Why is blood so important? Blood is important because it carries oxygen and nutrients. That's going to make the joints, make all the tissues healthier, and it's going to literally loosen the tissues so you can start moving easier. Then as you go about your day and your activities, it'll loosen up even more. Then as you're doing your work and your hobbies and using your hand, uh the inflammation will start to increase. So as the inflammation increases, you want to shrink it down. So what shrinks? Cold shrinks. So studies have shown that what's better than an ice bag for 10 minutes is cold running water. You just stick your wrist and hand under the cold running faucet or your elbow, whatever, whatever you and your hand therapist talk about. But let's go back to the wrist and hand. So lunchtime, I'll have people's or every break at their work just stick the wrist and hand under cold running water only until it's deeply cold, which typically takes 10 to 20 seconds. And doing that for 10 to 20 seconds is more effective than an ice pack or cold pack for 10 minutes. It's pretty rare in life that something easier and quicker is better. So we can take advantage of that. Another option is to have a vessel of water, just old Tupperware or an old water pitcher or something right in the refrigerator, take it out and stick your wrist and hand in it. I tell my patients to go right up to this bone right here. Beyond that, we start getting into muscle. You don't want to put cold on the muscles because that'll strengthen them up and tighten them and start causing trigger points or knots in the muscle. But going to that, you get all of the 15 bones of the wrist, the 24 contact surfaces, all the 24 ligaments that connect it all together. You can go right to the fingertips. Very, very effective. Also, other you know, another good idea is every time you wash your hands and with cold running water, and that just knocks down that that inflammation. Now, there's exceptions to every rule. In the winter, I live in the north, and it's you know, it gets 20, 30 degrees below zero Fahrenheit with a wind chill 40 degrees below zero Fahrenheit. So listen to your body. If it's a cold day and it's just kind of, you know, especially a you know, a cold rainy day, and it's just and and and you think to yourself, Carl's crazy, I'm not gonna put my wrist and hand under cold running water. Okay, then that that's fine. On days like that, you can get away with using the heating pad around your wrist and hand or around your elbow, whatever, whatever it may be, for 10 to 15 minutes, two to three times per day. So, in general, you can do this the low heat on those days like that, up to three times per day. Usually doing it more than three times per day causes an expansion of the inflammation and the pain. Now, here's the trap. The trap is, and I explained this to all my patients, the trap is the heat will feel great on 100% of the time. So when it's on your body, it just feels wonderful, soothing, great. And then they take it off, and the after effect is now ramped up inflammation. And then what do you naturally remember? It felt great when the heat was on, let's put the heat back on. And then I I have people come into the clinic, they've been living in the heating pad. And when they're not in the heating pad, they're wrapped in an electric blanket. Systemically, they just have a ramped up inflammation. And I talked them into just trying it. Try it for a day or two of decreasing the heat. Let's maybe zap that with some cold, and they and then they come back for a follow-up visit, and they're just amazed at how effective it is. So don't get pulled into that trap. So, in general, let's recap. In general, low heat first thing in the morning, 10 to 15 minutes, low steady heating pad. Well, what about the the the rice thing? I hit in the microwave. It starts out too hot, it starts cooling down right away. You want a low steady temperature with the thermostat for 10 to 15 minutes. Give it 15 minutes in the morning. Now during the day, you're aggravate using it, aggravating it, increasing inflammation. Let's shrink that down with cold, cold rain water, or cold water dips out of the out of the refrigerator. That works wonders. Then the exception is if it's a terrible cold day and it's a cold rainy day, uh, and you just feel averse to using any cold, you can use the heat two to three times per day. Now, there's other conditions, and and this is one of the many reasons why that this is not treatment or treatment advice. This is general information. So you can make best decisions for yourself and find a healthcare professional. There's many different conditions that require different methods and different locations and different timing, and maybe even some stretching while in the heat. There's it's many, many variables. It is most things, as we know, are not as simple as they seem, and this is certainly one of them. But these are some general rules of practice. I want to say thank you for liking, thank you for subscribing, and thank you for sharing this channel with people who you know are having some pain anywhere from their fingertips throughout the shoulder. We use these every day, all day for everything. And it's very important to have knowledge and how to get rid of your pain. At the hand to shoulder solution, we are the solution to your pain.