How to Correctly Use “Cold and Hot Compresses” for Bone and Joint Diseases

This is the 3842nd article of Da Yi Xiao Hu

Patients often ask questions about "cold compress or hot compress" in the orthopedic outpatient and emergency department. "Doctor, should I use cold compress or hot compress? How long should I use cold compress? When can I start using hot compress?" Today, we will answer in detail some common questions about "cold compress or hot compress" for bone and joint diseases.

Let’s first talk about sprains or fractures of our bones and joints. I believe everyone knows this situation. Bones and joints will become congested and edematous after acute injuries. According to the simplest principle of "thermal expansion and cold contraction", we must definitely apply cold compresses first.

How long does the cold compress need to last? Does it only take 24 hours? What are the methods and frequency of cold compress? Many people don’t know the details.

Generally, the peak swelling of bone and joint injuries occurs within 24-48 hours after injury, so we recommend cold compresses within 48 hours to eliminate swelling more thoroughly. The cold compress method is mainly ice cubes or ice water, and a towel or cloth is wrapped outside to prevent frostbite of soft tissue.

Cold compress usually lasts for half an hour at a time, and then it should be applied again after a period of time. This cycle should be repeated, but it does not need to be applied too frequently, generally 4 to 5 times a day.

Of course, we must also follow our classic RICE principle, namely rest (Rest), cold compress (Ice), pressure bandage (Compression), and elevation of the affected limb (Elevation).

After 48 hours of this method, except for particularly serious injuries, the swelling can be completely eliminated and hot compress can be started. The purpose of hot compress is to effectively promote local blood circulation, strengthen the supply of local oxygen and nutrients, eliminate local inflammatory pathogens, speed up the discharge of harmful metabolites, and speed up the recovery of damaged tissues.

There are many ways to apply heat. Simple ones include hot towels, hot water bottles, and Chinese medicine hot compress packs. More complex ones include moxibustion, infrared irradiation, Chinese medicine fumigation, acupoint application, etc., all of which can play a good role. Similarly, the frequency does not need to be too frequent, generally about half an hour at a time, 3-4 times a day.

Next, let’s talk about osteoarthritis. Infectious inflammation such as soft tissue infection or gout has obvious symptoms such as redness, swelling, heat and pain. In this case, hot compress cannot be applied. Only cold compress can be used to reduce swelling and alleviate local inflammatory response.

Aseptic inflammation such as osteoarthritis, frozen shoulder, tendonitis, etc. often does not cause obvious fever and redness. In this case, hot compresses can be used to promote local blood circulation, enhance local oxygen and nutrient supply, eliminate local inflammatory pathogens, accelerate the excretion of harmful metabolites, and reduce aseptic inflammatory reactions.

The above are some professional answers to the questions about "cold compress and hot compress" for bones and joints. I hope you can benefit from reading them carefully, and no longer be at a loss or panic when encountering these situations.

Author: Ju Yufeng, Shanghai Seventh People's Hospital