Hot Foot Therapy Vs Cold Foot Therapy: Which Is Best?
If not treated correctly, injuries to the foot and ankle can progress and become quite debilitating. More than 3-5% of all emergency visits in the hospital setting are attributed to acute ankle sprains(1). This corresponds to roughly 5,000 to 6,000 Emergency Room visits due to ankle sprains per day in the US!
What should you do if you develop an ankle or foot injury?
Fortunately, most cases of ankle and foot injuries are mild to moderate and do not require heroic measures or extensive medical management. Warm or/ and cold therapy is often the best and the only solution needed to manage the discomfort along with rest and relaxation. But is it really a good idea to use cold or heat therapy to manage pain and discomfort instead of over-the-counter analgesics? Most importantly; when to use heat and what are some situations when you should avoid cold therapy?
Warm and Cold Therapy for foot and ankle injuries:
The primary aim of using hot and/ or cold therapy is to alleviate pain symptoms by modulating the local tissue circulation and release of your body’s natural pain-mediators. On the other hand, most pain relieving medications exert their action by temporarily altering the biochemical environment of the tissues.
Hot and cold therapies have several other benefits that you don’t get when using pain relieving medications such as:
- Facilitation of the normal healing and recovery processes;
- Controlling the process of injury or tissue damage;
- Significant reduction in the soft tissue swelling; and,
- Help in restoring normal mobility and flexibility of tissues/ joints.
When to use cold therapy:
Cold therapies work best in case of acute traumas that are associated with bruises or acute swelling. Most cases of acute trauma are associated with extreme pain that is almost always instantaneous. If you suffer from twisted ankle or soft tissue sprain or if you drop something heavy on your ankle or foot, cold therapy can work wonders!
Cold therapy exerts its action by constricting the blood vessels to minimize the bleeding and internal blood loss. Additionally, exposure to colder temperatures also help in numbing the sensory fibers to reduce the sensation of pain and discomfort. Lastly, exposure to cold temperature via ice-packs or cold compresses also helps decrease the irritation and swelling which then aids normal mobility and joint motion.
How to use cold therapy:
Cold therapy can be applied a number of ways, such as an ice wrap, ice-cold water for compresses, ice bags, clay bags, or even bag filled with chilled frozen peas. For best results:
- Apply the cold compress or wrap to the injured/ affected area no more than 5 -10 minutes each time. Take small breaks in between the cold therapy sessions to allow tissue to return to normal room temperature.
- Don’t apply the ice bag directly to the skin, wrap it in a thin towel
- Start the therapy just after the injury and continue at regular intervals for up to 3-5 days.
When to use hot therapy:
Hot or warm therapy works best in the setting of chronic injuries with some degree of residual pain, stiffness and tension. Ideally, injuries that are not associated with bruising are best managed by hot therapy and not cold therapy. Heat therapy exert its action by:
- Improving the tissue circulation to ensure rapid regeneration and healing of inflamed or stiff tissues; and,
- Improvement in the basal metabolism of tissues and facilitation of elasticity of inflamed or stiff joints.
How to use heat therapy:
Heat therapy should be used for chronic aches, tissue or musculoskeletal injuries and different forms of arthritis. Heat therapy prior to highly vigorous and physically demanding activities can reduce the risk of pain and soft tissue swelling. It can be applied via heat pads or hot water bottles or just plain soaking your foot in hot water for 10 to 20 minutes. You can also use towel dipped in hot water, hot shower or even a hot tub to achieve soothing relief from pain and aches.
If your pain is severe or persists or worsens, you should always seek medical attention. Remember, if in doubt, seek medical attention.
- Doherty, C., Delahunt, E., Caulfield, B., Hertel, J., Ryan, J., & Bleakley, C. (2014). The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports medicine, 44(1), 123-140.
Janet D. Pearl, MD, MSc is the Medical Director of The Center for Morton’s Neuroma and Complete Spine and Pain Care, an interventional and integrated Pain Management program located in Framingham, Massachusetts. Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Fellowship program. She is the former Director of a satellite pain center of the Brigham and Women’s Hospital, Pain Management Center, located at the HealthSouth Braintree Rehabilitation Hospital. Dr. Pearl held academic appointments at Harvard Medical School and Tufts Medical School. She serves on the Health Care Services Board of the Commonwealth of Massachusetts Department of Industrial Accidents since 2000 as one of its physician representatives and is Chair of the Committee on Pain Management.