In a previous blog post, I discussed the RICE vs METH approaches to managing injuries (you can read it here). One of the biggest differences between these methods is whether you use ice or heat.
In this post, we’ll focus specifically on heat therapy, and in particular:
In a follow-up post, I’ll cover ice therapy in more detail.
While “heat is heat” might sound simple, not all heat sources are created equal. Choosing the right type of heat can make a noticeable difference to how your body responds.
In this post, we’ll focus specifically on heat therapy, and in particular:
- When it’s helpful
- The different ways to apply it
- How to use it effectively
- When not to use it
In a follow-up post, I’ll cover ice therapy in more detail.
While “heat is heat” might sound simple, not all heat sources are created equal. Choosing the right type of heat can make a noticeable difference to how your body responds.
Why Use Heat
Heat causes vasodilation, meaning it opens up the blood vessels and draws fresh blood to the area being heated washing away toxins etc. This is why the area being heated becomes red, its the blood being drawn to the area.
As the area warms, tissue metabolism also increases. This can help promote relaxation, circulation and healing.
Using heat should be calming, relaxing and reassuring.
It is used primarily to reduce muscular aches and pains and stiffness. Think of discomfort caused by over exertion, poor posture, and general arthritic type pains (not acute flare ups though).
As the area warms, tissue metabolism also increases. This can help promote relaxation, circulation and healing.
Using heat should be calming, relaxing and reassuring.
It is used primarily to reduce muscular aches and pains and stiffness. Think of discomfort caused by over exertion, poor posture, and general arthritic type pains (not acute flare ups though).
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When NOT to use Heat
Heat can be great for lots of aches and pains, but there are some things when heat should NOT be used. Some of more important ones are:
If you have an acute lower back injury, ankles sprain etc, we generally suggest to use Ice for the first 24-48 hours and then you can move to heat if required.
- An infection
- An acute injury with lots of inflammation (For example a sprained ankle, acute arthritis flare up)
- If there is lots of swelling
- If there is lots of bruising
If you have an acute lower back injury, ankles sprain etc, we generally suggest to use Ice for the first 24-48 hours and then you can move to heat if required.
Local Heat vs Systemic Heat
The first decision to make is whether to use local heat or systemic (whole-body) heat.
Local Heat
Local heat is applied directly to a specific area of the body. Examples include:
Systemic Heat
Systemic heat warms the entire body. Examples include:
Which is better?
Neither is inherently “better”, it really depends on your goal. A good rule to follow would be:
Local Heat
Local heat is applied directly to a specific area of the body. Examples include:
- Hot water bottles
- Wheat bags
- Heat packs or gels
Systemic Heat
Systemic heat warms the entire body. Examples include:
- Hot baths
- Spa pools
- Hot showers
- Saunas
Which is better?
Neither is inherently “better”, it really depends on your goal. A good rule to follow would be:
- Targeted pain = local heat
- Whole-body stiffness = systemic heat.
Moist Heat vs Dry Heat
The next consideration is whether to use moist heat or dry heat.
Dry Heat
Dry heat sources include:
Moist Heat
Moist heat sources include:
Moist heat is generally preferred because it:
Related: Lower back pain relief: Try these 4 simple moves
Dry Heat
Dry heat sources include:
- Electric heat pads
- Infrared heat lamps
Moist Heat
Moist heat sources include:
- Wheat bags
- Hot water bottles
- Steam towels
- Hot baths
Moist heat is generally preferred because it:
- Penetrates tissues more quickly
- Is less dehydrating to the skin
- Often requires less application time
Related: Lower back pain relief: Try these 4 simple moves
Do 'Heat' Creams (like Deep Heat) Actually Work?
Heat creams often feel warm, but they don’t significantly increase tissue temperature.
These products contain chemicals like rubefacients, that irritate the skin slightly and increase blood flow to the surface. Capsaicin (from chilli peppers) is a common example of a rubefacient.
Research suggests that while these creams may create a warming sensation, they do not raise deeper tissue temperature or produce true physiological heating effects.
So why do they help some people?
They likely work as a neurological distraction, temporarily shifting attention away from pain rather than treating the underlying issue. They have also been called a "counter irritant", where the irritation from the cream masks the other pain you have been feeling.
Heat creams can still be useful though, especially when other heat sources aren’t practical, but they shouldn’t be relied on as the primary form of heat therapy.
These products contain chemicals like rubefacients, that irritate the skin slightly and increase blood flow to the surface. Capsaicin (from chilli peppers) is a common example of a rubefacient.
Research suggests that while these creams may create a warming sensation, they do not raise deeper tissue temperature or produce true physiological heating effects.
So why do they help some people?
They likely work as a neurological distraction, temporarily shifting attention away from pain rather than treating the underlying issue. They have also been called a "counter irritant", where the irritation from the cream masks the other pain you have been feeling.
Heat creams can still be useful though, especially when other heat sources aren’t practical, but they shouldn’t be relied on as the primary form of heat therapy.
How Deep Does Heat Therapy Actually Work?
Our bodies are very good at maintaining a stable internal temperature, which means external heat doesn’t dramatically change deep tissue temperature. That said, even small changes matter.
A study from 1998 looked at heating subjects Triceps muscles with hot packs for 15 minutes. They found an average increase of 3.8 degree Celsius at a depth of 1cm and 0.78 degree Celsius at 3cm.
It is also thought that moist heat penetrates deeper than dry heat as the heat is transferred more efficiently.
A study from 1998 looked at heating subjects Triceps muscles with hot packs for 15 minutes. They found an average increase of 3.8 degree Celsius at a depth of 1cm and 0.78 degree Celsius at 3cm.
It is also thought that moist heat penetrates deeper than dry heat as the heat is transferred more efficiently.
Best Practices for Using Heat Therapy
There’s no single “right” way to use heat, the best approach depends on your body, your symptoms, and your goals.
That said, here are some general guidelines:
That said, here are some general guidelines:
- Choose the heat source that fits your situation
Local heat for targeted pain; systemic heat for general stiffness. - Moist heat is usually preferable
Wheat bags and hot water bottles tend to be more effective than dry heat. - Apply heat in short, controlled bursts
Around 15–20 minutes at a time, followed by a break (30–40 minutes) before reapplying. From a physiological point of view, doing a few short bursts will be more effective than simply leaving the heat source on for an hour or so. - Use creams when other options aren’t practical
They’re useful when you’re heading to work or exercising and can’t apply traditional heat. Even if the creams may work as a form of 'distraction', if it feels like it helps, it helps. This can get into the murky waters of Placebo effects. I will save this for another blog post. - Always listen to your body
Heat should feel soothing, not irritating or painful.
When to Seek Professional Advice
Heat therapy can be a helpful tool, but it’s not a cure-all. If pain persists, worsens, or keeps returning, it’s important to have the area assessed by a qualified health professional.
Addressing the underlying cause of pain, not just the symptoms, is key to long-term improvement.
Addressing the underlying cause of pain, not just the symptoms, is key to long-term improvement.
Final Thoughts on Heat
Heat therapy can be a simple, effective way to reduce muscle tension, improve circulation, and ease discomfort ..... when used correctly.
Experiment with the different approaches outlined above and see what works best for you. And remember, if symptoms persist, getting professional guidance is always a wise next step.
If you have any questions about your injury or whether to use heat or ice, contact us here. Alternatively if you would like an assessment, you can book online here.
Experiment with the different approaches outlined above and see what works best for you. And remember, if symptoms persist, getting professional guidance is always a wise next step.
If you have any questions about your injury or whether to use heat or ice, contact us here. Alternatively if you would like an assessment, you can book online here.
References
- Painscience.com. Heat for pain and rehab. https://www.painscience.com/articles/heating.php
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