Can heat compress be used during the remission period of chronic pain? Why?

Hot compresses can be used during the remission period of most chronic pain, but there are a few special cases where it is not suitable. The core depends on the trigger of your pain.

Last week I just met a young man who works as an Internet operator in the outpatient clinic. He has been suffering from myofasciitis in his lower back for half a year. In the acute stage, he was in so much pain that he could not stand up. After taking medicine to control it and enter the remission stage, his waist is still as stiff as a splint, and it becomes tight after sitting for two hours. I asked him to apply a warm water bag at about 45 degrees Celsius on his waist for 15 minutes every day when he got home from get off work. Don’t put it too close to the skin, just put a layer of cotton T-shirt over it. I came for a follow-up visit last week and he said that the stiffness was 80% gone, and the soreness and swelling that he had suffered from sitting for a long time rarely appeared.

In fact, the principle is not complicated. The little heat of warm compress is equivalent to "loosening" the local tense blood vessels and muscle fascia. The blood vessels dilate and the blood flow rate increases. The inflammatory metabolic wastes, lactic acid and other small pain-causing things that are usually piled up in the soft tissues can be metabolized faster with the blood circulation. The muscle fascia that has been tight for a long time can slowly relax like a dry towel soaked in warm water, and the discomfort of stiffness and tightness will naturally be relieved.

But this cannot be said with absolute certainty. In clinical practice, we have indeed encountered many patients whose pain worsened the more they applied it. Last month, an old man suffered from post-herpetic neuralgia. He heard from his neighbor that hot compresses can relieve pain, so he put the baby warmer on the painful area between his ribs at home. As a result, the pain kept him awake all night. When he came in, he lifted his clothes and the area where he put the baby warmer was red. In this kind of neuropathic chronic pain, the damaged nerves themselves are extremely sensitive. Warmth that others find comfortable is excessive stimulation to them, which will in turn aggravate the pain. There is also the remission period of gout. If the uric acid level has not been controlled stably, rashly applying heat to expand the blood vessels may increase the local inflammatory exudation and make the pain worse. ； If the local skin is ulcerated, or the joints are still swollen just a few days after the acute phase of rheumatoid arthritis has been relieved, it is not recommended to use hot compresses casually.

Of course, even if it is suitable for hot compress, you cannot apply it blindly. I met an aunt before who thought the hot water bottle was not warm enough, so she put a plugged-in moxibustion bag on her waist. She fell asleep while lying down, and woke up with a blister on her waist. Originally it was just a soreness in her waist, but it took almost half a month to heal. Generally, it is enough to control the temperature of hot compress at 40-50 degrees. Apply it over a layer of thin clothes for 10-15 minutes each time. Don't be too long and don't be too hot.

In fact, you can try it at home. If you have ordinary chronic pain such as sedentary back pain, cold legs, shoulder and neck strain, and the area is not red or swollen during the remission period, and the temperature is not high when touched, and you feel comfortable all over after applying it, then you can rest assured that there is nothing wrong with it. If you feel bloated and painful after applying it, don't bear it. Ask a doctor first to ask whether it is suitable for your situation. It is always right.