Heat Therapy

Rating

Category: Life Style Options

Injury Type: Acute

What is it?

Heat therapy involves the application of a heat causing agent to the body. Heat may be applied to the tissues directly by a heat pack or cream, or indirectly by a ray lamp. Tissue heating may also be caused by other forms of electrotherapy, but these are discussed separately.

How does it work?

The application of heat to a tissue such as muscle is thought to increase the blood flow to that area, possibly facilitating the healing process by delivering the required cells and nutrients. Heat may also increase the elasticity/extensibility of connective tissues, thus reducing muscle tightness and/or spasm. The sensation of heat within the tissues may distract the brain from pain sensations that might be coming from the same region (the so-called pain gate theory), thereby providing further pain relief.

Is it effective?

There is no clear evidence on the use of heat therapy in the management of whiplash.

Are there any disadvantages?

Care should always be used when applying heat to the body. It is imperative not to over heat the tissues as this may cause a burn or tissue damage. You should never lie directly on a heat pack, rather the heat pack should be placed on your body. Heat therapy should not be used in the first 48-72 hours after an injury as it can increase the amount of swelling in the area and exacerbate symptoms. People with altered sensation should not use heat therapy, and there are certain other conditions where heat therapy is not advisable. Seek advice from your doctor or treating therapist if unsure.

Where do you get it?

Heat therapy can come in various forms, and there are many different brands. Heat packs, creams and lamps are available via numerous retail outlets such as department stores, medical suppliers, pharmacies/chemists, or over the internet.

Recommendations

Although there is no direct evidence relating to the effectiveness of heat therapy, recent guidelines suggest that it may be used in conjunction with other manual and physical forms of therapy (i.e. multimodal care) in the first three weeks after whiplash injury (but avoided for the first 48-72 hours).

Key References

  • Hurwitz, E, Carragee, E, Van der Velde, G, Carroll, L, Nordin, M, Guzman, J, Peloso, P, Holm, L, Coˆte, P, Hogg-Johnson, S, Cassidy, D & Haldeman, S 2008, 'Treatment of neck pain: noninvasive interventions; results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders', European Spine Journal, vol. 17, no. 1, pp. 123-152.
  • Motor Accidents Authority, 2001, Guidelines for the management of whiplash-associated disorders. MAA, Sydney, Australia
  • Motor Accidents Authority, 2007, Your guide to whiplash recovery in the first 12 weeks after the accident, 2nd ed. MAA, Sydney, Australia.
  • Spitzer, W 1995, Chapter 8.2.2: QTF Recommendations for Clinical Practice, viewed 30 October, 2007, .
  • Verhagen, A, Scholten-Peeters, G, Van Wijngaarden, S, De Bie, R & Bierma-Zeinstra, S 2007, 'Conservative treatments for whiplash', Cochrane Database of Systematic Reviews, Issue 2, Art. No.: CD003338. DOI: 10.1002/14651858.CD003338.pub3.
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