Another Blog Article by David E. Smalley, M.D.
This article is on a principle of general interest that is covered much more in depth in the book, The Miracle of Pain. The content is educational and should not be used as medical advice.
The original photos below emphasize the wonders of nature around us, which reflect the miracles within us.
May 15, 2019 -- Is heat good for pain?
Heat is one of many good tools that can be used for pain in the right circumstances. If misused, it can be harmful. For example, if used the same day as an ankle injury, or even the next day, heat can increase the bleeding for a sprain or a fracture. If we spend too long in a hot tub, we can damage muscles with heat or cause more swelling if the injured part is below the level of the heart.
A few years ago, a patient came to me with shoulder pain that had been persisting for several months. There was no injury, but there was pain with resting and pain with using the shoulder. They were frustrated with their lack of progress, but they told me that the heating pad they were using was the only thing that gave them temporary relief. When I looked at the shoulder, it had a large square area of increased skin pigmentation, compared to the surrounding skin away from the shoulder.
They had damaged their skin with overuse of the heating pad. They explained that they did not know what else to do for the pain. We need to find several tools that work for our pain. If we only rely on one tool to help our pain, we will overuse it, and it will become a counterproductive tool. This is true for any good tool, but it is also true for marginal tools.
More than two days after a sprain injury, a heating pad is a good tool if used for 15 to 30 minutes at a time. It can be used for short amounts often. If used to warm up wisely before easy position changes and gentle movement, it can help neck, shoulder, knee or back pain attributable to muscle tightness that is not getting better on its own. If pain persists, seek help from a competent medical doctor.