Superficial Heat and Cold Periprocedural Care

Updated: Dec 13, 2022
  • Author: Milton J Klein, DO, MBA; Chief Editor: Dean H Hommer, MD  more...
  • Print
Periprocedural Care

Preprocedural Planning

Cold vs heat therapy

Modalities for the application of heat and cold can be used effectively in various clinical conditions. Many situations lend themselves to the use of these modalities to take advantage of known biologic effects for managing certain ailments. [16, 17, 18]

The similarities of these two modalities include the following:

  • There is a decrease in muscle spasm secondary to musculoskeletal pathology or nerve root irritation
  • Cold effectively decreases the spasticity of upper motor neuron etiology; heat reduces spasticity, but the effects are short-lived and ineffective for muscle reeducation
  • Heating and cryotherapeutic modalities cause analgesia

The following are examples of significant differences between the physiologic effects of heat therapy and those of cryotherapy:

  • A longer time is necessary for cooled muscle to return to normal temperature; because the application of heat increases blood flow, a heated muscle returns to normal temperature after a few minutes
  • The application of heat for the relief of muscle spasm is secondary to muscle hyperemia, which decreases muscle spasm–induced ischemia/pain and interrupts this vicious cycle
  • Increased tissue metabolism occurs with temperature elevation; metabolism is reduced by cryotherapeutic modalities
  • Heated muscle tissue can sustain a contraction for a shorter period of time; cooling to approximately 27ºC increases the ability of muscle to sustain contraction
  • Blood flow increases with heat and decreases with cold
  • The tendency to bleed increases with heat and decreases with cold
  • The formation of edema is facilitated by heat and is decreased by cooling
  • Immediate cooling of burns is beneficial; however, frostbite is treated by quick warming
  • Joint stiffness decreases with heating but increases with cooling
  • As a consequence of blood pooling, orthostatic hypotension is produced by the application of heat to large parts or all of the body; with cryotherapy, hypotension is decreased secondary to vasoconstriction