Heat therapy

Overview of Treatment

Heat therapy is a physical treatment method that utilizes thermal energy to improve human body functions, primarily by increasing tissue temperature to promote blood circulation and tissue metabolism. Its core principle involves relaxing muscle fibers, accelerating the metabolism of inflammatory substances, and enhancing cellular repair capabilities. This treatment is commonly applied in managing acute and chronic pain, postoperative recovery, and tissue healing scenarios.

Heat therapy can be divided into traditional hot packs and modern medical devices, with advanced techniques such as electromagnetic wave therapy and infrared therapy capable of precisely controlling temperature and depth of effect. The treatment aims include relieving muscle spasms, reducing tissue adhesions, and enhancing metabolic activity at the treatment site.

Types and Mechanisms of Treatment

Heat therapy mainly involves three modes of action:

• Surface Heating: Such as hot packs or hot stone packs, with temperatures around 40-50°C, primarily affecting the skin and superficial tissues.
• Deep Heating: Using shortwave or microwave technology, capable of penetrating muscles and joint cavities, with temperatures reaching 42-45°C.
• Whole-Body Heating: High-temperature hydrotherapy or thermal air therapy, suitable for systemic circulatory disorders.

The mechanisms of thermal energy include vasodilation of peripheral blood vessels, reduction of nerve conduction velocity, and acceleration of intracellular enzyme activity. Thermal energy can enhance interstitial fluid flow, promote waste metabolism, and suppress the excitability of pain nerves.

Indications

Heat therapy is mainly suitable for the following symptoms:

• Chronic musculoskeletal pain: such as stiffness caused by cervical spondylosis or lumbar disc herniation.
• Postoperative rehabilitation: accelerating tissue healing and reducing adhesions.
• Arthritis and ligament injuries: relieving morning stiffness and limited mobility.

Specific indications include:

• Peripheral circulatory disorders: improving blood supply to extremities.
• Neuropathic pain: such as diabetic peripheral neuropathy.
• Prevention of postoperative adhesions: such as tissue repair after knee arthroscopy.

Application Methods and Dosage

Traditional hot packs are usually applied for 15-20 minutes per session, 1-2 times daily, with temperature controlled below 42°C. Medical-grade deep heating treatments are shorter (5-15 minutes) but should be performed under professional supervision. Treatment intervals should be adjusted based on the condition, with a 6-8 hour gap recommended during acute inflammatory phases.

Controlling dosage is crucial:

• Individuals with sensitive skin should use a barrier cloth.
• Diabetic patients should reduce the temperature to 38°C.
• Whole-body thermal therapy requires monitoring core body temperature to not exceed 39°C.

Benefits and Advantages

Main therapeutic effects include:

• Immediate pain relief.
• Accelerating tissue repair speed by 30-50%.
• Non-pharmacological treatment avoiding addiction risks.

Advantages include:

• Ability to combine with other physical therapy modalities.
• Enhancing oxygen supply to the treatment area.
• Providing cumulative improvements for chronic lesions.

Risks and Side Effects

Common side effects include:

• Skin redness and swelling (about 15% of patients).
• Transient palpitations (within 10-15 minutes post-treatment).
• Excessive sweating leading to electrolyte imbalance (during systemic treatments).

Serious risk warnings:

• Burn risk (temperatures above 60°C may cause dermal damage).
• Worsening of local tissue edema (may exacerbate symptoms during acute inflammation).
• Contact dermatitis (allergic reactions to specific heat source materials).

Precautions and Contraindications

Contraindications include:

• Malignant tumor sites.
• Open wounds or infected areas.
• Patients with bleeding tendencies.
• Cardiovascular insufficiency (systemic heat therapy contraindicated).

Special precautions:

• Skin sensitivity testing before treatment.
• Patients with electronic pacemakers should avoid electromagnetic wave therapy.
• Pregnant women should only undergo superficial hot packs.

Interactions with Other Treatments

Drug interactions:

• Can enhance the local absorption of non-steroidal anti-inflammatory drugs.
• When combined with steroid therapy, a minimum interval of 2 hours is recommended.
• Adjust dosage when combined with nerve block treatments.

Combination with other physical therapies:

• Should be spaced at least 30 minutes apart from ultrasound therapy.
• Adjust heat output when used with electrical therapy.
• Follow the principle of "heat first, then cold" for ice therapy.

Therapeutic Effects and Evidence

Clinical studies show that patients with chronic low back pain experience an average pain reduction of 40-60% after periodic heat therapy. Arthritis patients show a reduction in morning stiffness by over 50% after an 8-week treatment cycle. The American Physical Therapy Association states that heat therapy can increase cellular repair efficiency by 30% for tissue healing post-surgery.

Objective improvements include:

• Increase in local tissue oxygen content by 25-35%.
• Average reduction in muscle tension by 20-30%.
• Decrease in inflammatory markers (such as CRP) by 20-25%.

Alternatives

Cold therapy: suitable during acute inflammation, can immediately constrict blood vessels and reduce metabolic rate but may delay tissue repair. Ultrasound therapy: improves tissue connectivity through mechanical energy but has weaker effects on deep tissues.

Electrical therapy: stimulates nerves with electric currents to block pain perception but may cause muscle spasms. Pharmacological treatment: NSAIDs can quickly relieve pain but carry potential gastrointestinal and renal risks.

 

Frequently Asked Questions

What preparations are needed before heat therapy? Should I adjust my diet or clothing?

It is recommended to avoid fasting or overeating before heat therapy. Consume easily digestible foods 2 hours prior. Wear loose, breathable cotton clothing, and remove metal jewelry or electronic devices. If there are wounds or skin conditions at the treatment site, inform the physician in advance to adjust the plan.

What should I do if skin redness or itching occurs after heat therapy?

Minor redness and swelling are normal reactions; applying ice for 15 minutes can alleviate symptoms. If itching persists or blisters form, stop treatment and consult a doctor. Avoid scratching the area, and apply a non-irritating moisturizer. Avoid hot water rinses or ointments within 48 hours.

Can I shower normally or engage in vigorous exercise during treatment?

It is advised to avoid hot baths or saunas within 6 hours after treatment. Use lukewarm water to shower and gently pat dry the treated area. Vigorous exercise may increase body temperature load; light activities such as walking or stretching are recommended on treatment days.

How long does it take to see the effects of heat therapy? How can I tell if the treatment is effective?

The effects vary by individual. Chronic conditions typically show improvement after 3-5 sessions. Doctors will track symptom relief, imaging changes, or blood markers. Patients should record pain levels and activity changes as subjective assessments.

What should I pay attention to when combining heat therapy with other traditional Chinese medicine treatments (e.g., acupuncture)?

If combined with acupuncture, it is recommended to schedule heat therapy after acupuncture to avoid excessive stimulation of acupoints. Maintain at least a 4-hour interval and monitor for symptoms like dizziness or fatigue. The combined treatment plan should be personalized and evaluated by a physician.