If you are in musculoskeletal pain, the first thing is that you should be applying something, either heat or cold, to the area. The reasons why are complex, but to make it very simple here is the rule of thumb:

If the area is swollen, hot to touch, or red (i.e the signs of inflammation) then apply cold NOT heat. For example you have tripped and torn a ligament in your knee.

Generally acute injuries requiring immediate medical attention need cold therapy. See various other websites for the “RICE” ( Rest, Ice, Compression and Elevation) procedure for the management of acute injuries.

If there is no swelling, heat or redness i.e. the area is not actively inflammed then apply heat.


Heat increases blood circulation to the area thus delivering more oxygen, and nutrients and moving more toxins from the muscles. This is paricularly useful when muscules have been overused e.g. shoulder and neck muscles (upper trapezius muscle and levator scapulae in particular) strained and sore from working at a computer all day with the arms reaching foward to the keyboard.

Pain resultant from arthritic conditions e.g. Osteoarthritis AKA joint degeneration is also often assisted by heat therapy. This is because the degeneration in the joint results in inflammation in the joint which subsquently results in ‘spasming’ in the muscles surrounding the affected joint. Heat by delivering extra blood therefore extra oxygen and nutrients to the muscles helps to release this spasm and allowing the joints to move more freely.

Hot showers and heated spa baths (blessed things) are alternative forms of heat therapy.

Heat also works because of what Health Professionals refer to as the “GATE CONTROL THEORY OF PAIN.”

Basically think of your nervous system as an old fashioned telephone system. The brain is the Switchboard where all messages from the body are directed to and sent out from. The peripheral nerves are the telephone lines. Like telephone lines they can only carry so many calls or signals before some just don’t get connected to the switch, or in this case the brain. So if you apply a heat pack to a painful back the nerves that send messages from the back to the brain are too busy sending ‘heat’ messages/calls’ and therefore can’t send as many ‘pain messages/calls.’

In case this sounds like rubbish have a think about the first thing you do when you hurt youself or when something is hurting…You rub it. This is the body instinctively applying the ‘GATE CONTROL THEORY OF PAIN’ to reduce your pain. The nerves which carry signals for light touch also carry the pain signals therefore fewer pain messages will get through to the brain, and as a result less pain is felt. So go ahead and rubs your “ouchie bits.”

The GATE CONTROL THEORY OF PAIN is also why vibration therapies work to reduce pain. Vibration is also transmitted on the same nerve pathways as pain. Be careful with the use of vibration though…because vibration causes “vasocontriction” in the blood vessels that feed the muscle. That is it causes the blood vessels to get smaller temporarily thus reducing blood flow to these muscles.

You can buy heat and cold packs all over the place, but I really like “Heat Wheat ” heat/cold packs as they are  specially designed for different parts of the body to make them much easier to use. I especially love the slipper packs, hand packs and back belt packs.


* Remember when using grain heatpacks in the microwave to put a glass of water in there with the pack to prevent the packs becoming too hot to use safely and to stop them drying out and ‘cooking.’ Always follow the manufacturer’s instructions.

** These are the general rules of heat and cold pack use and are as such not appropriate for the management of all health conditions. Please consult with you treating health professional regarding your particular condition.