Articles and Links

The Physicians of the Hand center want to share this list of articles and links.

This list includes articles that address certain patient questions as well new and current issues that may arise in the context of patient care. Our feeling is that an informed and up to date physician and patient make for better treatment and care.

Heat or Cold?

  • Heat or cold, hotpack or ice pack? These are common questions asked after injury, to relieve stiffness, after surgery. As any answer there is a  simple way to explain it but when dealing with a complex set of medical circumstances one answer does not always apply for all.
  • Simply stated warm up and cool down means that when you are stiff, and sore that warmth will generally help and after activity or something recent such as injury or surgery, cold will help reduce swelling and pain and inflammation.
  • However the way in which we apply cold or heat can have significant side efects and after effects. Thus speak to your doctor to clarify how to safely do this depending upon the phase of or timing of an injury or treatment or condition you are in.
  • for more detailed infomation here is an article from the Journal of Hand Surgery

Herpetic Whitlow

HEAT vs COLD for HAND AND ORTHOPEDIC ISSUES

HEAT AND COLD

Using heat or cold for fingers, hands and wrists can be very helpful.  Applying heat or cold is a common method for treating injury, stiffness, swelling and pain. When to apply heat or cold depends upon many things.

Heat and cold share common qualities.  When heat is applied the molecules move faster or speed up.

Cold, which is absence of heat, can slow molecules down 

HEAT: WARM UP

ICE: COOL DOWN

WARM UP

Heat or warmth will help get things moving. Heat speeds up the molecules in tissues and increases blood flow.

Heat is good for stiff joints and muscles. Heat is good to get things moving again. Heat is also good to use prior to an activity. We often see an athlete warming  up before an activity.

 

A warm shower or bath can help sore stiff joints especially in the early morning.  A warm compress or heating pad can relieve stiffness in muscles and joint.  Avoid prolonged warm bathing in a hot tub unless supervised. Too great a temperature increase can cause blood pressure to fall and lead to fainting.  Too much can cause burns to skin and tissues.  Too much heat can cause swelling to or a burn.

COOL DOWN

After an activity, if there is pain, swelling and irritation then cooling down can help.

 

Cold slows the molecule in tissue down and reduces blood flow.

Ice after an activity can help to relieve pain and irritation from activity. Ice can reduce swelling.

Too much COLD can slow down and stiffen sore joints too much

The most common way to apply cold is to use ice or something that has been made cold by placing it in the freezer. Ice cubes and gel packs  are often used

Applying ice or anything ice cold to bare skin  can cause injury of left on too long. One should always wrap the source of cold in fabric or a towel.  If a cast bandage or splint is too thick and the cold is not getting through then apply the cold close to or near the area on exposed skin.

Apply ice for 15 minutes then allow a 15-minute rest before re applying

Applying ice or anything ices cold to bare skin too long can cause injury.

Any extreme pain or numbness should cause one to stop icing

 

Athletes are often seen using ice baths after sports. Too much exposure ice water can lead to frostbite or hypothermia and injury.  Never bath in an ice bath without supervision

SPECIAL SITUATIONS

RECENT INJURY. Within the first several days of a bruise, fracture or injury (as long as circulation is normal) ICE can help with analgesia and to reduce swelling.

 

CHRONIC INJURY AND TIGHTNESS

After an acute injury period warmth or heat can be used to mobilize tight tissues and get blood flow to an area to allow the body to speed healing.

THERAPEUTIC ULTRASOUND

A qualified therapist will use ultrasound to slowly heat deeper tissues to aid with motio

CONTRAST BATH

Alternating heat and cold can be used under supervision

 

PARAFIN or WARM wax is to be used to apply heat only via machines that are highly regulated and use a wax mixture that avoids skin burns

 

PRECAUTIONS

Never use heat or cold on a limb or finger with impaired circulation or feeling.

Whether you are warming up or cooling down, too much can be harmful.

Monitor time, skin condition and if there are any questions always ask your medical provider.

Always test the hot or cold item first before applying to the affected or injured areas.

More References and Sources

  • American Society for Surgery of the Hand (ASSH)
  • Orthogate (Orthogate is an Orthopedic web portal that enables internet searches on any orthopedic topic)
  • Congenital Limb Differences is a web site for children and families with congenital limb differences. Information and support groups dealing with amputation, finger and hand abnormalities, fused fingers, absent fingers and hands, radial club hand, thumb pollicization and other topics. Lower extremity problems of the leg and foot are also discussed.
  • Eatonhand.com - An electronic listing of hand anatomy from e-hand.