Can heat compress be used during the remission period of chronic pain? How often should it be used?

Most chronic pain can be safely treated with hot compresses after entering the remission phase. It is generally recommended to apply hot compress 3 to 5 times a week for 15 to 20 minutes each time. The specifics can be adjusted flexibly according to the type of pain and your own tolerance. I have been working in pain management in the rehabilitation department for almost five years. I have encountered too many patients who relied on hot compresses to relieve the discomfort of chronic strain injuries. I have also seen many examples of blind hot compresses that were self-defeating. Two years ago, a young girl who worked as an Internet copywriter came to me. She suffered from chronic neck and shoulder pain for more than 2 years. Every time she worked on a big project, she would experience an acute attack of pain that made her unable to lift her arms. After entering the remission period, she heard others say that hot compresses were useful, so she used a rechargeable hot water bag to rub her neck every day. She took it away every time until her skin was hot and red. The result was that it came back within 10 days. She said that her neck was stinging when she touched it. The tight feeling did not go away much, but she had more skin sensitivity problems. I adjusted the frequency of hot compresses to once every other day for 15 minutes each time. The temperature was adjusted to a level where it would not burn when applied to the back of the hand. I also asked her not to apply it directly to the skin, and put a thin cotton T-shirt in between. She did so for almost a month. When she came back for a follow-up visit, she said that the stiffness in her neck and shoulders had basically disappeared, and there was no more skin tingling.

Of course, this matter is currently controversial. Not all chronic pain is suitable for hot compresses during the remission period. For example, for neuropathic chronic pain such as postherpetic neuralgia and diabetic peripheral neuralgia, many clinicians do not recommend hot compresses because damaged nerve endings are particularly sensitive to temperature stimulation. Hot compresses can easily induce abnormal discharges. There is no pain during the remission period, but acupuncture and electric shock-like discomfort occur after application. There is no need for such patients to join in the excitement of hot compresses. There are also patients with rheumatoid and gouty arthritis. If they suddenly find signs of redness and swelling in their joints during the remission period, do not apply heat rashly, even if the pain is mild. Otherwise, it will easily aggravate local inflammatory exudation and trigger an acute attack in advance.

As for the frequency of hot compresses, there are actually no strict rules. The 3 to 5 times a week we mentioned are just a general reference. If your muscles tend to stiffen when you stay in an air-conditioned room in winter, applying 6 times a week is no problem. In summer, if the temperature is high, the metabolism is fast, and the muscle tightness is not obvious, applying 2 to 3 times a week is enough. Hot compress is actually like giving a gentle SPA to soft tissue that has been tight for a long time. You don’t have to focus on how frequent or how hot the temperature is. The key is that you feel comfortable and relaxed after applying it. If you feel local stuffiness and increased pain after applying it, you have to stop applying it even if it is only once a week. If you are really not sure whether it is suitable for your situation, it is always right to seek evaluation from a rehabilitation doctor.