Can hot compress be used during the remission period of chronic pain? Why can’t it be relieved?

First of all, it must be said that hot compresses are not absolutely forbidden during the remission period of chronic pain. Nor is it that hot compresses are inherently useless for pain during the remission period. If you apply it, it will have no effect or even cause more pain. Most of the time, it is because you have not found the right type of pain for you, or you have used hot compress method wrongly.

Not long ago, I met a 30-year-old programmer in a rehabilitation studio. He had suffered from lumbar muscle strain for almost three years. During the remission period, there was no sharp pain, but his waist was so stiff that it felt like a piece of cardboard was tied to it. He heard someone said that hot compresses can relax him, so he put the warmer on his lower back at work every day for three or four hours. After applying it for almost two weeks, he came to the door and said it was of no use at all, and he was still so stiff that he couldn't bend down. I lifted up his clothes and saw that there were light red marks on the area where the baby warmer was applied. The maximum temperature of the baby warmer can soar to over 50 degrees. After applying it for such a long time, the surface of the skin became a little numb due to the heat. The deep tension in the muscles was not released at all. Instead, it was congested due to the high temperature for a long time and became more stiff. Of course, it was ineffective.

In fact, the current industry’s views on hot compresses during the remission period are not uniform. Most people engaged in sports rehabilitation will recommend hot compresses for chronic pain due to strain. After all, thermal stimulation can relax tight muscle fibers, accelerate local metabolic circulation, and take out accumulated metabolic waste products such as lactic acid. Many people with backache after sitting for a long time will feel their whole body stretched after applying it for more than ten minutes. It is indeed useful. However, pain doctors with more clinical experience tend to be more cautious. If the source of your pain is not muscle tension at all, such as nerve root entrapment in the lumbar protrusion remission period when edema has just subsided, or neuropathic chronic pain such as post-herpetic pain, hot compresses will stimulate the nerves that are already in a highly sensitive state. It is equivalent to adding another source of stimulation to the nerves that are already "having a bad temper". It is normal for the pain to be more obvious.

To put it bluntly, hot compress is actually like "softly relaxing" a twisted rubber band. If your pain is caused by muscles being twisted into knots, it will be comfortable to loosen it after applying it. However, if your pain is due to nerve entrapment, urate crystals in the joint cavity, or autoimmune inflammation, just heating the surface of the skin will be like wiping the faucet shell of a clogged water pipe at home. It will definitely not open, and naturally it will not be effective.

Just like a gout patient I met before, the ankle was still a little heavy during the remission period. I ignored the advice and used a hot water bottle to apply it once. The pain was so painful that I couldn't sleep that night. The urate crystals originally deposited in the joint cavity were affected by the hot compress. The surrounding blood vessels expanded, and the crystals ran into the surrounding soft tissues, which instead caused a dull pain. At this time, let alone relief, it is not aggravated. For patients with rheumatoid arthritis, casual heat application during the remission period may aggravate the sterile inflammatory reaction in the joints, which is counterproductive.

This is not to say that hot compresses during the remission period are completely useless, but you must first understand the source of your pain. Control the temperature between 40 and 42 degrees, and apply it for 15 to 20 minutes each time. If you apply it for two or three times and it does not relieve the pain or even makes it more painful, don’t apply it forcefully. See a doctor to clarify the type of pain before choosing a plan. It is more reliable than blindly trying folk remedies.