Can hot compress be applied during the remission period of chronic pain? How long will it take to get better?

Most chronic pains originating from muscles and joints can be treated with hot compresses after entering the remission phase. There is no fixed time limit for how long it will take for them to completely improve. Those with mild symptoms and simple causes may be able to get rid of discomfort in a few weeks. Complex neurogenic and immune-related chronic pains may require months or even long-term follow-up to control.

In the past few years of nursing in the rehabilitation department, I have encountered the most elderly patients with lumbar muscle strain and degenerative knee arthritis. Many people have figured out the rules themselves. They dare not apply blindly during the acute phase when the pain is so severe that they cannot straighten their waists or walk. In the remission phase, which is dominated by soreness, stiffness, and difficulty in moving, they apply a warm towel or a charged hot water bottle. The area that has been stiff for a long time will loosen up in ten minutes, and even the muscles that are usually tight can be relaxed a lot.

But this is not absolute. There is still controversy in the academic circles. Not all chronic pain relief periods are suitable for hot compresses. I met an aunt who suffered from post-herpetic neuralgia before. The rash had gone away for almost two months, which was clinically judged to be in the remission period, but she still had discharge-like throbbing pain from time to time. She heard from her neighbors that hot compresses can activate blood circulation and relieve pain. She used a hot water bag at home to apply it for a week, but the pain was so bad that she couldn't sleep all night. She came to check and found out. Even in the remission period of neuropathic chronic pain, hot compresses will dilate local blood vessels and increase the sensitivity of nerve endings, which will in turn amplify the pain. For patients with gouty arthritis, if the uric acid level is not controlled stably during the remission period, hot compresses may also induce acute attacks. In these two cases, casual hot compresses are not recommended in clinical practice.

Even if it is suitable for hot compresses, don’t think that the higher the temperature and the longer you apply it, the better. Last month, there was a 28-year-old young man with lumbar protrusion. During the remission period, he felt that it was very comfortable to apply a hot water bottle on his waist. For two nights in a row, he slept with the hot water bottle and developed shallow second-degree blisters on his waist. He was almost able to go to work normally, but it delayed his recovery for less than half a month. Generally, it is enough to control the temperature of hot compress at 40 to 45°C. It will feel warm to the touch without burning the skin. Apply it for 15 to 20 minutes each time, two or three times a day. If you feel tingling or itching after applying it, just stop immediately.

After talking about the importance of hot compress, everyone is most concerned about when it will be completely healed. There is really no guarantee on this point. There used to be a 32-year-old girl who worked in design. She suffered from chronic lumbar muscle strain for almost two years. The pain made it difficult to even sit for two hours. Later, during the remission period, she insisted on regular heat compresses and found time to do core training twice a week. She usually stood up for two minutes after sitting for half an hour. Within three months, she almost didn’t have any pain again. But there are also uncles suffering from rheumatoid arthritis. During the remission period of joint pain, they insist on applying hot compresses and taking immunomodulators as prescribed by the doctor. They can only control the symptoms without acute attacks, but they cannot say that they are completely "recovered." After all, chronic pain is inherently a problem affected by multiple factors. Hot compresses are only a means to assist in relieving discomfort, not a magic formula that can cure the disease. If you want to shorten the recovery time as much as possible, you must also cooperate with targeted treatment of the cause and adjustment of lifestyle habits. Hot compresses alone are definitely not enough.