Heat patches and ice packs ‘could do more harm than good’, warn physiotherapists


  • American Physical Therapy Association (APTA) has issued new rules
  • Heat patches and ice packs discourage patients from being active, they said
  • They exacerbate fears and anxieties about moving when in pain 
  • Also stall recovery, and could lead to patients needing injections or surgery
  • Should only be used to facilitate more active treatments, they said  

By
Madlen Davies for MailOnline

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They are seen as the pill-free way to combat those aches and pains.

But heat patches and ice packs could actually harm patients and stall their recovery, experts have warned. 

New recommendations from the American Physical Therapy Association (APTA), an organisation representing 88,000 physiotherapists in the U.S., state these remedies ‘discourage patients from becoming active’.

This makes the time it takes for them to recover longer, and increases the risk of eventually needing injections or surgery, they said.

Heat patches and ice packs could do more harm than good because they discourage people from being active, which helps recovery,  new guidance from the American Physical Therapy Association (APTA) warns

The new guidance recommends: ‘Don’t employ passive physical agents [i.e. heat patches and ice packs] except when necessary to facilitate participation in an active treatment program.’

Explaining the recommendation, the guidance said there is ‘limited evidence’ that the use of cold pads and heat packs works – and that active treatments have ‘a greater impact on pain, mobility, function and quality of life’.

Active treatments include physiotherapy and gentle exercise. 

The guidelines do concede there is some evidence the remedies could be used for short-term pain relief, but add this should be supported by more evidence.

It also warned they could do more harm than good: ‘There is emerging evidence that passive physical agents can harm patients. 

Commenting on the new report, Sammy Margo, a spokesperson for the Chartered Society of Physiotherapists, agreed ice packs and heat patches can harm patients if they are used inappropriately.

But she added that if used as a tool to help patients become active again, then their use should be welcomed.

She told MailOnline: ‘In the first few days when an injury is inflamed, and might be bleeding, it is appropriate to apply a cold ice pack because this will encourage ‘vasoconstriction ’- the constricting of the blood vessels – which will reduce inflammation and bleeding.

U.S. physiotherapists recommend that active, rather than passive treatments, speed up recovery

‘But some people turn to heat which increases vasodilation [the widening of blood vessels] and increases bleeding. It aggravates the problem.’

‘When the injury is more chronic, for muscle spasms, muscle tightness, you should use heat. But heat therapy can be applied on the wrong occasions.

She added: ‘The current thinking is that patients should move as much as possible but within the boundaries of the pain.

‘Is the heat/ice pack going to discourage it? It shouldn’t, because it should encourage people and enable them to be active.

‘If you make an early return to being active, psychologically you will recover more quickly because you’re getting back to normal.

‘If you really understand how heat and cold can be applied then they are very useful tools.’

 

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