Hot & Cold Packs for Shoulder Pain

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Overview

Hot and cold packs are widely used, very inexpensive, have evidence of effectiveness and are generally very safe. Heat increases circulation, increases flexibility and increases metabolism, while ice reduces circulation, edema (swelling), inflammation, and spasm.

RESCU Treatment Ratings

R = Risk      E = Effectiveness      S = Self-Care

C = Cost     U = Usefulness (overall rating)

1 = Least Favorable     5 = Most Favorable

R

RISK: 5/5

5_Hearts_Treatment_Rating

The use of hot or cold packs is still somewhat debatable. Some believe that the swelling/inflammation process is nature’s way of reducing range of motion to allow your body to heal, and that the swelling itself contains the nutrients needed to heal properly. Therefore, do not become overly reliant on either ice or heat. The use of either ice or hot packs is very safe and you should consider them as a first-line treatment. If pain persists, see your doctor or therapist.

E
S
C
U

Products for Treatment

Ice and Heat for Neck Pain Background

For decades, the advice has been to use ice packs for acute injuries, trauma or pain, and typically heat after about three days. It makes sense: ice may reduce inflammation and swelling, slow the conduction of pain impulses and hopefully reduce pain. Heat is thought to increase blood flow and relax muscles.

The research suggests ice may help reduce pain, but studies are somewhat contradictory. However, use of ice is generally safe and quite inexpensive. Similarly, continuous heat wraps may be more effective than ibuprofen or acetaminophen according to a couple studies. Again, the research is not particularly definitive.

Ice and Heat Treatment Suggestions

For ice packs, you can use frozen corn or peas, commercial cold packs, or a small resealable bag, such as a Ziplock, filled with crushed ice. Apply ice for 10-20 minutes (not longer) once an hour while you are up. Don’t fall asleep with an ice pack, and always use a thin towel between the ice pack and your skin to avoid an ice burn.

Similarly, heat packs are widely available. You can also wet a small towel, such as a dishtowel and microwave it for 20-45 seconds. Be careful not to burn yourself. Moist heat is thought to penetrate more deeply, but any source of heat, such as an electric heating pad may help. Heat should generally not be used for more than 15 to 20 minutes per hour since the tissue needs time to return to a normal temperature periodically or it can become damaged.

Sources:

Nadler SF, Steiner DJ, Erasala GN, Hengehold DA, Hinkle RT, Beth Goodale M, Abeln SB, Weingand KW, Continuous low-level heat wrap therapy provides more efficacy than Ibuprofen and acetaminophen for acute low back pain, Spine 2002 May 15;27(10):1012-7

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