• Adriane Maxwell, LMP

How to Safely Use Heat & Cold Therapy Before and After Massage

Updated: Aug 8, 2021

Heat and cold are the two most common types of non-invasive and non-addictive pain-relief therapies for muscle and joint pain. Which one you use depends on whether the pain is new or recurring. Remember, heat helps muscles relax; cold helps to minimize inflammation and pain.


Pain that recurs can be treated with heat, which will bring blood to the area and promote healing. Heat opens up blood vessels, which increases blood flow and supplies oxygen and nutrients to reduce pain in joints and relax sore muscles, ligaments, and tendons. The warmth also decreases muscle spasms and can increase the range of motion.

Sources of heat can supply either dry or moist. Dry heat sources may dry the skin. However, moist heat penetrates better. A few ways to apply heat would be an electric or microwavable heating pad, a hot water bottle, gel packs, and hot baths. It is not recommended to use a microwave to reheat a heating pad or wrap. It’s best to use hot water.

Moist heat is less likely to cause skin dehydration. It comes in many forms, including steam towels, hot baths, moist heating packs, etc. It helps to increase tissue elasticity, making it ideal for patients with dry and/or aging skin. Overall, most people find moist heat to be better. Apply heat if you have stiff joints or chronic muscle and joint pain

How to use safely:

  • Do not apply the heat source directly to your skin. Instead, wrap the hot device in a thin towel.

  • Do not apply heat for longer than 20 minutes

  • Do not use if there’s swelling. Use a cold pack first to reduce and eliminate swelling.

  • Do no use heat if you have poor circulation or diabetes

  • Do not use heat on open wound or stitches

  • Do not lay down on a heating pad for the possibility of falling asleep and causing a burn to the area


In general, a new injury will cause inflammation and possibly swelling. Ice will decrease the blood flow to the injury, thereby decreasing inflammation and swelling. Cold therapy slows circulation, reducing inflammation, muscle spasm, and pain. It should be used if swollen or bruised. Cold can be applied by ice or gel pack. Any cold treatment should be used for 24-48 hours after an injury. Cold therapy is good for sprains, strains, bumps, and bruises that may occur in sports or lifting. Apply cold packs or ice bags to the injured area for no more than 20 minutes at a time, removing cold for 10 minutes and re-applying it again.

How to use safely:

  • Do not apply the cold source directly to your skin. Instead, wrap the ice or ice pack in a thin towel before applying.

  • Do not apply longer than 20 minutes

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