Using Heat Therapy for Injury, Surgery, Exercise and Arthritis

Dr. Phil Zeltzman is a traveling, board-certified surgeon in Allentown, PA. His website is He is the co-author of “Walk a Hound, Lose a Pound” (

Zee Mahmood, a veterinary technician in Reading, PA, contributed to this article.

Heat therapy is an easy and effective way to make your dog feel happier while relieving pain associated with injury, surgery, exercise or even arthritis.

Concept of heat therapy
The application of heat is used to reduce stiffness and muscle spasms, increase blood flow and relieve pain. Unlike cold therapy, heat therapy is applied after the initial swelling and inflammation (a.k.a. irritation) stage of an injury. Typically, cold therapy is used for the initial 72 hours.

Heat therapy can also be used for ongoing conditions such as arthritis. Click here to learn more about arthritis if your dog is having a hard time getting around. By reducing stiffness, heat therapy helps to improve joint range of motion during and after exercise. In addition to these healing benefits, heat therapy provides comfort, relaxation and anxiety reduction.

Location of heat therapy
Heat therapy is most commonly applied to joints: shoulders, elbows and wrists in the front legs; and hips, knees and ankles in the back legs. It can be used on any part of your dog's body where muscle damage, strain or spasm occurs. For example, a dog with a disc problem in the spine (neck or back) may have muscle spasms, which heat therapy can relieve.

Technique when using heat therapy
Many forms of commercial heating devices, wraps and electrical heating blankets are available in sporting goods stores and pharmacies. Instructions on the packaging should be carefully followed to avoid burning your dog’s skin.

Alternatively, a simple homemade heating device consists of a tube sock filled with uncooked rice and tied at the open end. This “rice sock” can then be microwaved to the desired temperature. How long you need to warm it up will depend on your microwave. Before applying the rice sock on your dog’s skin, shake it a few times to make sure the heat is distributed evenly.

[Editor’s Note: Check with your veterinarian before using any kind of heat therapy on your pet.]

Danger of heat therapy
Burning the skin is probably the biggest risk of applying heat therapy to a pet. Your heating device should be warm, never hot.

Don’t apply the device directly to your pet’s skin. Padding, such as a thin towel, should always be used between the heating device and your dog's skin to avoid burning.

Always test the temperature of the heating device on your inner wrist (similar to testing the temperature of a baby's bottle) before applying it to your dog's skin. Test it on your skin for about 30 seconds before using it on your dog.

Appropriate heat therapy usage
After your dog has surgery, an injury, or goes through any strenuous physical activity, heat therapy may be an option. It is important however to wait for 72 hours before applying heat to the affected area: remember, cold therapy is applied for the first 3 days following surgery or an injury.

If your veterinarian has recommended heat therapy he may suggest this course of action or something similar:

  • Hold the pack in place on the affected body part for about 15 minutes, or until the skin feels warm to the touch
  • Heat therapy can be repeated every 6 to 8 hours.

It is not unusual for your dog to fall asleep during the heat therapy process, which shows how soothing this treatment can be. If your dog displays any signs of discomfort during the therapy such as excessive movement, growling or biting, stop the treatment immediately and contact your veterinarian.

Heat therapy is a simple, yet effective way to help your dog feel better after an injury, surgery or exercise. At the same time, it will increase comfort, relaxation, and happiness for both your dog and yourself.

Questions to ask your veterinarian

  • Should I use heat therapy on my dog?
  • Which exact protocol would you suggest?
  • Which heating device should I use on my particular dog?

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.

Next, click here to learn about cold therapy.

News & Events

Although it seems like a simple concept, one question that we are commonly asked is when to use ice versus heat therapy to treat pain. In this post, we will discuss how each one works on a physiologic level, and when to use each one. Both heat and cold therapy are an inexpensive and easy-to-use treatment for the management of acute, chronic, and postoperative pain. These therapies are also great to use after vigorous exercise to stimulate healing. One main point to keep in mind is that ice reduces inflammation, while heat stimulates blood flow. Knowing that simple fact can help if there’s ever a question about when to use which one.

Cold Therapy

Cold therapy such as ice baths or ice packs are commonly used for the treatment of acute, injury provoked pain. As previously mentioned, cold therapy reduces inflammation. When the body is undergoing an inflammatory response, many chemicals are secreted and directed to the injured area. These chemicals are used to stimulate healing. While the end result is the body repairing itself, inflammatory responses can be somewhat painful. Due to the abundance of chemicals released, other symptoms such as redness, swelling, and pain are often experienced as well. Cold is a great option because it not only reduces inflammatory symptoms, it can be an analgesic as well. Topical application of cold or ice will decrease the temperature of the skin, muscles, and even inside our joint capsules. Cold also slows the conduction velocity of peripheral nerves, which can mask or override our sensation of pain. One way that cold can actually treat pain instead of just numbing or masking it is by its effect on swelling and edema. Cold causes vasoconstriction, which slows the bloodflow to the area, reducing the amount of fluid buildup and the symptoms that go along with that.

Heat Therapy

Unlike cold therapy, heat therapy stimulates blood flow. This is helpful in the treatment of pain due to chronic, overuse type injuries or disease processes. Pain from sore or tight muscles is often associated with a buildup of lactic acid. Applying heat to these areas helps to stimulate the flow of oxygen-rich blood which can decrease the amount of lactic acid in the muscles, thereby decreasing pain and improving range of motion. Heat may also lead to pain relief by way of muscle relaxation. When using heat at therapeutic levels, collagen tissue relaxes and elongates, easing tension built up in the muscles. Using heat in conjunction with a stretching or home exercise program or along with a formal physical therapy program will provide the greatest results.

Similarities between Heat and Cold Therapy

Something that heat and ice both have in common is that they both reduce muscle spasms and alleviate pain. Both applications also have an effect on free nerve endings within our tissues. The effects that both heat and ice have on the peripheral nerves may increase the pain threshold among patients.

When to Use What?

Using ice is critical for use after procedures such as total joint replacements, joint manipulations under anesthesia, fusions, tendon repair, etc. For example, after a total knee replacement, there is bleeding into the joint that occurs post operatively. Because of the joint capsule, this bleeding stays contained in the joint, and isn’t actively visible. Using ice to slow some of this bleeding is so important for a few reasons. Bleeding into a joint post operatively can cause a hematoma. Hematomas in post op total knees can increase the risk of infection, can decrease range of motion, and cause pain which leads to immobility. These are all risks for having post op complications or requiring further surgery to wash out the hematoma. Icing 20 minutes on and 20 minutes off for the first 48-72 hours after a total joint replacement, or other orthopedic surgery is extremely important. Ice is also great to use in the period immediately following trauma such as sprains, strains, contusions to decrease bleeding and edema (swelling).

Heat is great to use for more chronic-type pain. A lot of patients find it helpful to loosen arthritic, stiff joints, and also to relax muscles and decrease spasm.

Please take a look at the chart below and make sure to always follow the safety precautions when using heat or ice therapy!


  • Treat for no longer than 20 minutes at a time
  • During ice treatment, check skin every 5 minutes to make sure the skin is not red or blistered, indicating freeze damage
  • Do not place ice or heat directly on the skin, use a thin towel in between
  • Do not lie on a heating pad or fall asleep using one to prevent burns
  • Do not use heat or ice if you have no feeling in that part of the body
  • Never use heat if you have swelling or bruising

Physical Therapy

Five treatments you probably don’t need

Physical therapists can help people who are having trouble moving after an injury or surgery. They also help people with conditions such as:

  • Arthritis
  • Back or shoulder pain
  • Cerebral palsy
  • Osteoporosis (weak bones)
  • Spinal cord injury
  • Stroke

Physical therapists can help people gain strength and get moving again. They can help reduce or prevent pain and disability.

Physical therapists provide care in hospitals, private practices, nursing homes, schools, rehabilitation centers, or in your home.

They use a variety of treatments, with a focus on physical activity and exercise. Goals include:

  • Strengthening muscles that are weak from lack of use.
  • Helping stiff joints move again.
  • Helping you use your muscles correctly, so you can move with less pain and avoid injury.

But some physical therapy treatments are not useful. They can make your symptoms last longer, and even cause new problems.

Avoid treatments that don’t help.

Most insurance plans pay for a limited number of physical therapy visits. If your treatment doesn’t help, then you have wasted those visits.

Also, if treatment doesn’t help, people are more likely to seek unnecessary tests, injections, and surgery. These can be costly and risky.

As part of the Choosing Wisely series, the American Physical Therapy Association has listed five common treatments that are usually not helpful. They can lead to harm and to more tests and treatments. And your costs go up. Here’s why:

Heat treatments

The problem: Treatments include hot packs and deep heat machines, such as ultrasound. They can feel good on a painful back, shoulder, or knee. They may help relax you before exercise, but there is no proof that they have any lasting effect.

For example: Studies have found that deep-heat ultrasound, added to an exercise program, does not improve arthritis of the knee. It’s better to learn specific exercises and new ways to do things.

The harms: Many people are afraid to be physically active when they’re in pain. Physical therapists may support these fears by using heat treatments. But avoiding movement only makes the problem worse. This can lead to unnecessary medical procedures, such as knee surgery or steroid injections for back pain.

When to consider heat:

  • Home heat treatments, such as a hot bath or shower or a heating pad, can help give temporary relief of aches and pains.
  • Calcific tendonitis is a painful shoulder condition. Deep heat using ultrasound can help.

The wrong kind of strength training for older adults

The problem: Many older adults have weak muscles—due to lack of activity, hospitalization, or surgery. This can cause problems with walking, balance, rising from a chair, and other everyday activities. The risk of falls increases.

The right strength training program can make you stronger and help prevent falls. A physical therapist can teach you how to use exercise machines, free weights, elastic bands, or your own body to build strength.

But the exercises may be too easy. The therapist may be afraid that you’ll be hurt.

Studies show that a challenging program offers the most benefits, even for seniors in nursing homes. The therapist should match the program to your abilities. When you can do a task easily, the therapist should add weight, repetitions, or new exercises.

The harms: If strength training isn’t challenging, it is a waste of time and money. You will still have problems from weak muscles. And you will still be at risk of falls.

When to go easy on muscles:

  • Start out with lighter weights so you can learn the correct way to use them.
  • Don’t do strength training if you have a painful, inflamed joint, such as a swollen elbow or knee.

Bed rest for blood clots

The problem: Older adults and people who have had surgery have a risk of deep vein thrombosis (DVT). This is a blood clot in a deep vein—usually in the leg.

The main treatment for DVT is medicine that dissolves blood clots. In addition, patients are often put on bed rest.

The purpose of bed rest is to keep the clot from breaking loose. A loose clot may travel to the lungs and block blood flow in the lungs. This is called a pulmonary embolism (PE), and it can be fatal.

But studies show that bed rest doesn’t help. People who walk around with a clot are no more likely to develop a PE than people who lie in bed.

Also, getting up and walking has many benefits. It makes people feel better. It relieves pain and swelling in the leg. And it reduces the risk of more leg problems.

A physical therapist can help you start walking as soon as the clot-preventing medicine starts working. Or the therapist or your doctor can tell you how active to be on your own.

The harms: Bed rest can make a clot larger and lead to new clots. And you will have a higher risk of complications, such as pneumonia. Your entire body will become weaker.

When to consider bed rest for DVT:

  • You can’t take clot-preventing drugs
  • You have another medical reason for bed rest, such as bleeding in the brain from a stroke, or severe breathing problems.

Exercise machines (CPM) after total knee replacement

The problem: Most people start physical therapy within 24 hours after knee replacement surgery. The therapist should show you how to exercise your knee, walk, and get in and out of a bed or chair. This helps you move your knee again. It reduces the risk of a blood clot in the leg and shortens hospital stays.

But some surgeons recommend that you also use a continuous passive motion (CPM) machine. A CPM machine keeps moving the knee for several hours a day while you’re in bed. A physical therapist teaches you how to use the machine.

But studies show that adding a CPM machine to physical therapy doesn’t improve pain. It doesn’t help you bend or straighten your knee better. And it doesn’t help you return to normal activities or improve your quality of life.

In fact, people do just as well with physical therapy whether they add a CPM machine or not.

The harms: CPM is a large, heavy machine. It is hard to put on. You have to pay to rent it. And you may stay in bed longer, instead of getting up and being active.

When to consider CPM:

  • You had a serious complication from the surgery, such as a stroke or respiratory failure. In this case you may need more bed rest.
  • You are recovering from a second knee replacement operation because the first one failed.

Whirlpools for wound care

The problem: Physical therapists are often asked to treat wounds that are slow to heal, chronic, or infected. One treatment uses a whirlpool bath to soak and clean the wound. But there is little evidence that whirlpools help. And they can cause infections.

There are safer, gentler, more effective ways to clean wounds. The therapist can:

  • Rinse the wound with a saltwater wash.
  • Spray liquid on areas of the wound with a single-use sterile device.

  • If the tub is not clean, bacteria can spread from person to person.
  • Bacteria can spread from other parts of your own body to the wound.
  • An infected wound heals more slowly and you may need antibiotics.
  • If your immune system is weak, the infection can spread to the blood and cause a serious
  • condition called sepsis.
  • Chemicals used to clean the tub and disinfect the water can damage the new skin cells on the wound.
  • Whirlpool jets can harm fragile new tissue growing in the wound.
  • Long soaking can break down skin around the wound.
  • The placement of the leg can cause swelling. People who have vein problems may have serious complications.

When to consider whirlpool therapy:

Never use whirlpool therapy to treat open wounds. It may help sports injuries such as strained muscles, but the benefit has not been proven.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2015 Consumer Reports. Developed in cooperation with the American Physical Therapy Association.

The Classic Dog Arthritis Remedy: Heat Treatments

The Classic Dog Arthritis Remedy: Heat Treatments

Along with massage and joint lubrication, an effective dog arthritis remedy is heat treatment. Today, this old-school remedy provides modern well-being for your pet.

Select Heat Sources

Be sure and gather supplies to administer the treatment.

Investigate several mechanisms to find the ones that suit your dog best. Here are some ideas:

* Select a hot water bottle which is a therapeutic aid. Consider the newer hot water bottles on the market that come with fleece covers they make for a softer touch on your dog's body. * Choose different sized towels to administer the dog arthritis remedy: wet them and adequately wrap around your dog's legs, arms, or lay across his back. You should administer the heat for 20 minutes at a time, two or three times a day. * Find heated pet beds and pads: heated sleeping items are made specifically for dogs with conditions like arthritis. The heat works to relax muscles and promote increased mobility and activity or simply help your dog sleep comfortably. * Consider an orthopedic bed with a heat element: helps distribute your dog's body weight and eliminate pressure points along with soothing his joints and muscles. * Shop for dog clothing: keep your dog warm on cold days or on damp mornings. A dog hoodie in a breathable material like a poly-fleece blend offers insulation and keeps the chill out. * Follow a dog arthritis remedy by applying a microwavable heat pack to your pet's problem area. * Only use pet-specific heating products on your dog.

Using Heat Therapy for Injury, Surgery, Exercise and Arthritis - pets

Heat Therapy Helps Relax Stiff Joints

Learn different ways to ease joint pain using warm water or a hot compress.

Heat Therapy Helps Relax Stiff Joints

Learn different ways to ease joint pain using warm water or a hot compress.

Looking for a natural way to get your joints moving in the morning? Close the medicine cabinet and try an age-old remedy that has stood the test of time: heat.

If you have a chronic condition like fibromyalgia, arthritis, or lower back pain, try heating things up. Soaking in warm water or applying a heated compress is one of the oldest, cheapest, and safest forms of complementary therapy. Research has shown that heat treatments can loosen stiff joints and relieve achy muscles.

Here is how it works. When you warm up a sore joint or tired muscle, your blood vessels get bigger. This allows more blood, oxygen, and nutrients to be delivered to the injured tissues. Better circulation means more relaxation for those stiff muscles and joints.

Stay away from heat if you have an acute injury or are having a flare. If you have a sudden onset of swelling and redness from overdoing it yesterday, you are better off using cold treatments for a few days. Cold has the opposite effect of heat: it reduces blood flow and decreases inflammation.

Here are a few simple ways to heat up your daily routine.

Here are a few simple ways to heat up your daily routine.

Take a Steamy Shower

Start your day right by taking a long, warm shower. The heat of the water will reduce morning stiffness, limber up the body, and increase your range of motion for the daily activity ahead.

Make sure the water is not too hot, particularly if you have heart problems. A healthy temperature is between 92 and 100 degrees.

Add in some prep time. Taking a shower before you workout or go on a long walk can prepare tight joints for exercise and reduce your chance of injury.

Apply a Warm Compress

Buy an electric heating pad from the drug store. Heat up your hip, back, shoulder, or knee before you stretch or exercise.

Make a moist heating pad by putting a wet washcloth in a freezer bag and warming it in the microwave for one minute.

Rest with the warm compress on the affected area for 20 minutes when you’re doing computer work or reading the newspaper.

Dip your hands or feet in melted paraffin wax (test the temperature first!). Wait for it to cool and peel the wax off.

Stretch Out in the Pool

Go for a dip. When you have arthritis, a warm pool is the ideal place to strengthen your muscles and increase your flexibility. The water will reduce the force of gravity compressing the joint and offer 360-degree support for sore limbs that have limited range of motion.

Reap the rewards. Flexibility and relief last long after you towel off. Studies show that patients with arthritis and fibromyalgia who participated in warm water exercise programs two or three times a week could move around better and had as much as 40 percent less pain.

Don’t overdo it. Maximum benefit is reached after about 20 minutes in a warm pool or bathtub. Make sure you drink water before and after your dip.

Soak in the Bathtub

Relax in a warm tub if a heated pool is inconvenient. Unwind your mind and loosen any joints that may have stiffened up from your daily activities with a nightly dip.

  • Treat yourself to some bath salts. Bathing in magnesium sulfate crystals (Epsom salts) may boost your magnesium levels – a mineral that is important for bone and heart health.
  • There are benefits to switching between hot and cold therapies for joint pain. Cold is better for acutely painful and swollen joints. It’s helpful after the muscle and joint aches or soreness after activity or exercise. Don’t alternate hot and cold immediately. Give a couple of hours between sessions.

    When to Ice or Heat an Injury

    Our physical therapists and athletic trainers see injuries of all types at Rebound, whether they’re brought on by sports or everyday activities. This certified group has extensive experience helping patients overcome injuries, reclaim their mobility and live pain-free.

    In honor of National Physical Therapy Month, one of our physical therapists has some expert advice on a popular topic: icing an injury versus heating an injury. When is the right time? What is the difference between the two?

    Physical therapist Michael Baer fills us in on when to ice or heat an injury and some general rules of thumb below.

    “The best way to understand what type of injuries should be iced is to understand how your body reacts to injuries,” says Baer. “Knowing the difference between an acute injury and a chronic condition helps determine when it’s time for ice or heat.”

    What Types of Injuries Should You Apply Ice To?

    Best practice is to apply ice to an acute injury or new injury. An acute injury, such as a sprain, involves tissue damage and inflammation around the injury site. Acute injuries are short-term injuries. Some common acute injuries:

    • Ankle sprain
    • Knee sprain
    • Muscle or joint sprain
    • Red, hot or swollen body part
    • Acute pain after intense exercise

    “When you sprain something, like an ankle for instance, you damage blood vessels,” says Baer. “When blood vessels are damaged, swelling usually occurs. Applying something cold, whether it be ice or even a bag of frozen vegetables, causes the blood vessels to constrict, reducing the swelling.”

    Tips for Icing an Injury

    Like with any injury, it is important to respond quickly. The sooner ice is applied to reduce inflammation, the more likely it is that the injury will heal quickly (ice may limit/prevent internal bleeding). Ice may also be used after high-intensity exercise to prevent inflammation or reduce inflammation.

    Be sure to limit icing sessions to 20 minutes, because excessive icing can irritate the skin or cause tissue damage. Continue to ice the injury for the next 24-48 hours.

    If you are uncertain whether your condition calls for ice or heat therapy, or further medical attention, our physicians will suggest the appropriate treatment method for your individual needs. Physical therapy may be an option if your pain is causing mobility limitations.

    “The easiest trick to remember? If there is swelling, use ice,” says Baer. “If swelling does not go down, visit with your doctor.”

    What Types of Injuries Should You Apply Heat To?

    Chronic pain or conditions usually call for heat therapy. Chronic pain indicates that the body has not fully healed, and pain reoccurs frequently. Some common chronic conditions include:

    • Muscle pain or soreness
    • Stiff joints
    • Arthritis
    • Old/recurring injuries

    “Heat therapy does the opposite of what cold therapy does. Unlike cold therapy’s ability to constrict blood vessels, heat allows for our blood vessels to expand and our muscles to relax. Applying heat creates a soothing effect,” says Baer.

    Tips for Heating an Injury

    This soothing effect occurs because heat also stimulates circulation and increases tissue elasticity, providing pain relief. Heat therapy is generally not to be used after activity. Heat can be applied with a hot, wet towel or heating pad/pack. A hot bath or shower may also relieve pain.

    Just like with cold therapy, it’s important to take certain precautions. “Avoid using heat for an extended amount of time and never sleep with a heating treatment on,” says Baer. “These common mistakes can lead to blisters, irritation and sometimes even burns. Using 20-minute increments is typically most effective.”

    With sub-specialty training in treating shoulders, knees, foot and ankle problems, the spine and a host of sports injuries, our physical therapists are experts in their field. They work with our physicians to rehabilitate patients, helping them move past mobility and pain limitations. If you’re experiencing pain or swelling that does not subside with appropriate ice or heat therapy methods at home, contact us at 1-800-REBOUND.

    Watch the video: Hand u0026 Finger Fitness to STOP Pain u0026 Stiffness After Surgery or Arthritis (July 2021).