Can hot compresses be used during the remission period of chronic pain? Why shouldn’t water be used?

Hot compresses can be used in most cases during the remission period of chronic pain. However, the so-called "no touching water" is not a general taboo at all, but is only a requirement for a few special scenarios. Many people get it confused.

Not long ago, an aunt came to my clinic who had been suffering from lumbar muscle strain for almost 3 years. During the remission period, she always felt stiffness and coldness in her lower back. She usually used a hot water bag at home to apply it, which was very comfortable. But last week, I heard a neighbor in the community say that "touching water in painful areas will leave the root of the disease." Even when taking a bath, she only dared to wipe her upper body with a towel, and she didn't dare to touch her lower back. When she came, she rushed to ask me if this was true.

In fact, for the most common chronic pains such as lumbar muscle strain, degenerative arthritis, and myofasciitis, the inflammation in the remission period is non-infectious. To put it bluntly, it means that the local blood supply is poor, metabolic waste is piled up and cannot be discharged, and the muscles are always tense, and the temperature of the hot compress penetrates. It's like "opening the gate" of a blocked blood vessel. The blood flow rate is increased, and the accumulated lactic acid and inflammatory factors are metabolized. Tight muscles can also be relaxed, and the feeling of soreness and pain is naturally relieved. Many people feel that after applying it, they feel relaxed. This is the reason.

However, not all chronic pain is suitable for hot compresses during the remission period. I have also come into contact with many colleagues who disagree. For example, for patients with gouty arthritis, we will not recommend hot compresses even during the remission period. Increased temperature will increase the local permeability of the joints. Uric acid crystals are more likely to irritate soft tissues, which may induce acute attacks. There are also neuropathic pains such as postherpetic neuralgia. Some patients have hyperalgesia. The temperature stimulation of hot compresses will actually aggravate the pain. Of course, do not apply hard compresses in this case.

As for the "no touching water" that everyone hears, it is a myth. The earliest taboo was for acute injuries. For example, touching hot water within 72 hours after a sprained foot will aggravate the swelling, or if the skin at the hot compress area is ulcerated. Touching water can easily induce infection, and it will gradually turn into chronic pain. Do not touch water. In fact, as long as there are no breaks in the skin, it is absolutely fine to use warm water of a suitable temperature during the remission period. You can even bathe in warm water and shower the painful area, which is a large-scale hot compress in itself, and the effect is better than applying a hot water bag alone. After the aunt returned home, she took a shower every day and rinsed her lower back with warm water at about 40 degrees for 10 minutes. Last week, she came for a review and said that the stiffness in her waist was much better than when she only applied a hot water bottle.

Of course, some people say that the pain is more severe after touching water during the remission period. Most of them are caused by touching ice water, or not drying off in time after touching water and being blown by the wind. The stimulation of cold water will cause the blood vessels to contract suddenly and the muscles to spasm. The already fragile soft tissue will definitely be uncomfortable if it is stimulated. This is not a problem caused by touching the water, but because the temperature of the water is wrong.

In fact, these precautions do not need to be too dogmatic. If you feel comfortable after applying hot compress and warm water, you can continue to use it. If the pain becomes more obvious after using it, just stop. If you are really not sure, it won't cost much to ask a doctor in the pain department or rehabilitation department.