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Treatment Techniques: Heat Therapy

The next of our treatment techniques, and the opposite of last week, is heat therapy. Again, this is an incredibly basic and easy technique to use but the benefits of therapeutic heating is very underrated. This is mainly due to muscle often being a common source of pain, and muscle responds very well to heat. Muscle pain is often mistaken for other problems, but can contribute to pain from over-exertion, muscle cramps and spasms, and trigger points (‘knots’). Heat therapy gives relaxation, comfort, reassurance and takes the edge off lots of types of body pain. It also relaxes spasmodic muscles, causing pain relief.


Additionally, heat can help with tissue healing. By increasing the temperature of the skin or soft tissue, heat therapy works to increase blood flow by vasodilation. This increases metabolic rate, tissue extensibility and oxygen uptake- all of which help to accelerate tissue healing and aid pain relief, for example, helping muscle soreness after exercise.


Heat is also great for warming muscles and aiding connective tissue mobility before exercise or stretching. For example, hot water bottles on the back of your horse before riding warms up the muscles and tissue, making them more supple, increasing the range of motion and improving their movement.



Sally loves to sit just like this ontop of the sofa where she can warm her paws or body on the radiator!


When not to heat!


However, heat should never be used during the very early stages of injury, post-surgery, infection or flare-ups of arthritis when the inflammatory stage is in full swing. The rule of thumb is that heat therapy can begin around 72-96 hours afterwards- but this is dependent on each case. This is because the increased blood flow to the injured area from the heat therapy will increase swelling, and thus pain. If the skin is hot and red already, swelling and inflammation is still present and therefore it does not require extra heat!


On the other hand, heat is fantastic to use in the second and third phases of tissue healing (after the inflammation phase). During the second phase (proliferation phase) new tissue and scar tissue is formed. Heat can be applied here to help soften and increase extensibility of this scar tissue, facilitating the healing process. In the third phase (remodelling phase) whereby the tissue is returning to health by restoring the structure and function of diseased or injured tissues, heat can be used to aid and encourage processes such as blood clotting, tissue mending, scarring and bone healing.


Heat is reassuring

Heat is reassuring, and reassurance is comforting which often helps with pain relief. Animals are in their comfort zone in warm places- for example, Sally loves to be tucked up under warm blankets or lounging and splayed out by the fire- as I am sure your dogs are too! They feel safe and comforted in warm places, and this, believe it or not, can really help with pain relief. The brain does not feel threat or danger from cold areas- it can relax, rest and heal, and that’s always good for pain relief.




Sally's two favourite places: tucked up in warm blankets or enjoying the heat of the fire.


Heat for trigger points

The very common trigger point (or ‘knot’) is a small area of very sensitive soft tissue within muscle. It can cause anything from general discomfort and stiffness to real excruciating pain. These, in turn, greatly affect an animal’s movement or gait as they attempt to compensate for the pain- thus causing secondary compensatory problems. Furthermore, the pain from the trigger point often spreads and grows, surrounding other painful problems, making a map of complex and hurting muscle tissue that can be very difficult for the veterinary physiotherapist to unpick and understand.


Anecdotally, heat appears to be a great therapy for trigger points. This has been speculated because warmth causes relaxation which reduces muscle tone. Stress and high muscle tone, a state which many animals are in within some areas of their body, are a breeding ground for trigger points. If we can heat, relax and reduce the tone of these muscles, there is a good chance the trigger points will relax also, or will be prevented from developing in the first place. Thus reducing trigger points and the associated pain.


Reduce the use of pain medication

Furthermore, if we can increase pain relief with heat therapy, we may be able to reduce the amount of pain medication your animal is on. This is always a good thing as reducing the pain medication reduces the chances of the unknown side effects the drugs may be causing. This is especially true for pain medication which is taken for a prolonged amount of time.


Ways to heat

There are many types of heat therapy, local heating means specific heating, such as applying a hot water bottle or two, a heating pad, heated gel pack or bean bag to a specific place on the body. For both horses or dogs, gloves can also be filled with hot water or commercial heat wraps can be used.


To conclude, heat is a fantastically simple technique used to reduce pain, reduce muscle tone, spasms and trigger points, prepare tissue for exercise and accelerate tissue healing. If you have any queries on whether your animal may benefit from veterinary physiotherapy or think they could use some therapeutic heating, you can contact me by phone, email, or visiting my website where you can find more of my contact details.



References


Ingraham, Paul. 2020. Heat for Pain: A detailed guide to using heat as therapy for acute and chronic pain. [Online]. Painscience.com. Available from: https://www.painscience.com/articles/heating.php


Physiopedia. 2020. Thermotherapy. [Online]. Physiopedia. Available from: https://www.physio-pedia.com/Thermotherapy

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