Precautions

Cold pack

• Never apply the ice directly on the skin.
• Never treat by ice for more than 30 minutes.
• Remove the cold pack immediately if the skin appears bright pink or red.
• Don’t use a cold pack on the left shoulder if you have a heart condition.
• Don’t use a cold pack on the front of the neck.
• For elderly patients, you can use the intermittent icing technique (e.g., 10 minutes on 10 minutes off).

Hot pack:

• Never apply the heat directly on the skin.
• Do not use a hot pack after activity or after an acute injury.
• Never use over an area has a swelling or inflammation.
• Never leave heating towels or hot packs on any area for extended periods or while sleeping.
• Don’t use hot packs over a skinny area like the front of the neck or back of the knees
• Take care when applying heat over a bony prominence area.

Other precautions for hot and cold packs

Don’t apply :

• Over poor condition areas of the skin.
• Avoid applying cold or hot packs over areas of low sensation to the heat or cold.
• Over areas of the body with known poor circulation.
• If you have diabetes.
• If there is an infection.

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REFERENCES:

1. https://www.scoi.com/patient-resources/education/articles/should-you-ice-or-heat-injury

2. https://www.physio-pedia.com/Cryotherapy_Guidelines

3. https://www.ncbi.nlm.nih.gov/pubmed/25526231

4. https://physio-pedia.com/Thermotherapy