Cold Compression - Indications and Methods

Cold compression is a physiotherapeutic modality used to treat pain and inflammation due to injuries or post-surgeries. Read this article for elaboration.

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What Is Cold Compression?

Cold compression is a type of physiotherapy technique that combines heat and compression for treating painful and inflammatory conditions. The therapist uses gauze, soft linen, or lint piece for moist cold application to the area affected. Cold compresses cause vasoconstriction in the skin applied, and if the cold compress covers a large area of the body, some blood is driven there. This is used beneficially for treating many wounds. Cold compression is often applied immediately after an acute injury or after surgery to reduce symptoms like pain and swelling and enables speedy recovery.

What Are the Indications?

Cold compression can be applied for pain relief in the following conditions:

• It can be used in conditions like fever.
• When there is throbbing pain due to edema or trauma, a cold compress can be used.
• It can be applied for pain relief due to sprain.
• It can be used as a precordial compress when there is tachycardia (a fast heartbeat of more than 100 beats per minute).
• Conditions like headaches and sinusitis can be treated. Sinusitis is a condition in which the cavities in the face called sinuses are inflamed.
• They can also be used for relieving congestion in the face.
• Congestion in the chest can also be relieved with a cold compress combined with fomentations.

What Is the Mechanism of Action?

The cold application acts on the surrounding soft tissue by suppressing the metabolic rate. This suppression leads to a decrease in enzymatic activity, preventing tissue damage that occurs due to hypoxia. Local hypothermia is developed, which will induce vasoconstriction and will lower the microcirculation that can continue for 30 minutes even after the cold application is stopped. This vasoconstriction induced by cold compression reduces the extravasation of blood into the adjacent tissue, edema production, and local inflammation. Edema can be moved away from the site of injury, and there it can be resolved. Cold compression can reduce swelling and blood flow by moving the edema away. Cold application combined with compression can increase the speed of temperature drop and lymph drainage to reduce swelling.

What Are the Methods of Cold Application?

1. Icecap or Ice Collar: An ice cap is a type of dry cold application. It has a wide opening through which ice chips can be filled. Single-use bags are often used in this method. An ice bag is filled with finely chopped ice that measures about 2 centimeters. The bag is closed and then wrapped on a towel for application on the skin. It is applied every 20 minutes, and a 20 minutes rest is given between each application. They are specifically shaped to be used in curved spaces like the neck (cravat), spine, and head (ice cap).
2. Cold Sponging: This method is used to reduce the temperature in patients with a fever. A wide area of the body is sponged to allow heat transfer to the cold solution. After the cold application, the area is tapped using a towel instead of rubbing. Rubbing can cause heat production. Vital measurements are taken throughout the therapy to prevent any unwanted complications. The temperature of the water is moderated between 65 to 90 degrees Fahrenheit.
3. Tepid Sponging: It is a safe technique to be used in hyperpyrexia (free) and uses tepid water to bring down the temperature. The temperature of the water is moderated between 85 to 100 degrees Fahrenheit. Long strokes are used for sponging, and circular movements are avoided in this technique to reduce friction that can produce heat.
4. Cold Compress: It is a type of moist cold application. Cold compresses are made sterile and applied on breaks in the skin or open wounds. They can be applied with old soft linens and gauze or ice water in evaporating lotions.

How Is Cold Compression Done?

The therapist explains the procedure to the patient. A small basin with cold water is placed over a large basin containing ice. After washing the hands, the therapist places the compress in cold water. The waterproof material is placed under the area to be treated. Cold compression is applied over the affected area and checked every five minutes. The compress is changed every five minutes or when the compress gets heated. The compress is removed after 20 minutes. Then that area is patted with a dry towel. Cold application for more than 20 minutes can lead to secondary effects. The application of a cold compress over the skin helps in the conduction of heat.

What Are the Effects of Cold Compression?

• Cold compression helps to reduce pain and swelling.
• It helps in providing comfort to patients suffering from painful conditions.
• Cold compresses help reduce body temperature.
• Cold compress application reduces inflammation and edema caused due to underlying medical conditions.
• Burning sensation and irritation in the wounds can be eased by applying cold compresses.
• A cold compress can be used to anesthetize a particular area for a short time.
• A cold compress can be used to control hemorrhage. Hemorrhage is the loss of blood from a damaged blood vessel. Blood loss can be minimal or significant, and the bleeding may occur inside or outside the body.
• Cold compress also helps in the inhibition of bacterial growth. In this way, suppuration is also prevented.
• If a cold compress is applied over the heart region, the heart rate will be slowed, and an increase in the force and rise of the arterial blood pressure is seen.
• A cold compress helps to relieve congestion.

What Are the Contraindications?

• A cold compress should be used with caution in patients with diabetes.
• It cannot be used in a localized area of inflammation.
• Patients with cold intolerance are contraindicated.

Conclusion

Cold compression therapy, when compared to other techniques to obtain pain relief, is the best technique. Cold compression therapy is routinely applied as a preventive measure for sports injuries and immediately after an acute musculoskeletal injury. Cold compression directly acts on the pain, inflammation, and swelling that occur along with the injury. This technique has also been employed as a post-operative measure for various surgeries. The tissue damage caused due to surgery can be treated with cold compression.

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