Professional athletes may use ice massage, cold water immersion, and whole-body cryotherapy chambers to reduce exercise-induced muscle damage (EIMD) that can lead to delayed onset muscle soreness (DOMS). DOMS commonly emerges 24 to 48 hours after exercise.

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Contrast water therapy (CWT) uses both heat and cold to treat pain. Studies show that it is more effective at reducing EIMD and preventing DOMS than doing nothing.

It should not be applied directly to the skin, as this can freeze and damage body tissues, possibly leading to frostbite.

As the blood vessels expand, circulation improves, and the incoming flow of blood brings nutrients to help the injured tissues heal.

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It may be less helpful for back pain, possibly because the injury is not new, or because the problem tissue, if it is inflamed, lies deep beneath other tissues and far from the cold press.

In 2006, a team of researchers found that patients with lower back pain who exercised and use continuous low-level heat wrap therapy (CLHT) experienced less pain than those who did not use CLHT.

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For cold therapy, or cryotherapy, a water bottle filled with cold water, a pad cooled in the freezer, or cool water can be used.

A study published in The Cochrane Library in 2012 suggested that a cold bath after exercise may help prevent DOMS, compared with resting or doing nothing.

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Basic heat therapy, or thermotherapy can involve the use of a hot water bottle, pads that can be heated in a microwave, or a warm bath.

However, the researchers point out that it may not better than other strategies, such as heat treatment, cold treatment, stretching, or compression. They say that more evidence is necessary.

Cold treatment reduces blood flow to an injured area. This slows the rate of inflammation and reduces the risk of swelling and tissue damage.

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Heat and cold treatment may not be suitable for people with diabetic neuropathy or another condition that reduces sensations of hot or cold, such as Raynaud’s syndrome, or if they are very young or old, or have cognitive or communication difficulties.

Heat should not be used on a new injury, an open wound, or if the person is already overheated. The temperature should be comfortable. It should not burn.

Some researchers have suggested that moist chemical heat packs, which can be used for 2 hours, may be the best way to prevent DOMS through heat treatment.

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Heat packs can be dry or moist. Dry heat can be applied for up to 8 hours, while moist heat can be applied for 2 hours. Moist heat is believed to act more quickly.

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Improved circulation can help eliminate the buildup of lactic acid waste occurs after some types of exercise. Heat is also psychologically reassuring, which can enhance its analgesic properties.

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Science has yet to firmly establish the effectiveness of heat and cold therapies, but neither treatment is very potent, and the danger of an adverse reaction, when applied to a particular point on the body, is usually low.

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Heat is not suitable for all injury types. Any injury that is already hot will not benefit from further warming. These include infections, burns, or fresh injuries.

It also numbs sore tissues, acting as a local anesthetic, and slows down the pain messages being transmitted to the brain.

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When cold is applied to the body, the blood vessels contract, vasoconstriction occurs. This means that circulation is reduced, and pain decreases.

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Applying heat to an inflamed area will dilate the blood vessels, promote blood flow, and help sore and tightened muscles relax.

However, the researchers were not certain whether there may be negative side effects, or if another strategy might be more helpful.

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Ice should not be used if a person is already cold. Applying ice to tense or stiff muscles in the back or neck may make the pain worse.

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Previous studies had shown that, for some people, CLHT relieved pain more effectively than oral analgesics, acetaminophen, and ibuprofen.

A review of studies has suggested that, for elite athletes, CWT is better at reducing muscle pain after exercise compared with doing nothing or resting.

The participants spent between 5 and 24 minutes in water between 50 and 59 degrees Fahrenheit, or 10 to 15 degrees Celsius.

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There is some evidence that this might help, but heat that is applied for only 5 to 20 minutes may be less effective, as does not have the chance impact the deeper levels of tissue.

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