Heat treatments are placed at or near the site of the pain to relieve the pain. Heat relieves pain by: 1) improving circulation to skin and muscles, 2) relaxing muscles and reducing muscle spasms and irritation, and 3) decreasing sensitivity to pain.
Heat Treatment Options:
Instant heat pack
Portable hot water therapy pump
Adhesive warming patch
Heat Application guidelines:
Don’t use if it increases the pain
Don’t use on areas being treated by radiation or open wounds
Do not put boiling water in a hot water bottle or on a washcloth - water temperature should be between 104- & 113-degrees Fahrenheit
Do not apply heat directly over transdermal medication patch
NEVER USE PRODUCTS CONTAINING MENTHOL WHEN USING HEAT. These products cause skin to absorb heat more deeply and might cause burns (examples: Icy Hot or Ben-Gay)
Don’t use heat on an acute injury; may increase inflammation or bleeding in area
Don’t use a heat lamp
Regularly check skin areas for irritation or burns and document
Think WARM, not HOT. Keep single layer of material between heat source & skin
Use moist heat… increases effect of heat
Apply heat on the area for 20 to 30 minutes every 2 hours
Patient with peripheral neuropathies - use caution in areas where there is an impaired ability to feel
On individuals with thin/fragile skin
Heating pad, on lowest setting, while individual is awake
Necessary equipment for warm, moist compress treatment:
Small hand towel
Compress (e.g., flax seeds bag, clay pack, reusable gel pack)
Thermometer (type used for pools or spas)
Six-inch elastic wrap, or other device to secure the pack
Flax seed or clay/gel compress can be microwaved per manufacturer’s instructions.
Place towel in warm water, or moist towel can be placed in a towel warmer.
Check temperatures of moist towel and compress, making sure that temperatures of both items are between 104- and 113-degrees Fahrenheit.
Wrap warm moist towel around the warmed compress
Apply to appropriate area and secure loosely with elastic wrap
Keep towel/compress on area for as long as possible to obtain relief, usually 20 – 30 minutes. Re-warm when towel or compress is no longer warm. Check temperature each time the compress is reapplied. Typically applied intermittently on skin for 10 – 20 minutes at a time. May be used for any length of time if skin is not irritated.
Try alternating hot and cold to improve comfort. Find correct area or temperature that provides optimal pain relief.
What else the Caregiver should do:
Ensure you are trained appropriately prior to implementing this Nondrug Treatment Technique, speak with a professional or your loved one’s healthcare team to determine correct technique or where to find prior training if you need additional training.
Provide assistance as needed to your loved one with implementing this Nondrug Treatment Technique, i.e. if needed to prepare & apply the warm compress or ace wrap; assist with timing the application of heat; etc.
Document all Nondrug Treatment Techniques on your loved one’s Pain Diary and log pain information before and after use of Nondrug Treatment.
Adapted from: Fouladbakhsh, J.M., et al., Nondrug therapies for pain management among rural older adults. Pain Manag Nurs, 2011. 12(2): p. 70-81. 2. The Nursing Home Pain Management Algorithm Clinical Trial, R01 NR009100, 7/1/05 – 4/30/10; Mary Ersek (PI) Used with permission of Mary Ersek and HPNA (2009).
Reference: Swedish Medical Center. Nursing Assistant End-of-Life: Computerized Educational Program. Pittsburgh, PA: Hospice and Palliative Nursing Association; 2006.