General

Warm Compress Tips for the Patients

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27 Aug 2016 - General
 


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Warm compress is a very popular adjunct to pain medications for relieving pain. However, a lot of people are using warm compress inappropriately. It is our role as healthcare providers to correct some misconceptions of warm compress.


Patient education should center on the following:

* Temperature - it should feel warm and not hot or scalding. Application of compress that is hot may cause skin burns.


* Duration - 20 minutes of warm compress is ideal. Studies have shown that there were no additional pain relief or other benefits from using warm compress for more than 20 minutes. Extending application beyond 30 minutes will only increase risk for burns.


* Time of application - Warm compress is generally not ideal for use during the first 48-72 hours of pain onset. It causes vasodilation that will cause influx of inflammatory mediates and further swelling. It increases sensitivity of muscle spindles and Golgi tendon organs that will worsen muscle spasm, if present. Use of warm compress is ideal after 3 days from first onset of pain. However, immediate warm compress application is indicated for some ophthalmologic conditions to facilitate drainage of infection.


* Frequency - Warm compress should be done at least 3x a day to optimize physiologic benefits such as pain relief.


* Interval - Interval between compress application should be at least one hour to prevent skin burns.

For the MIMS community, what are the other instructions that you provide to patients who will benefit with warm compress application? Do you know of other conditions that require immediate warm compress application instead of cold packs?

Mark Edmon Tan Well no, we are not really that cautious with the use of NSAIDS. After abdominal surgery generally we give IM pethidine as analgesics, because as I mentioned earlier keeping the patient pain free is important to maintain good ventilation and reduce the risk of chest infections. After the first few days, we change the analgesics to NSAIDs, most commonly diclofenac per rectally twice a day, along wit...
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Lianne Marie Victoria Laruan Thank you for showing interest in the article. I am glad that you found the article helpful. I have heard that this works for dysmenorrhea too. As for your question, the onset of pain is crucial to deciding whether to use warm or cold compress. For the first 2-3 days of pain, it is better to use cold compress because it prevents further flow of inflammatory cells to the site of pain. A...
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Theekshana Abayawickrama Surgeons are really adept with post-operative pain management. Patient distress is really common with onset of pain. Most have low pain threshold and would really request for their medications round the clock. Providing them with the option of compress application actually empowers them or the relatives to manage pain. In turn, they rely less on taking pain medications and become reassured...
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Mark Edmon Tan Thanks for sharing this information! I usually use warm compress for dysmenorrhea and a variety of pains that don’t go away after a day or two, especially if I don’t want to take medications. Now I know better how to use warm compress! Like many, I used to think that the longer the contact on skin, the better; I’m surprised that only 20 minutes is actually needed. Now I know how to better recommend...
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Yeah that is very true. Management of pain plays a big role in post operative management of surgical patients. Having a 10 inch long cut in the middle of the tummy is extremely painful for a two or three year old kid. Even an appendicectomy scar is too painful. Pain management is important fro surgical patients for two reasons. One is to keep the patients without distress. Second is to make sure their respiration occurs without difficulty and the lungs expand properly so they don't get sec...
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Theekshana Abayawickrama Yes, we have to start educating them that warm compress is ideal for this amount of time only. It is human nature to think that doing more is better. However, it does hold true for warm compress like it is for most instances. Patients might even setup themselves for skin burns if they apply warm compress longer with increased frequency. I think this comes in handy for your field where pati...
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Thank you for this post. I did not know that there was a, ideal duration for warm compress. I would just advice patients to keep a warm cloth or bag of water on the aching area, that's it. I think from now on I should start mentioning that they have to do it for 20 minutes, and 20 minutes only. And yeah, the time of application of warm compress is also important. at the onset of the local inflammatory reaction, dilatation of blood vessels by heat can cause a flare up of the disease, so we sh...
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