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Shoulder Pain - Using Heat To Treat Trigger Points



Shoulder Pain can often be effectively managed with a combination of heat and ice

Shoulder injuries can be extremely painful, and the shoulder is one of the easiest parts of the body to re-injure. Shoulder damage can often benefit from heat and/or ice therapy.

Frozen Shoulder

Frozen shoulder and shoulder inflammation is best treated locally with a simple ice pack.

Interestingly, a study in Korea concluded that patients suffering from adhesive capsulitis (AC) of the shoulder can benefit from whole body cryotherapy (see below).

During the acute phase of frozen shoulder, the patient suffers from night pain and spasms. There is also chronic inflammation. The long head of the biceps tendon is often characterised by both acute and chronic symptoms. Treatment should involve icing the top front of the shoulder for about 10 minutes before bed every night.


Hot and cold therapy is very effective in the treatment of arthritis. Doctors suggest treating the inflammation and pain associated with arthritis by using both heat and ice.

You should use heat before you do exercise and cold after exercise.

To deal with pain and inflammation, use an ice pack for 20-30 minute intervals every 4-5 hours. Heat relaxes the muscles and reduces pain.

You should only use a heat pack for 20-30 minutes at a time. Wait at least an hour before applying the pack again, or you may cause tissue damage.

If your joints are swollen, do not apply any heat at all. If you have nerve damage, you should avoid hot and cold therapy altogether.

Calcific Tendonitis

Calcific tendonitis benefits from a combination of heat and ice. Alternating heat and ice reduces pain and helps the injury to heal.

Starting with cold, alternate cold and hot packs in 15 minute intervals a few times each day until you feel the pain diminishing.

Bursitis, Biceps Tendonitis, Impingement and Rotator Cuff Tendonitis

Putting ice on your shoulder helps reduce inflammation and pain. Use a cold pack for 15 to 20 minutes every three or four hours.

After a few days, when the pain and inflammation have improved, hot packs or a heating pad may help relax tightened and sore muscles.


Another form of cold therapy is cryotherapy, which involves freezing part of the skin with liquid nitrogen.

This method has been used to treat tissue damage since the 17th century. It is very effective in constricting the blood vessels and decreasing inflammation, pain and spasms.

Cryotherapy is used to treat a number of problems, and is even used in surgery to remove the prostate and by dermatologists to remove skin lesions.

There is also full body cryotherapy, where the patient enters a chamber cooled with liquid nitrogen for a short period of time – around 3 minutes.

During the treatment the patient is dressed only in a bathing suit, but wears socks, gloves, and protection for their ears and mouth to prevent frostbite.

This procedure diminishes pain because it stimulates the body to release endorphins.

Patients report positive, healing effects for a number of mental and physical conditions including stress, shoulder pain, muscle and joint pain, rheumatism, and fibromyalgia.


Heat and Ice Therapy for Trigger Points


Trigger Point Therapy

Many therapists will recommend heat and ice therapy for patients to help manage pain between trigger point treatments. 

Both heat and ice are commonly used as a key component of effective trigger point treatment.

This usually includes massage, compression, stretching and the application of both ice and heat at time of treatment.

Don't apply heat or ice directly to the skin!

It’s important to remember not to use cold next to dry skin. Put either oil with a plastic bag over it or oil and a wet towel on your skin first, and then apply the cold pack.

This is to prevent you from getting frostbite, because ice can burn your skin. It’s also a good idea not to put heat directly on your skin unless it is only warm.

A heating pad next to dry skin can burn you if the heat is extreme. To prevent this, put a towel in between your skin and the heating pad.

When not to use heat and ice

There are a number of situations when ice and heat should not be used.

These include having poor circulation, skin with lesions or scratches on it, nerve damage, skin with a negative reaction to hot or cold, an infection, or diabetes. In addition, never put heat or cold over an open wound or an area that is bleeding.

If you’re pregnant, you should avoid taking a very hot bath or putting heat near your abdomen area.

There are other conditions when using heat and ice is inappropriate, so always check with your doctor or health professional before you begin treatment.



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Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.

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We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.

Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.

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Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.

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There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.

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Niel Asher Technique

Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.

The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. 






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