Application of heat generally increases metabolic activity, with resulting increase in circulation and exacerbation of inflammation, while cold in most cases has the opposite effect. Choice of treatment method in a given case is based on many factors, including the physical properties (ie, depth of penetration and method of energy delivery) of the modality under consideration and knowledge of the contraindications. A thorough understanding of the physiologic bases for use of thermotherapy and cryotherapy as well as of the various methods for delivery of therapeutic heat and cold will allow the physician to make optimal use of the modalities available.
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Tepperman et al. (1983) studied this question.
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