Heat and Cold Therapy for DOMS Relief: Evidence from 32 RCTs

Overview A systematic review and meta-analysis evaluated the effectiveness of heat and cold therapy in managing delayed onset muscle soreness (DOMS). The study synthesized findings from 32 randomized controlled trials (RCTs) involving 1098 participants to determine whether these treatments alleviate pain after exercise.

Key Findings

Cold Therapy:

• Most effective when applied within 1 hour post-exercise.
• Reduces pain within 24 hours after exercise (Standardized Mean Difference [SMD] -0.57, 95% CI: -0.89 to -0.25; P = 0.0005).
• No significant effect observed after 24 hours (P = 0.05).
• Among cold therapies:

Cold water immersion: Significant pain reduction (SMD -0.48; P = 0.008).

Other cold methods (e.g., ice packs): Also effective (SMD -0.68; P = 0.03).

Heat Therapy:

• Demonstrated significant pain reduction both within and beyond 24 hours.
• Within 24 hours: SMD -1.17 (95% CI: -2.62 to -0.09; P = 0.03).
• After 24 hours: SMD -0.82 (95% CI: -1.38 to -0.26; P = 0.004).
• Hot packs were particularly effective:

Within 24 hours: SMD -2.31 (P = 0.03).

Over 24 hours: SMD -1.78 (P = 0.003).

• Other thermal modalities showed no statistically significant results.

Cold vs. Heat:

• Both therapies were effective, but no significant difference was found between them (P = 0.16).

Conclusion

Applying cold or heat therapy within the first hour after exercise can effectively reduce DOMS-related pain. Cold water immersion and hot packs emerged as the most beneficial methods. Despite promising results, further high-quality research is needed to determine whether cold or heat therapy provides superior benefits.

Practical Implication: For individuals experiencing DOMS, incorporating either cold immersion or hot packs promptly post-exercise may aid in pain relief and muscle recovery.

Source: PubMed PMID: 33493991 (https://pubmed.ncbi.nlm.nih.gov/33493991/).