This article is a transcribed edited summary of a video Bob and Brad recorded in December of 2021. For the original video go to https://youtu.be/zSnELDxFz4E.
Brad: Today we’re talking about the dangers of plug-in hot pads, things you must know. Now, Bob, I, and Mike, as physical therapists have been using hot pads in the clinic with patients as long as we’ve been treating. They work very effectively, but there are some dangers that we know, because that’s what we work with. You’ll want to know if you have these or if you want to work with a plug-in hot pad. So first, why heat works. You really want to increase the circulation. You put your hot pack around the injured area, and it’ll allow the muscle to relax.
Mike: It increases the blood flow to the area. Your blood carries all your nutrients, helps your healing process occur faster.
Brad: And the oxygen, of course. And you get rid of the waste products, the carbon dioxide, the lactic acid, whatever else may be there that needs to get back.
Mike: And it just feels nice.
Brad: Yeah, it does.
Mike: Especially during winter.
Brad: It’s one of those things as a therapist, it’s nice to say, “We’ll put your hot pack on now” and the patient says, “Oh thank you.” It’s a good rapport builder right there, versus a cold pack. Sometimes they do not want those.
Mike: They don’t like you. They make faces at you.
Brad: So, let’s talk about this. We have two different kinds of hot packs here. We have the plugin conduction, this is your standard hot pack. They’ve been around for years.
Mike: You can find them anywhere.
Brad: They don’t cost too much. They’re about $30-40. Obviously, they plug in, they often have three to four temperature settings. For these to work, they are conduction hot pads. The electricity flows through them, there is resistance that creates heat. That heat gets to your body through contact. If you’re going to heat up your leg, you have to have it touching your leg in order for it to work.
Mike: You can use either side with this one. The far infrared, you can only use one side the way that hot pack’s set up.
Brad: So, with the far infrared, you can only use one side. Instead of conduction, it uses light rays, far infrared light rays. It works like the sun, or if you’re by a fire, you can feel the heat from a fire. That’s the same principle. So, if I’m going to heat up my leg, I’m going to put it down and wrap it around. I have elastic straps to help it stay on there. They work nice. Now, here is the biggest difference, aside from the cost, but there’s a reason why the far infrared costs more. The depth the heat will penetrate from a conduction hot pack like that is?
Mike: One eighth inch.
Brad: Right. One eighth inch versus 2.36 inches with far infrared. So, much deeper with the far infrared pad. So, if you put it on your leg, and we have three panels, you’re going to put it on. It’s going to go 2.36 inches in the sides of your legs. That’s going to get deep into the muscle. It’s going to get into the joint, get that synovial fluid, the blood circulating at a depth that that will not compare to. That’s the big difference.
Mike: I should say, I’ve used both. Obviously, you have two. The infrared gets nice and warm, but it doesn’t get overly hot. Like, I’ve never had an issue where it feels hot or hot superficially where this one, I’ve had that issue before.
Brad: And which brought me up to the question, how hot do these get? Well, I looked it up at Thermotex, they have a nice website, and they said, this get up to 116 or 117 degrees, is what they had. The other one, I didn’t know. This says four different temperature settings. So, what I did is I took a thermometer, made for putting in your meat to see how hot your meat is.
Mike: Did you clean it off before you did that?
Brad: Of course, I did!
Mike: Okay, just checking.
Brad: As a matter of fact, I even tested it to make sure it’s accurate by, cleaning it off, put it under my tongue, then I took my oral thermometer that’s made for putting under your tongue and one, the difference was 0.1-degree Fahrenheit, so, I felt that it was going to work out well.
Mike: These are the scientific methods at Bob and Brad.
Brad: Whatever, I’m using the same thermometer there. This is a digital thermometer.
Mike: Still works the same.
Brad: What I did with the conduction heating pad is, I folded it over, I put it on the table. I put the thermometer which is about four or five inches long and put the needle in the crease and I left it there for five minutes until the temperature stabilized.
Mike: Yep, and it has four settings on here, just FYI.
Brad: Thermotex only has on/off. I did the same thing with it. Put it over there and I waited longer. I went 15 minutes on this because far infrared heats up slower. Quite a bit slower. But it goes quite a bit deeper. So, you leave it on longer than you would that standard heating pad. So, here are the temperatures. This is interesting. I thought it was interesting. For the lowest setting on the standard one, it went to….
Mike: 110 degrees.
Brad: The next setting up…
Mike: Well, that was warm. Low was 124 degrees. Medium was 134 and high was 145 degrees. This has a 15-to-20-minute time limit.
Brad: Now, that’s what they recommend. That has an automatic shutoff at two hours.
Mike: Oh.
Brad: Now, we’re going to talk about precautions. Now you can start to see why maybe you can get burned. You can burn your skin with these temperatures if they’re not used properly. Now, the Thermotex on my thermometer went to 119 degrees and it leveled off there. Again, the factory said 116 and it might be just that my meat thermometer was off a few degrees. Either way, the temperature between the two is quite different because we had the same thermometer and we had 145 to 119.
Mike: Yeah. It’s a big difference. Precautions you should follow for either of these is never put them directly on your skin. You should always try to have one layer of clothing and be cautious if you have very fragile or thin skin.
Brad: Right. I would say if you had one layer and you have an elderly person or with fragile skin, take a towel, put it over and then put the hot pack on.
Mike: It’s different if it’s laying on top or you’re lying on it. The amount of pressure is going to intensify, so you’re going to need more layers if you’re on it.
Brad: Right. Not so much with the far infrared, but with the standard electric conduction heater. Number two, never use near your eyes, or there’s no reason to use it around your head.
Mike: Like I said earlier, never use it directly on frail skin. We’ve had that with elderly patients before. Be very cautious, they can blister and burn a lot easier or even start weeping.
Brad: Right. That’s big because when you have a burn from a hot pack, they go deep, and they don’t heal quickly. Particularly with fragile skin. Never use on abdominal area if pregnant, particularly with the far infrared. Just stay away from that.
Mike: Never on skin with poor sensation. So, if you had a stroke, you have neuropathy of sorts, if you can’t have good sensation in the area, you should probably not use it on there because again, you can leave it on too long, get hotter than you think, lead to burns.
Brad: Right. Again, the biggest thing is falling asleep. You do not want to fall asleep with these on, that can cause a burn. Now, the far infrared does not get near as hot, but if you fall asleep with this one, and you have frail skin, and you put it directly on your skin or on thin skin, there’s a possibility you could have some problems with it. Be safe, always use some caution.
Mike: Yeah, you’re more prone to get burned on a shallow skin area, not a big muscle belly. Just keep that in mind.
Brad: Yeah, exactly. Over the kneecap where you have skin and bone directly underneath, that would be a definite hotspot. So again, people who cannot communicate well. Let’s say someone had a stroke or there’s some cognitive issues and it’s hard to get distinct response to" Is this too hot?" And if they cannot come up with a yes or no, it’s not a good person to use a warm pack on.
Mike: Yeah, you never know if it’s going to get too hot because the burn doesn’t always appear right away. Sometimes it takes a day to have that happen. Never use by water.
Brad: Right. That’s obvious that’s for both.
Mike: There are some other precautions like don’t have metal with it. They don’t suggest using it by oxygen. That’s basically about it.
Brad: Length of time, you would typically use these. The standard conduction pad, we would go 15-20 minutes max in the clinic. Again, continue to ask the patient or let them know if it feels too warm, put another layer of toweling or some cloth between it.
Mike: And you can use it numerous times a day if you want to do it longer just take breaks from it. Don’t use it for like two hours nonstop.
Brad: Exactly right. Now with the far infrared, it takes longer to heat up, but you can put more layers of cloth and it’ll go right through the cloth anyways. It’s still going to get you 2.36 inches, minus the cloths. So, put that on. I’ve tried that with winter clothing on and I put it on that to test it. Takes about 5-10 minutes before you feel the heat, but it gets in there and it’s still going to get deep. Then the other thing is just a hygiene issue. Use cloth between the skin. That’s why in the clinic we don’t share one patient to the other and do it directly on skin.
Mike: I mean if you have your own at home, it’s fine.
Brad: Right.
Mike: Also, this standard conduction heating pad is from Walgreens, it comes with all the precautions on the back in case you’re curious.
Brad: I needed my reading glasses on, but yeah, they’re covering all the ones we had, plus a few other ones I think were obvious. So again, the far infrared, 45 minutes is what they recommend. I’ll be honest with you, I’ve had this on my back at home, it’s great in wintertime, I sit with it behind my back in my chair and I’ve fallen asleep on it, but I have clothing. I’ve never had any problem with skin burning, but we don’t recommend that, naturally. Thanks!
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