Reference;https://mbp-japan.com/jijico/articles/32450/
Modified and translated by CFJA
In North America, people don’t have the habit of using medicated compresses for pain, but Dr. Seino’s article about Japan’s custom of applying them could be very informative for us Canadians as well.
Should you be cautious about applying a warm medicated compress just because of pain!?
Sometimes, “anpō therapy” (compress therapy) is used to relieve pain.
According to the website of the Pharmaceutical Society of Japan,
“Anpō (compress therapy) is a treatment method that applies either heat (warm compress therapy) or cold (cold compress therapy) to the affected area to relieve inflammation, congestion, and pain, thereby improving the condition and alleviating the patient’s subjective symptoms.”
The site lists the following categories:
Cold Compress Therapy (Rei-anpō)
- Dry cold compresses: water pillow, ice bag, CMC-based products (e.g., Ice-Non®)
- Moist cold compresses: cold medicated compresses
Warm Compress Therapy (On-anpō)
- Dry warm compresses: electric heating pad, hot-water bottle, disposable heating pad (kairo), etc.
- Moist warm compresses: warm medicated compresses
Both cold and warm medicated compresses can help “relieve pain and reduce subjective symptoms.” However, when used for conditions other than inflammation, it is essential to understand how to apply them correctly.
Some people think that warm compresses are better than cold ones and continue applying them to conditions like acute low back pain (“lumbago” or “gikkuri-goshi”). However, just like cold compresses, prolonged use of warm compresses can lead to poor blood circulation and impaired nerve function.
Although warmth may give the illusion of improved circulation, the effect is similar to feeling cold after stepping away from a fire—prolonged heating eventually causes reduced blood flow to the area. As with cold compresses, continuous application of warmth lowers the body’s natural self-regulating force (seitai-ryoku), making the pain gradually worse and increasing the likelihood of being unable to move.
How can cold and warm compress therapies (anpō treatments) be applied effectively?
When pain occurs, it can be difficult for someone without medical knowledge to determine whether it will develop into inflammation, or whether it originates from an internal organ disorder. Based on my many years of clinical experience, I would like to introduce the method I often recommend to my patients.
(Example Method of Cold Compress Therapy)
- Apply a cold towel (about 4°C) to the affected area—just cold enough for the patient to feel slightly cool. When the cold sensation fades, remove the towel. The application time varies by person but is roughly 60 seconds.
Note: 4°C is also an effective temperature for cooling the forehead during a fever. - After removing the towel, allow a short interval—about 10 seconds—for the area to return to body temperature. Once the area no longer feels cold to the touch, reapply the cold towel. If the affected area becomes warm, the interval was too long. During the second application, the cool sensation fades faster; this time, apply for 40–50 seconds.
- Remove the towel again and wait another short interval of about 20 seconds until the area no longer feels cold. Then reapply the cold towel. If the area becomes hot, the interval was too long. On the third round, the cooling sensation will fade even faster; this time, apply for 30–40 seconds.
- After the third application, wipe off any moisture with a dry towel.
After finishing cold compress therapy, rest quietly and observe any changes in the pain. In my experience, this procedure has a high likelihood of reducing or eliminating pain.
The exact duration of each step is not fixed—the times above are simply for illustration. The entire process typically takes about three minutes in total.
(Example Method of Warm Compress Therapy)
- Apply a warm, moist towel to the affected area—hot enough for the patient to feel comfortably warm but not painful. When the heat sensation fades, remove the towel. The first application usually lasts around 30 seconds.
- Immediately replace it with another warm towel without any pause. The second time, the heat fades more quickly; apply for 20–25 seconds.
- Replace it again immediately with another warm towel. The third time, the heat will fade even faster; apply for 15–20 seconds.
- After the third application, wipe off any moisture or sweat from the area with a dry towel.
After completing warm compress therapy, rest quietly and observe how the pain changes. This method also has a high probability of eliminating pain.
As with the cold compress, the times given are for reference—the entire procedure should take roughly three minutes.
Warm compress therapy is especially effective when the body feels fatigued or during the chronic phase, typically two weeks or more after the onset of symptoms.
The methods introduced above are effective for relieving pain even without analgesic medication, unlike commercial cold or warm medicated compresses.
When there is inflammation in the body, is it better to cool it or warm it? 01