“My Physio Said Use Heat” — But How, Exactly?

“Use some heat on it” is one of the most common things a physio says, and one of the least specific, lol.

You get home and realise you don’t know where exactly, for how long, how often, or whether to do it before or after your exercises.

Here’s the version most clinicians mean.

The short version

• Where: on the muscle that’s tight, not necessarily where the pain is sharpest.
• How hot: clearly warm, never hot. Lowest setting that you can feel.
• How long: 15–20 minutes.
• How often: two to four times a day, with at least an hour between.
• When: before your exercises, not instead of them.

That last point is the one that matters most, and the one most often missed.

Why “before” is the whole point

Warm tissue stretches further and hurts less to move. Your physio is giving you a window where the exercises are easier and you get more range from the same effort. This is the same reason clinics warm an area before hands-on work: what the evidence says about heat before manual therapy.

The window is short, maybe twenty or thirty minutes. Heat, then sit back down, and you’ve had a pleasant twenty minutes and nothing more.

So the sequence is: heat, then exercises, straight away, while you’re still warm.

Getting the position right

One rule covers most of it: put the pad on top of you, don’t lie on it.

Lying on a pad presses it into your skin and squeezes out the blood flow that would carry heat away. Pressure plus heat is how burns happen at settings that would otherwise be fine.

• Lower back: on your side, knees bent, pillow between them, pad over the back.
• Neck and shoulders: sitting upright and supported, pad draped over.
• Knee, ankle, elbow: wrapped loosely, lowest setting only. Thin skin over bone.
• Hands: pad flat, hands resting on top.

The skin check

Look at your skin after every session, at least for the first week with a new pad.

• Even light pink that fades within an hour: normal.
• Blotchy red, or white patches: too hot or too long. Turn it down. See toasted skin syndrome.
• Blistering, or stinging hours later: stop, and see a doctor if it’s larger than a coin.

If your skin goes pink at the lowest setting, add a layer of clothing under the cover rather than shortening the session to five minutes.

Questions worth asking at your next appointment

• Exactly where should I put it?
• Before or after the exercises?
• Is there anywhere I should keep it off?
• How will I know it’s working?
• When should I switch to cold instead?

Most clinicians are glad to be asked. Vague advice usually means it wasn’t the main part of the plan, not that the detail doesn’t matter.

If you’re the clinician giving the advice, there’s a one-page version to hand out: prescribing home heat.

When to go back rather than keep heating

• Nothing has changed after two weeks of doing it properly
• The area is more painful or swollen after heat
• New numbness, tingling or weakness
• You’re using it several times a day just to function

Before you start, check you’re not on the list in who should not use a heating pad.

For the timing detail: how long to use a heating pad.

For the settings: what temperature should a heating pad be?

And if you don’t own a pad yet: the best heating pad in Singapore.

Clinically reviewed by: Nigel Chua (Hand Occupational Therapist) & Louise Yow (Physiotherapist). This article is general information, not a diagnosis. electricheatpad.com sells electric heat pads.