Is Heat Good For Rotator Cuff Pain? | Yes, Here Are 5 Reasons Why

70% of the time, shoulder pain stems from a rotator cuff injury. (1) Fortunately, there are treatment options that help relieve pain, including heat therapy. But, is heat good for rotator cuff pain? 

Well, yes, it is! Heat is extremely beneficial for this injury. It can ease pain, boost healing, and help in other ways. You’ll learn all about it below.

Here are the topics I’ll cover. Tap on any of the bullets to go straight to that section:

• The top 5 benefits of heat therapy for a rotator cuff tendinitis
• When NOT to use heat therapy for a rotator cuff?
• When should you use ice for rotator cuff injuries?
• FAQs

So, let’s dive right in.

5 Reasons why heat is good for rotator cuff injuries

1) Reduces rotator cuff pain

Heat treatment triggers the release of endorphins. (2) These are some of our body’s natural painkillers. They can decrease our pain levels and increase our well-being.

Applying heat for 15 to 20 mins to your shoulder joint sends signals to your brain to release endorphins.

That’s why you tend to feel relaxed and with less pain after hot therapy.

This is extremely helpful if you have shoulder pain at night. The soothing pain relief and relaxation from the heat can help you get a full night’s sleep.

This can help: How to relieve rotator cuff pain at night?

2) Relieves muscle spasm

Muscle spasms are involuntary contractions of the surrounding muscles of an injured body part.

This can be a good thing during the early phase of the healing process, as it serves as a protective mechanism. But if it goes for too long, it can cause severe pain.

Heat reduces muscle spasms by lowering muscle excitability. Less excitable muscles mean fewer involuntary contractions. 

And, since pain and muscle spasms go hand-in-hand, it also leads to pain relief.

3) Improves shoulder motion

During the initial stage of your rehabilitation, your doctor may ask you to put your arm in a sling. This prevents it from getting injured and lessens inflammation.

But, one side effect of being immobilized is developing joint and muscle stiffness around your shoulder. You can easily manage this by applying heat for 15 to 20 minutes on your rotator cuff. (3)

4) Boosts rotator cuff healing

Our body depends on its blood supply to heal itself. But, not all tissues receive the same amount of blood.

For instance, most rotator cuff injuries happen on the bone-tendon junction of the upper arm. (4) This area has a poor blood supply, which makes it harder to heal by itself.

Blood contains oxygen and nutrients, key ingredients to help with tissue healing.

Now, heat can widen the diameter of blood vessels. This in turn improves blood flow, which means more oxygen and nutrients to your injured shoulder.

Learn more: Can a rotator cuff heal itself?

5) Helps warm-up rotator cuff muscles 

Heat therapy is an easy way to warm up your shoulder muscles before a workout, which leads to (5): 

• Less chance of muscle and tendon tear
• Better reflexes
• More healing

But, it’s important to note that excessive use of heat before a workout can decrease your muscle endurance. (6) So, only use a heating pad for no more than 20 minutes at a time. 

When not to use heat for a rotator cuff injury?

Right after a fresh injury 

Your blood vessels are also damaged after a fresh rotator cuff injury. You may notice this by an increase in local skin redness and swelling.

In this case, heat will only make symptoms worse because it helps widen these vessels, increasing swelling and pain. 

Related: How to know if your rotator cuff is torn

Poor skin sensation

60% of those who suffer a torn rotator cuff are well into their 70s and 80s. (7) And, they may also have other age-related conditions such as diabetes. 

This metabolic condition can make it harder for you to sense temperature accurately, increasing the chances of skin burns if you use heat therapy. 

Poor blood circulation

Some health conditions reduce the blood supply to the extremities. This is the case for peripheral vascular disease (PVD), which can happen from:

• Fat clogging your arteries, or
• Your blood vessel’s inability to increase its diameter.

With that said, one side effect of heat is that your soft tissues will need more oxygen than usual. And poor circulation like the one from PVD can fail to meet this demand.

This means your tissues won’t have the oxygen they need to work properly. (8) Which, in turn, can cause more pain.

Ice or heat: When should you use cold therapy for rotator cuff injuries?

Here are a few instances when ice therapy works better than heat: 

First 24-48 hours after an injury 

You can expect some swelling after any physical injury. This is normal, as it is part of your body’s initial recovery process. But, a huge amount of swelling can also cause pain and discomfort.

Ice therapy can lessen inflammation, by reducing the diameter of blood vessels. This in turn helps reduce pain and can decrease swelling around the shoulder joint.

After workouts

Inflammation builds up around your shoulders after exercise. This can delay the natural recovery process of your body. But, putting an ice pack over your rotator cuff can counteract this.

Learn more: How to ice rotator cuff injuries properly?

FAQs:

Resources

1. Pribicevic, Mario. “The Epidemiology of Shoulder Pain: A Narrative Review of the Literature”. Pain in Perspective, Subhamay Ghosh, IntechOpen. October 24, 2012. DOI: 10.5772/52931
2. Bender, Tamás et al. “The effect of physical therapy on beta-endorphin levels.” European journal of applied physiology vol. 100,4 (2007): 371-82. DOI: 10.1007/s00421-007-0469-9
3. Portugal, Salvador. “Treatment of Pain and Inflammation”. New York University, Robert I. Grossman School of Medicine. Aug 2021. https://www.msdmanuals.com/home/fundamentals/rehabilitation/treatment-of-pain-and-inflammation#v713816
4. Zumstein, M-A et al. “The biology of rotator cuff healing.” Orthopaedics & traumatology, surgery & research : OTSR vol. 103,1S (2017): S1-S10. DOI: 10.1016/j.otsr.2016.11.003
5. Shellock, F G, and W E Prentice. “Warming-up and stretching for improved physical performance and prevention of sports-related injuries.” Sports medicine (Auckland, N.Z.) vol. 2,4 (1985): 267-78. DOI: 10.2165/00007256-198502040-00004
6. Hedley, Andrew M et al. “The effects of acute heat exposure on muscular strength, muscular endurance, and muscular power in the euhydrated athlete.” Journal of strength and conditioning research vol. 16,3 (2002): 353-8. https://pubmed.ncbi.nlm.nih.gov/12173948/
7. Minagawa, Hiroshi et al. “Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village.” Journal of orthopaedics vol. 10,1 8-12. 26 Feb. 2013, doi: 10.1016/j.jor.2013.01.008
8. Chaitow, Leon et al. “Thermal modalities as treatment aids”. Orthopedic Massage (pp.27-42). December 2009. DOI:10.1016/B978-0-443-06812-6.00003-9