ISSN 2398-2977      

Heat therapy


Graham Munroe

Kate Hesse

Synonym(s): Heat physiotherapy, Thermotherapy, Thermal therapy


  • One of the oldest and simplest physical treatments in the horse is thermal therapy. Heat or cold therapy Cold therapy can be administered in a number of ways from simply applying water from a hose to specially designed therapeutic boots or pads.
  • The application of cold therapy is the most common and the most effective if used in the acute phase, post injury or surgery.
  • Heat therapy increases the metabolic activity in cells, which leads to locally increased demand for oxygen, and subsequent induced capillary dilation. This increased blood supply leads to increased supplies of oxygen and nutrition into the area, and enhanced removal of cellular waste products, such as prostaglandins and bradykinins, which decreases nerve fiber sensitization and pain. Increased cellular metabolic activity (2-3 times for tissue temperature increase of 10oC/50oF), including membrane diffusion and tissue enzyme function, increases the possibilities of cellular healing.
  • Heating prior to exercise can improve the flexibility of structures such as soft tissue contractures or scarring around joints, facilitating more comfortable exercise. Heating of dense connective tissues renders the tissue more flexible and pliant, due to effects on collagen molecular bonding. Heating and stretching of tissues around joints over a period of time can increase the range of joint movement. Application of heat can also relax and decrease spasm within muscles.
  • Studies on the precise effect of heat therapy on various equine musculoskeletal injuries are few and research is needed to create evidence-based guidelines on the effective duration, frequency, temperature, and safe application in order to optimize outcomes after injury.


  • Treatment of chronic injury (greater than 72 h post injury).
  • Increases tissue extensibility as part of treatment and also prior to exercise. Tendons, joint capsules, and muscles can all be mobilized more by low-load, prolonged stretching of tissues heated from 40-45oC/104-113oF. 
  • Increases healing response of soft tissues, including wounds.
  • Improves resorption of edema.
  • Decreases pain and muscle spasm in musculoskeletal injuries such as back problems and arthritis of the joints of the distal limb Musculoskeletal: osteoarthritis (joint disease).


  • Simple to use and readily available.
  • Relatively inexpensive.
  • Effective after acute inflammation has subsided.
  • Multiple effects of: analgesia and increased blood flow, tissue metabolism and activity of inflammatory enzymes.


  • Not useful in acute cases.
  • Requires repeated application to achieve results.
  • Some of the more sophisticated application devices are expensive to purchase.
  • Contraindicated in cases with infection or neoplasia, where there is hemorrhage, altered skin sensitivity, burns, circulatory problems, or acute inflammation.


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Further Reading


Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Kaneps A J (2016) Practical rehabilitation and physical therapy for the general equine practitioner. Vet Clin Equine 32 (1), 167-180 PubMed.
  • King M R (2016) Principles and application of hydrotherapy for equine athletes. Vet Clin Equine 32 (1), 115-126 PubMed.

Other sources of information

  • Kaneps A J (2000) Tissue temperature response to hot and cold therapy in the metacarpal region of a horse. In: Proc AAEP. pp 208-213.

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