Q Is ice pack or hot pack better for Achilles tendonitis? How should I manage it at home?
A During the period of acute pain and swelling, the priority is to reduce the inflammatory response using ice packs (15–20 minutes, 3 times a day). Once the acute phase passes and chronic pain and stiffness become the main symptoms, using hot packs to promote blood circulation is effective. After applying the compress, wear a heel pad or heel cushion and avoid strenuous walking.
Detailed Answer
For the 48–72 hours immediately following an Achilles tendon injury, the RICE principle (Rest, Cold, Compression, Elevation) is the basic guideline. Cold packs constrict blood vessels to suppress inflammatory exudation, while subsequent hot packs dilate blood vessels to increase blood flow and promote tissue recovery. To prevent pain from worsening at home, avoid running down stairs or uphill, and sprinting; if necessary, wear heel cup inserts to slightly elevate the heel.
Korean Medicine Clinic Perspective
In Korean medicine, there is a misconception that applying cold compresses during the acute phase adds cold energy to the body; however, for pain characterized by localized burning and rising heat like this stage, temporarily cooling down the heat is actually the correct approach. After the chronic phase, maintaining warmth in the calf and heel areas helps with energy and blood circulation. Applying moxibustion or a heating pad to the upper calf transmits warm stimulation down to the area beneath the tendons, relieving stiffness. Dongjedang also provides guidance on heat management methods that you can perform yourself at home.
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