Try reading this:

http://www.spine-health.com/treatment/heat-therapy-cold-therapy

Usually if there is inflammation, heat will not feel good.

But most recently when I had inflammation after surgery, my doctor told me to use heat to bring the blood to the surface and away from the inflamed area.

I usually just use what feels best, which is almost always heat.

Lidoderm patches are room temperature, so yeah, might feel a little cold going on but they warm up to body temperature next to your skin. Like you I hate cold, so in the winter I would put my box of patches on a small table about a yardstick away from our woodstove, they were nice and warm going on. Since it's summer can't do that anymore. I just use them room temp now, but I suppose you could put one out in a sunny spot in a window, porch, etc and let the sun warm it up before you put it on.

The biggest problem most people have with Lidoderm patches is expense. The cheapest I've seen them is about $225 a box and there is no generic. If you have great insurance, I'd give them a try. If you have bad insurance or no insurance, then I wonder if you could get a couple to try from your doctor to make sure they work well enough for you to make it worth all that money.

I was given Lidoderm shortly after surgery when I first started having problems sitting then standing after laying down. It's a topical anesthetic only and has no purposeful hot/cold associated with it, and don't go very deep into the tissues, and I used one (had to pay cash, so only got one to see if it worked), and because my pain was not "only skin deep" it did nothing. It will, however, help with topical nerve pain (the pain that you can only "feel" by lightly touching your skin), but that's my opinion, I'm not a doctor.

Good luck, and I hope it helps!

Mine goes further than skin deep and I do get some relief from them in the muscles too. Since my pain is localized at the back of my neck and upper shoulders I put on two patches at a time to cover it all and use medical tape to keep them in place. But that is one of the problems with them, they only work on the areas they cover and no further than that, anywhere outside of the patch will get no pain relief at all. The same goes for the tape, they aren't sticky enough and will start to roll off if you don't tape them down.

Generally, with injuries or new problems, its
Cold for the first 48 hours.
After that, then its time for Heat

If you have any inflammation, sprain, twisted ankle, etc, until the swelling goes down, stay with Ice, applying heat to something like that will just make matters worse.

Now in Physical Therapy, they will generally apply heat to start with. That will loosen up muscles and such and make it easier for them to work with. Then after all the treatment is done, my therapist will then use Cold therapy to calm things down.

Whenever I go for my deep tissue massage , the first 20 minutes I have heat wraps applied to my back. Then the work begins.

when i use ice i think it confuses the brain, easy for me..haha, to forget the pain. the hot /cold nerves run right next to pain receptor nerves in the spinal cord so throwing all kinds of temperatures at yourself can be very beneficial....hm i think i'll publish this in the journal of medecine!!
pete