No we don't do the hot pads, it causes the creepy crawly skin to act up. We did do the ice pads at the end of the last session because i demanded them after the worlds worst accupressure massage. He decided to try to loosen the muscles running up my spine, which felt more like jabbing his thumbs under the sides of my vertebrae, which I made him stop after a few minutes because the pain kept getting worse. I believe it was at this point that I had to threaten bodily harm to the man.