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The mud is packed in plastic so they can be held under warm water before use to be more comfortable. Unlike the stones, the packs do not have to be warm or hot to make them effective. Temperature will not vary the energy level. Put a thin cotton material between the skin and the pack over the affected area for at least eight hours a day (more is better). Sleeping with it is an excellent way to get uninterrupted usage. If the packaging breaks or leaks do not be alarmed as it is not dangerous to have skin contact.