Heat and Cold

Both heat and cold are common and often very effective treatments for reducing the pain and stiffness of arthritis — particularly as supplements to other pain-control strategies. Heat, which is usually recommended for muscle pain, promotes blood circulation, which nourishes and detoxifies muscle fibres. Cold, on the other hand, soothes excited nerve cells and reduces swelling in an inflamed joint by constricting blood flow. Not everyone responds to heat and cold the same way, so you may have to experiment with each to find out which works best for you, and it may not always work for every situation. Again, experiment; in fact, for some people, the best pain relief comes from alternating cold and heat, five minutes or so of each at a time.

A few suggestions before you heat up or chill out:

Check with your doctor first to find out if there are any reasons why you shouldn't use a hot or cold applications. A cold application may not be appropriate, for example, if you have poor circulation, vasculitis or Raynaud's phenomenon, because cold will shrink already diminished blood vessels. Make sure you don't fall asleep with a heating pad on your painful joint; you could burn yourself severely. Whether you're applying heat or cold, avoid extremes: Don't make your icepack or heating pad too hot or too cold, always place a towel or extra padding under the heat or cold source to avoid burning or freezing your skin, and leave it on for no more than 15 or 20 minutes at a time.

There are a number of applications that produce cold, including vapocoolant sprays and mentholated gels that are applied to the skin. Cold packs, or ice packs, are especially good for joint pain caused by a flare (whereas you don't want to apply heat to an inflamed joint). Cold packs are available commercially, but if you feel a need for a quick numbing of a joint that's sore, inflamed or swollen, take a bag of frozen vegetables from the freezer, wrap it in a towel and apply it directly to the painful area. You can also use ice in a plastic bag — again, wrapped in a towel.

Heat is a natural muscle relaxant, an especially good remedy for muscles in spasm from joint pain; it can also be used to stimulate circulation, though it shouldn't be used on already inflamed joints. There are innumerable sources: Some people find a warm shower or bath are all they need; others like to soak in a hot-tub or whirlpool bath.

Some people can't get enough of hot springs and saunas, but most of the pain relief they experience is due mostly to general relaxation and a psychological sense of well-being, so the results are fleeting at best. For everyday pain, heat lamps, heating pads, heat packs and of course hot water bottles are all about equally effective, though some therapists suggest wet heat (a hot water bottle) is better than dry (an electric blanket). Gel packs that can be heated in a microwave oven or boiling water are a versatile approach to pain relief.

Other forms of heat applications include ultrasound, which uses pressure waves to penetrate and relax inflamed joints, and diathermy, which uses electromagnetic radiation (from a lamp with an infrared bulb, not the ultraviolet light bulb in sun lamps) to heat the joint from the middle outward. Both produce a significant vasodilation (enlarging) of the blood vessels in the skin and a consequent warmth.

This page was last reviewed/updated on : 02/23/2008