By Heidi Godman, Contributor | Featured on US News
ARTHRITIS PAIN CAN BE disabling. Stiff, swollen, aching joints may keep you from doing the activities you love or the ones required to get through each day, like walking or dressing. While prescription medication and physical therapy are the first line of defense for addressing arthritis causes, an age-old home remedy – heat or cold therapy – may help reduce pain and improve range of motion. “It doesn’t change or improve arthritis, but it can provide symptom relief,” says Dr. M. Elaine Husni, a rheumatologist and physician scientist at Cleveland Clinic.
There are many types of arthritis. One of the most common is osteoarthritis. “It’s a noninflammatory arthritis that affects more than 27 million Americans,” Husni says.” OA occurs when the cartilage that cushions the bones wears away, typically with age or use. This can happen in any joints of the body from the neck and spine down to the toes, especially weight-bearing joints such as the knees or hips.
When cartilage wears out, the bones can rub together, leading to bone overgrowth (bone spurs), ligament damage and a narrowing of the joint space. OA symptoms include pain and stiffness, decreased joint function, swelling and a crunching or grinding sound when you use the joint.
Another common type of arthritis is rheumatoid arthritis. It’s an inflammatory condition that affects more than a million Americans, especially women, according to the American College of Rheumatology. RA occurs when the body mistakenly attacks the synovium (the lining of the joints), causing it to become inflamed. The synovium then releases chemicals that irritate the nerves, trigger pain and eat away at the synovium, bones and ligaments.
RA attacks come in waves or flares that commonly strike the wrists, hands and feet. Attacks can also target the shoulders, elbows, knees and even some organs. Symptoms include joint stiffness (notably in the morning or after long periods of sitting), swollen joints that are hot to the touch, tenderness and pain. Fatigue and low-grade fever are also common RA symptoms.
Using Heat Therapy
Think of heat therapy as a way to thaw out joints that are frozen with stiffness. “Heat warms up the area and brings in a lot of blood supply,” Husni explains.
Getting more blood flow and oxygen to the joints and muscles helps make them more pliable, which may help relieve pain and improve your range of motion. “It makes a big difference in your ability to move, especially if you warm up first and then go about your daily activity. You have less pain and less trouble reaching up to a cabinet or putting on a seatbelt,” says Jyo Supnekar, an occupational therapist who specializes in upper extremity rehabilitation at the Johns Hopkins Hospital.
Heat therapy is applied on top of the skin. Supnekar says moist heat is best – as opposed to dry heat from a heating pad – because it penetrates deep into tissue.
You can apply moist heat therapy in any of the following ways.
- Take a warm bath or shower, which may be helpful to relieve morning joint stiffness.
- Place your hand in a basin of warm water and move your fingers around.
- Use a moist heating pad, which can be found in any drugstore. “You put it in the microwave and it heats up,” Supnekar explains.
- Immerse your hands in warm paraffin wax baths. Don’t attempt this at home because of the risk of burns; go to a rehabilitation center for treatment.
- A newer treatment used in heat therapy involves a low-level light therapy (laser) to stimulate tissue repair. “There is some emerging evidence that shows it may help with knee pain, tendinitis and shoulder pain. We use it occasionally for osteoarthritis,” Supnekar says.
- After heat therapy, Supnekar recommends that you gently stretch the joints and muscles while they are warmed up to increase your range of motion.
- A word of caution, however: If you have fragile skin, bruise easily or have neuropathy (numbness, tingling or burning in the extremities), place padding on top of your skin to protect it from heat sources.
Using Cold Therapy
Cold therapy causes the blood vessels to constrict, which slows the blood supply to the area and lowers the temperature around the joint. That’s helpful for quelling the burning heat of RA as well as the joint inflammation of RA and OA. “When your joints are swollen and warm, just cooling the area can bring temporary relief,” Dr. Husni says.
You can apply cold therapy to specific joints by using cold packs. But don’t reach for the ice pack you put in a lunch box or cooler. “Use a gel pack that you place in the freezer and then wrap around your arm, leg or ankle,” Supnekar recommends. It’s more comfortable and conforms better to the shape of your body, she explains.
Cold packs come in different shapes and sizes, including squares, rectangles and long gel packs that you can wrap around you. You’ll even find a sleeve or brace with gel packs that you slide into them. If you can’t find a suitable sleeve in a store, ask your doctor or pharmacist if one can be ordered or look for one on the internet.
A type of cold therapy available in clinics combines cold with compression. It’s called vasopneumatic compression therapy. “It’s a sleeve that goes on the body part,” Supnekar says. “Cold water gets pumped into the sleeve, so it provides compression along with lower temperature.” The combination packs a double punch to fight inflammation by forcing excess fluid out of the swollen joint and constricting blood vessels.
You may not be a candidate for cold therapy if you’re very sensitive to cool temperatures. That might include people with conditions like Raynaud’s disease, a blood vessel disorder that causes numbness in the fingers and toes in response to cold and stress.
A Final Word
While heat is typically used to reduce stiffness and cold is typically used to reduce inflammation, experts say the therapies are actually interchangeable. “There’s no right or wrong,” Husni says. In other words, use the therapy that feels best.
But don’t rely on heat and cold exclusively. There are other pill-free ways to address arthritis pain, such as weight loss (if you’re overweight), the use of braces, strength training and water-based exercise therapy. “We like strength training to build muscle around the joint,” Dr. Husni says. “That’s more helpful to get you back to functioning normally. Heat and cold are just for symptom relief.”
But when you want a quick fix for aching joints, it won’t hurt to use heat or cold therapy, and it may make you feel better.
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