The Hot and Cold of Arthritis: The Heat vs. Ice Debate – by Ashley Boynes-Shuck

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Some people swear by heat for arthritis; others will only use ice.  With weather, too, responses vary: some people enjoy a warmer climate, others prefer cooler weather. So, what’s the deal: is “hot” or “cold” better for arthritis patients?

The truth is, as with anything, it varies from person-to-person and case-to-case. Some of it has to do with what type of arthritis or joint pain someone has; some of it has to do with personal preference. I personally had an orthopedic surgeon tell me: “Just do whatever brings you the most comfort and makes you feel best.” My rheumatologist agrees. However, some medical literature and some physical therapists may beg to differ.

My personal theory – and this is just my point of view – agrees with my doctors: we are all different and unique, and may respond to various treatments differently, so just do whatever works for you. Your doctor may have a different perspective, though, and therefore, it is important that you take his or her advice into consideration, as always.

But, if you want to know the hows and whys behind these ideas, here is some information for you.

  • If your pain is from an acute injury, most doctors will tell you to always use ICE for immediate relief.
  • Many will suggest ice for rheumatoid arthritis and inflammatory arthritis, and heat for osteoarthritis and other forms of chronic pain.
  • Heat can relax muscle spasms, but, some argue that it could increase inflammation. (Studies yield mixed results on this.)
  • Cold compresses reduce swelling by constricting blood vessels. While cold packs may be uncomfortable at first, they can numb deep pain.
  • Heat dilates the blood vessels, stimulates blood circulation, and reduces muscle spasms. In addition, heat alters the sensation of pain, so you may not feel it as badly.
  • Some RA patients report that dry heat helps them, while moist heat worsens the condition.
  • For some RA patients, ice actually worsens the pain.
  • Athletes often bathe in ice after a rough game.
  • The combination of heat and ultrasound; or heat and massage; is often used in physical therapy.
  • A hot bath with epsom salts is one age-old arthritis treatment.
  • Some doctors will recommend the RICE method: Rest, Ice, Compression, Elevation — especially after joint surgery.
  • Many doctors or physical therapists, and even patients, suggest alternating ice and heat.
  • As for climate, many RA patients report LESS pain in the colder winter months; but many OA patients will say that the coldness worsens their arthritis.
  • People with pain from multiple sclerosis and fibromyalgia often have heat intolerance. Some lupus patients report this, too.

It may just be a matter of trial and error to find what works better for you: ice or heat. It also seems to vary from person-to-person on what kind of weather worsens arthritis pain. For me, personally, I do better in warmer weather, but cool, damp weather makes me sore, as do drastic changes in weather. I also prefer heat to ice in most instances, save for an acute injury. However, I know people with arthritis who are the complete opposite, so, it really does come down to individual preferences. Ask your doctor what they recommend, and then try it out and see if it works for you!

Good luck – and stay warm – or cool – this winter! ;)

Stay Well,

Ashley Boynes-Shuck

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2 thoughts on “The Hot and Cold of Arthritis: The Heat vs. Ice Debate – by Ashley Boynes-Shuck

  1. My doctors say the same thing – just do which ever feels best. I enjoy using heat more, but sometimes ice is the only thing that will help my wrist or back pain. I use both on a regular basis.

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