Home Health A-Z What’s better for soothing Arthritis Pain? Ice or Heat?

What’s better for soothing Arthritis Pain? Ice or Heat?

Verified By Dr Bhanu Prakash Reddy Rachamallu June 6, 2021 3837 0
Arthritis Pain
Arthritis Pain


Although common in the elderly, arthritis pain is more than just age-related wear and tear of the joints. Arthritis has several forms and can also occur in children and young adults. Women and overweight people are more likely to develop these joint diseases.

What is arthritis?

Arthritis is an informal term for over 200 types of joint diseases. It means inflammation of the joints and can affect single or multiple joints.

Symptomatically, arthritis ranges from mild to severe. Also, the condition can take years to progress or can cause symptoms within a short time, worsening rapidly. Osteoarthritis and rheumatoid arthritis are the most commonly occurring forms of arthritis.

What causes arthritis?

The cause of arthritis depends on the type of arthritis. Different types affect the joints differently.

  • Osteoarthritis

It is the most common type of arthritis. Osteoarthritis damages the joint cartilage. Cartilage acts as a cushion between the two bony surfaces in a joint. It prevents friction, absorbs shock, and protects the underlying structure from wear and tear. 

Cartilage damage grinds the bones directly on each other, further leading to pain and restricted movement. The wear and tear can be gradual with aging or sudden, following a trauma or injury. Osteoarthritis also causes inflammation of the joint lining.

  • Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disorder. The body’s immune system attacks the lining of the joint capsule. The capsule is a tough connective tissue membrane that encompasses the structures within the joint. In rheumatoid arthritis, the inner lining gets inflamed and swells. The disease can progress and eventually destroy cartilage and bone within the joint.

What are the symptoms of arthritis?

Symptoms of arthritis include:

  • Joint pain
  • Swelling in the knee and around the joint
  • Tenderness
  • Joint stiffness
  • Restriction of movement
  • Pain during weight-bearing activities, such as walking, rising, standing, etc
  • Occasional warmth and redness around the joint
  • In RA, you may experience tiredness and reduced endurance.

When to see a doctor?

An early diagnosis of arthritis can help preserve your joints and prevent further damage through lifestyle modifications and treatment. If you experience any symptoms, consult your doctor immediately to ensure appropriate treatment.

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What are the risk factors of arthritis?

The following factors can increase your risk of developing arthritis:

  • A family history of arthritis can increase your likelihood of developing the joint disease.
  • Aging can increase the risk of arthritis like osteoarthritis, gout, rheumatoid arthritis.
  • Women are more likely to develop arthritis than men.
  • Previous joint injury can enhance the degenerative changes within the joint , increasing the  risk of arthritis.
  • Overweight or obese people have more compressive pressure on their joints.

What is the treatment for arthritis?

Often, the management of arthritis requires a multidisciplinary approach involving orthopedic surgeons , rheumatologists, and physical therapists. You can also consider lifestyle and dietary modification, as weight and a sedentary lifestyle  are risk factors for arthritis.

Exercise therapy

Regular exercise can help improve your joint condition by developing flexibility. Exercising specific muscles can also protect your joints. Strong muscles can bear the load and prevent the affected joints from being overburdened. Exercise can also help you maintain your weight.

Bodyweight exercises can improve bone density. Experts also recommend swimming and other water-based exercises. They are easy to perform, relieve joint pressure, and strengthen muscles.


Medications can help manage your pain and reduce the inflammation in your body. 

Medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics help control the pain. Your doctor can also prescribe menthol or a capsaicin-based gel that you can apply on the skin along the joint for pain relief. 

If your arthritis symptoms are due to an autoimmune disorder like RA, your doctor may advise corticosteroids or disease-modifying antirheumatic drugs (DMARDs). These drugs will suppress your immune system.


In severe arthritis with structural changes in the joint, surgery may be the only option. Your surgeon will replace the joint with an artificial one to enable you to lead a pain-free life. Joint replacement is a common procedure for arthritis of the hips and knees.

In severe arthritis of smaller joints (like hands and wrists), your doctor will perform a joint fusion. In this surgery, your doctor will fuse the bones of your joint in a fixed functional position.

Regardless of the type of surgery, you will require physical therapy and rehab to recover your functions.

Arthritis Pain – What to use – hot fomentation or ice packs?

Hot fomentation and ice packs are both convenient methods for relieving pain. They are cheap, readily available, and have no side effects. Also, you can place these packs along the painful region to get local benefits. 

So which should you use – a hot fomentation or an ice pack? And when to use them?

During the early stages of healing, known as the inflammatory phase, there will be redness, warmth, swelling, and pain. You need to protect your joints and the injured area from further damage. Cold therapy can help you do so. It can cause the blood vessels to constrict and narrow, lowering the flow of inflammatory infiltrates to that region.

The inflammatory phase lasts for a few days. Avoid the use of heat during this phase. Heat raises the blood flow into the injured area and increases swelling. 

Hot fomentation increases the temperature of the skin and soft tissue. It permits the blood vessels to expand, allowing more blood flow to the region. Heat also increases the metabolic rate and uptake of oxygen and accelerates tissue healing. It can help relieve muscle spasms and improves flexibility. Hot packs are preferable during the later stages of healing when the tissues are mending.

Chronic osteoarthritis respond better to heat. However, for an acute episode with inflammation, Ice packs can be a wise choice. Ultimately, try the one that suits you the best.


Arthritis comes in many forms and has varied causes. The treatment for each type of arthritis varies according to its cause. Exercise, medications, and lifestyle changes are the first line of treatment for arthritis management. You can apply ice packs in the initial stages, where the pain is due to inflammation. Chronic pain, where the tissues are undergoing healing, responds better to heat therapy.

Frequently Asked Questions (FAQs)

How long should you use the hot packs for arthritis pain?

For minor to moderate pain, 15-20 minutes of hot pack application is sufficient. In the case of back pain, you may need to apply it for longer, about 30 minutes.

Who should avoid hot or cold packs?

For people lacking thermal sensations, i.e., they cannot recognize or feel temperature sensations, avoiding these therapies is the best. Both high and low temperatures can damage the skin when the sensory nerves are not functioning well .

Does the effect of heat therapy last long in arthritis pain?

The effects of heat and cold therapy are temporary. Based on your pain levels, you may need to reapply for continued pain relief.

Verified By Dr Bhanu Prakash Reddy Rachamallu
MBBS, D'ORTHO, DNB (ORTHO), Mch (ORTHO), FELLOWSHIP IN ARTHROPLASTY, Consultant Orthopaedic Surgeon Trauma, Joint Replacement & Arthroscopic Surgeon, Apollo Hospitals, Jubilee Hills, Hyderabad

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