When and Why to Apply Cold to an Arthritic Joint

Painful arthritis inflammation can be treated with a cold compress. This is an inexpensive, effective treatment that can be used many times a day or occasionally, as needed.

See Understanding Joint Pain

Cold therapy can:

• Decrease inflammation. Cold causes the blood vessels of the muscles to constrict, and can therefore decrease the flow of blood and help reduce inflammation.
• Slow the production of joint fluid. Synovial joint fluid is essential to a healthy joint, but too much can contribute to swelling and discomfort. Applying a cold compress to a resting joint can slow the production of joint fluid.
• Distract the brain from the inflammation. Cooling an inflamed joint can stimulate sensory receptors in the skin and decrease the transmissions of pain signals to the brain.

Cold therapy constricts the blood vessels in the muscles. This constriction decreases blood flow to the affected area and helps to reduce inflammation.

How long should cold be applied?
An ice or cold pack may be applied for no more than 20 minutes at a time, but this process can be repeated throughout the day—up to 8 or 10 times in a 24-hour period.

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In This Article:

• Applying Heat vs. Cold to an Arthritic Joint

• When and Why to Apply Heat to an Arthritic Joint

• 9 Easy Ways to Apply Heat to an Arthritic Joint

• When and Why to Apply Cold to an Arthritic Joint

• 3 Types of Cold Packs for Arthritis

• Video: How to Make a Gel Ice Pack

• Video: How to Make an Ice Massage Applicator

• Video: How to Make a Homemade Heat Pack

Cold application precautions
Applying ice or another cold source directly against the skin can injure the skin. To avoid skin damage, some precautions may be taken:

• Do not apply ice directly to the skin. A towel or other protective barrier can be used between the ice and skin. Cold therapy should not be painful to the skin.
• Limit the cold therapy to no more than 15 or 20 minutes at a time.
• People with certain conditions may be advised to avoid ice application, such as people who have:
  • Raynaud’s Syndrome
  • Cold allergic conditions
  • Paralysis or areas of impaired sensation (i.e. nerve damage)

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For some people, alternating heat therapy with cold application provides the most pain relief.

Dr. Brandon Kambach is an orthopedic surgeon who specializes in adult and pediatric spine surgery. He practices in Jacksonville, FL. Dr. Kambach has several years of experience evaluating and treating conditions of the spine and joints, and he has participated in clinical research studies for cervical spine disorders.

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Editor’s Top Picks

• Understanding Joint Pain

• Rheumatoid Arthritis (RA) Treatment

• Osteoarthritis Treatment

• Video: How to Make a Gel Ice Pack

• Video: How to Make an Ice Massage Applicator

• Video: How to Make 5 Quick and Easy Ice Packs

Cold Therapy for Arthritis

Living with Arthritis

PUBLISHED 11/27/18 BY Teresa Dumain

Sayonara, swelling.

Just like you would ice a swollen toe or sprained ankle, cold can provide the same kind of symptom relief for inflamed joints. During acute flares of rheumatoid arthritis, or if you have inflammation with osteoarthritis, cold therapy helps reduce swelling and pain, say experts.

A review of research published by Cochrane found cold packs can be used as palliative, or supportive, therapy for people with rheumatoid arthritis. And studies on people with knee osteoarthritis showed cold packs reduced swelling, and ice massage improved knee strength, range of motion, and function.

How Cold Therapy Works for Arthritis Pain

Cold constricts the blood vessels in the muscles, which decreases blood flow to the joint area to help reduce swelling and inflammation, explains Eric Robertson, PT, DPT, director of Kaiser Permanente Northern California Graduate Physical Therapy Education and associate professor of clinical physical therapy at the University of Southern California. Cold therapy also slows the transmission of pain signals to the brain, adds Robertson, who serves as a spokesperson for the American Physical Therapy Association.

What it won’t do is cool down your body: “One misconception about cold therapy is that the effects can reach deep into the joint or muscles,” says Robertson. “While your skin may feel very cold to the touch, your body is remarkably efficient at maintaining its internal temperature, so cold therapy really only affects tissues near the surface — like skin, fat, or small portions of muscles.”

Do Cold Therapy at Home

Apply cold therapy for about eight minutes at a time, advises Robertson; but remove it as soon as your skin feels numb to the touch. Keeping it on too long can damage tissue or even cause frostbite. To help protect your skin, wrap the cold object in a thin towel or cloth. Talk to your doctor before trying any new therapy to make sure it’s safe for you.

1. Grab a bag of frozen veggies

Robertson advises using what’s readily available at home — like a bag of peas or corn right of the freezer that you wrap with a thin, damp towel. A plastic baggie filled with ice works too (try adding a little water so the bag is less lumpy).

2. Or freeze a towel

Put a damp, folded towel in a plastic bag and toss it in the freezer for about 15 minutes. Then take the towel out of the bag, and lay it on your achy area. Do the same with a damp sponge — freeze it in a plastic baggie, then apply the bag with the sponge to a sore joint.

3. Make a reusable DIY cold pack

Fill a sock with rice and store it in the freezer; rice gets as cold as ice, but won’t melt when used. To make your own gel-type pack, fill a sealable plastic bag with liquid dishwasher detergent and freeze.

4. Or buy an ice or gel pack

They come in different shapes and sizes, including squares or long gel packs that can wrap around you. You can even find sleeves or braces for your wrist made to fit frozen gel packs.

5. Try an ice massage

Fill a paper cup with water and freeze; then peel back off the top of the cup, leaving a little at the bottom for you to hold on to, says Robertson. Rub the ice in small circles all over the affected area, avoiding spots where the bone is close to the skin (such as right over the kneecap or point of the elbow).

6. Keep instant ice packs on hand

These single-use versions can be cracked, which activates a chemical reaction that causes the pack to become cold right away. They are a convenient option when you travel, for example, or a freezer is not accessible.

When to Try Heat Therapy for Arthritis Instead

Heat therapy helps decrease pain and improve muscle flexibility in patients with arthritis, say experts. With acute inflammation during an RA flare, cold is best, says Robertson. “Outside of that, there are few hard and fast rules,” says Robertson, who encourages patients to follow their preference.

Keep Reading

• The Tried-and-True Tips 13 Patients Use to Cope with Arthritis Flares
• Got Painsomnia? These 9 Tips May Help You Sleep Well Again
• 8 Daily Arthritis Hand Exercises that Can Soothe Your Pain

• Was This Helpful?

what to do if you are experiencing an exacerbation

In this article, we have collected tips to help alleviate the condition and cope with difficult periods of exacerbation. They also told why it is important to seek help from loved ones in a timely and open manner.

• Helpful Hints

Patients with rheumatoid arthritis experience flare-ups. According to the current version of the clinical guidelines for the treatment of RA, during an exacerbation a person experiences weakness, loss of appetite, fever, pain in muscles and joints, as well as stiffness in the joints, which is most pronounced after morning awakening or rest [1]. It is also often compared to the flu – general weakness, muscle and joint pain, and stiffness in the joints are so severe that simple actions such as getting out of bed and brushing your teeth are difficult to perform.

To prevent flare-ups, take your medications as directed by your doctor.

The good news is that flare-ups can be controlled. Over time, you will definitely understand what factors provoke inflammation in you. It can be stress, an infectious disease, or too intense training. Knowing this, it is much easier to predict, control and avoid aggravation.

The most important rule that will help you not only avoid exacerbations, but also make them easier to bear, is to take your medicines in accordance with the recommendations of your doctor. The fact is that the exacerbation occurs due to the increased activity of the immune system. Medicines that are prescribed for rheumatoid arthritis suppress the excessive activity of the immune system.

Give yourself a few days to rest

When you wake up with an exacerbation, think about how you can reduce the load in the next 1-2 days in order to ensure peace and rejuvenate yourself. Postpone everything that is not urgent [6]. Some work meetings and calls can also be rescheduled – to do this, talk to management about your condition and indicate the time it will take for you to recover. Also find out if it is possible to work from home on days when you are experiencing an exacerbation – we talked about the advantages of working from home and building a dialogue with the employer in an article about working with RA. Check if any medical documents are needed for this, for example, the opinion of the attending physician.

Close friends and relatives can be involved in household chores. Some patients report that they feel uncomfortable when asking others for help. To understand this situation, we spoke with a psychologist and found out the following:

1. People around you can really be happy about the opportunity to care for a loved one with RA, because this way they feel needed and fulfill their role as a loved one;
2. One feels like a burden when making decisions for other people. We can arbitrarily assume what another person will think of us when asked for help. He can both get angry, having stopped communicating with us, and rejoice, because he will feel good, realizing that he is helping people who need his help. Whether a person is ready or not ready to accept your request is in any case only his decision. Therefore, the right thing to do in such a situation is not to think for a loved one, but sincerely accept his decision, whatever it may be.

Avoid prolonged rest, as lack of movement can lead to increased stiffness and pain, muscle spasms, which will also increase pain. It is important not to give up work completely, choosing a feasible load, and after several days of bed or semi-bed rest, gradually return to work, physiotherapy exercises (exercise therapy) and social activity [11].

Think about what you have gained thanks to the aggravation, instead of thinking about missed opportunities

Anxious thoughts that arise during an exacerbation can not only increase the perception of pain, but also generally worsen well-being. In this state, patients tend to think about missed opportunities:

• “I had to cancel an important meeting for which I had been preparing for so long”;
• “When I get better, I’ll be forced to do twice as much work because I’m not doing anything right now.”

In this situation, you should remind yourself of the following [2, 8]:

1. Aggravation is a temporary condition. Yes, now you feel bad, but in any case it will pass and everything will be as before. In addition, with proper treatment, episodes of exacerbations can be minimized. Over time, you will understand and learn to avoid the factors that provoke an exacerbation, and if it happens again, you will be able to control it more effectively.
2. Instead of thinking about missed opportunities, try to focus on the positive things you get in return. So, you have the opportunity in the middle of the working week to read your favorite book all day or watch a series that you have long wanted to watch [10].

Do only the essentials to save energy

The inflammatory response requires a lot of energy. Because of this, the feeling of tiredness that is always present in rheumatoid arthritis can be exacerbated. Therefore, first transfer most of the tasks or delegate them to loved ones, and then think about how you can make the rest of the tasks easier. For example, you can brush your teeth while sitting, wear shoes without laces and clothes with Velcro, and instead of cooking, you can order ready-made food [2].

Also, prioritization, which we talked about in the article about the fight against feeling tired in RA, can help with an exacerbation.

Create a comfortable space around you

If you have to spend the next few days in bed, make this place as comfortable as possible. Here is how one of the RA patients copes with it [5]:

“I use aromatherapy, listening to my favorite music, virtual reality, dark curtains, a chair to take a shower, drinking straws, disposable cups, paper plates, flip flops. I also rearrange the house so that frequently used items can be easily reached in it.”

Other patients are distracted and cope with stress in the following ways [5, 3]:

• listening to soothing podcasts;
• watching movies and TV shows that were always put off for later because of work or household chores;
• prolonged sleep;
• being in a cool dark room in silence;
• pets – you can wrap yourself in a blanket and stroke your favorite cat or dog;
• meditation and breathing exercises.

Apply a cold compress to the inflamed joints

Ice or a special hypothermia pack available from a pharmacy can be used as a source of cold. Cold reduces inflammation and inhibits the work of enzymes that destroy the cartilage of the joint. Do not hold the compress for more than 5 minutes, as hypothermia can cause vasospasm and worsen blood circulation, which will only increase pain. It is better to apply cold 2-4 times, taking breaks, so that the skin and tissues return to normal temperature [6, 9, eleven]. To protect the skin from hypothermia, place a towel or cloth between the skin and the cold source.

Do not apply heat to the joints during a flare-up

Do not use heat during an arthritis flare-up, as this may exacerbate the inflammatory response. Heat is best used outside of aggravation to relax stiff muscles. To learn more about heat and cold therapy, see our article on RA treatment.

Fix painful joints

When there is inflammation, any movement in the joint can cause severe pain. To fix the joint and avoid even the slightest accidental movements, special medical fixators can be used [2, 4, 7]:

• finger splints;
• fixing bandages and orthoses for knees, elbows, ankles;
• neck collars;
• Kinesiology Tape, etc.

Stay away from new foods during flare-ups

While there is no proven benefit or harm of any food for rheumatoid arthritis, introducing new foods to the diet can trigger inflammation. Therefore, during an exacerbation, it is better not to use new, unknown foods. You should also avoid eating foods that make you feel worse, such as aggravated RA symptoms [2].

Talk to your healthcare provider about taking pain medications

Some medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), can be taken during a flare-up to reduce inflammation and pain. These can be either tablets or powders for oral administration, or gels that need to be applied to painful joints [2, 9].

Discuss this with your doctor ahead of time to confirm that taking NSAIDs will not interfere with your essential medications, and to find out who you can contact during a flare-up from the comfort of your home [2]. Some doctors leave their phone number so you can text or call them. In this case, you need to write briefly and succinctly so as not to distract the doctor from the main work or rest, if the exacerbation occurred on a day off.

Ways to help cope with pain

​We tell you how, in addition to medicine, you can cope with pain. The article collected 22 recommendations from various medical professionals. The properties of various pillow fillings and helpful tips from medical experts and patients to help properly fix painful joints can be found in the article on healthy sleep in rheumatoid arthritis.

If the pain becomes unbearable, seek help

If you experience a severe aggravation of symptoms during an arthritis flare-up intolerable pain, high fever, inability to move the affected joints, etc., call an ambulance. You may need to be admitted to the hospital to receive inpatient care.

Treatment of RA

drugs, physiotherapy,
Physical therapy and traditional medicine

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Living with rheumatoid arthritis

Find out how to manage your daily life and take care of your health to stay active. Read articles about nutrition, exercise therapy and a healthy lifestyle.

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Doctors Name 5 Ways to Relieve Joint Pain Without Medicines

• Health

Arthritis is a common disease that causes great discomfort. The joints hurt, the skin swells, sometimes it hurts to walk. Let’s find out how you can alleviate unpleasant symptoms.

November 18, 2022

Source:

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Joint pain, swelling, and impaired mobility are symptoms that affect millions of people around the world. This is how arthritis manifests itself. This disease greatly interferes with the usual way of life: it can be painful for a person to walk, bend his arms, legs, and sometimes even just remain in a motionless position.

Most often, men and women suffer from either rheumatoid arthritis (this is an autoimmune disease in which the immune system is damaged), or from osteoarthritis – in this case, cartilage becomes inflamed and destroyed. In any case, the diagnosis is made by the doctor, after which he prescribes treatment. Of course, you should not refuse the drugs prescribed by the doctor, without them the condition can greatly worsen.

Read also

However, along with therapy, one should not forget about folk methods that will reduce the severity of arthritis. Healthy lifestyle expert Zara Kenyon shared a few of them.

Exercise

— To keep your joints mobile, get into the habit of exercising regularly for all muscle groups. But be warned: high-impact cardio and strength training can do more harm than good,” Kenyon was quoted as saying by British Express.

Training should be “soft”: no intense jumps and long planks. Try yoga, stretching, start going to the pool. By the way, walking is also a great option! 30 minutes is enough for the first walks.

– And don’t forget to load the brushes. Clench and unclench your fist, gently pull your wrists,” Kenyon added.

Read also

Meditation

— There are two types of people: those who believe in the power of meditation, and those who think it’s a fad . If you’re in the latter group, then it’s time to rethink your beliefs, Kenyon insists.

The fact is that when you experience stress and tension, it can make your arthritis pain worse. And here relaxation is just perfect to help relax the muscles, relieve spasms. It really works, it just takes a little practice. Try to include any video with meditation practice and give yourself 10-20 minutes.

Read also

Hot bath

It has long been known that water procedures help to relax and calm down. A warm bath with foam or salt is a great option to break away from everyday affairs, relax, take time for yourself.

This method will help to cope with muscle spasms, reduce joint pain. This was proved not so long ago by a group of Turkish scientists – their work can be found HERE.

— Researchers found that 30 men and women with osteoarthritis of the knee were able to take longer, faster steps after immersing themselves in warm water for 20 minutes a day for two weeks, Kenyon said.