Information Leaflet

Using Heat & Cold Therapy for Arthritis & Rheumatism

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Arthritis and Rheumatism

With some types of arthritis you may experience 'flare-ups' of inflammation. During a flare-up your joints can be painful, swollen and feel warm.
Whilst in flare-up the affected joints require more rest. However, gentle exercises should be continued to prevent further stiffness. The exercises will also keep the muscles working preventing weakness.
If joints become stiff and muscles weak this makes it harder to move and do every day activities.
During a flare-up make sure that you use your medication (painkillers and anti-inflammatory tablets) as prescribed by your Doctor.
You may also find that using heat or cold, as well as your medication and gentle exercise, will help to improve your symptoms.
The aim of this leaflet is to show you how to use heat and cold at home.
However, if a joint feels hot to touch, it is usually better to cool it down.

Note

If you have any circulation or heart problems, or heart problems, or if you have areas of numbness, ask your Physiotherapist's advice before using heat or cold.

Heat

Heat can be very useful in helping to relax muscles and reduce pain and stiffness in joints.
Heat Helps increase the blood flow to the area being treated, causing the skin to turn pink.

Examples of Heat

• Hot water bottle (do not use boiling water).
• Wheat bag.
• Electric heat pad.
• Warm shower or bath.
• Bowl of warm water (for hands and feet).

(Do not sit next to fire to warm joints)

If using a hot water bottle, wheat bag or heat pad, follow these safety measures:

1. Wash the area to be treated to remove any creams (Ralgex, Deep Heat, etc).
2. Protect the skin with towels before applying heat.
3. Sit or lie in a comfortable, supported position.
4. Place the heat pack on the painful area for 10 - 20 minutes, The skin will become pink. It should feel comfortable and warm.

Remove immediately if it feels too hot as it may cause a burn.

Cold

Some people find it more beneficial to cool a painful area. If a joint feels hot to touch, it is better to cool it down.

Examples of Cold

• Bowl of cold water (for hands or feet).
• Cold, damp towel or flannel.
• Bag of frozen peas.
• Frozen gel pack.

Remember that ice may cause a burn and therefore if using any frozen items follow these safety measures:

1. Protect the skin with a small amount of unperfumed oil (eg olive or baby oil).
2. Sit or lie in a comfortable, supported position.
3. Wrap the frozen peas/gel pack in a damp towel.
4. Place the cold pack on the painful area for approximately 10 minutes. The skin will become pink.

Remove immediately if there is any sensation of burning.

Note

For a small area of your body (eg finger, thumb, toe) wrap an ice cube in a cloth and massage it over the area until it melts (approximately 5 - 10 minutes).

Contrast Bathing

Using heat and cold together may be useful to reduce swelling in hands and feet.

Use a bowl of warm water and bowl of cold water (with ice added if you wish).

Immerse the hands/feet in the warm water for 1 minute then cold water for 2 minutes.

Repeat this prices 5 times, for a total of 15 minutes.

Always finish the cold water and then dry the hands/feet and elevate afterwards on pillows for up to 1\2 hour.

Exercises can be done whilst the hands/feet are elevated.

Further Information

One of the most important things to learn when living with arthritis or rheumatism is getting the balance between exercise and rest.
Many exercise are similar to daily activities, others are aimed more at strengthening specific muscle groups or increasing movement.
You Physiotherapist should advise you of the exercise most appropriate for you.
You may find it useful to use the heat treatment before exercising. You may also use heat or ice after exercise.
You may use the heat or cold treatments several times during the day, particularly during a flare up.