So... Which One Do I Use for My Arthritis, Heat or Ice?

Heat has long been used to provide temporary relief of arthritis pain, and is utilized in many diverse forms. Contrast baths, whirlpools, electric pads, microwaveable gel packs, hydrocollator packs, infrared lamps, and hot showers are some of the various techniques used. Even warm tap water probably will meet some of your needs for heat therapy at home.

Heat can provide temporary relief of pain and stiffness, and can prepare you for physical activity or exercise. By way of example, morning stiffness is a frequent issue for many people with rheumatoid arthritis. Because your body has been during the night you may need special support to get going in the morning. This combination of methods using heat can reduce the length and the severity of morning stiffness:

1. Sleep in a sleeping bag (which will help retain body heat) or using an electric blanket (after the manufacturer's directions ).

2. Take your aspirin or other anti-inflammatory medication an hour before getting out of bed in the morning. (Keep a few crackers at your bedside to take with the medication to avoid stomach irritation.)

3. Take a warm shower or bath immediately after you get up.

4. Then do limbering-up exercises after your shower or bath as you still feel warm.

Safety is important in selecting the kind of heat you use. You should take great care to avoid burns or electrical shocks. Heat has to be used with much caution on any area of the body with poor circulation or at which you cannot feel heat or cold normally. It shouldn't be used over areas where your skin is fragile or broken.

Only light heat is necessary to get results. You are aiming to get a temperature only slightly above body temperature, and you don't have to apply heat for a very long time. You'll get complete benefit by utilizing heat for 20 minutes each time.

Moist heat is any technique where water is used to run the heat, such as a bath or shower or hydrocollator packs. Individuals with arthritis prefer moist rather than dry heat, such as a heating pad. Moist heat penetrates more deeply than dry. You'll have to try both and see which is more effective and convenient for you.

Heating pads are available that provide either moist or dry heat, but they need to be chosen and used with care. Make sure that the pad is approved by the Underwriter's Laboratory. Start looking for those that have temperature control buttons; those with no temperature settings get hotter and hotter until you turn them off.

When using a pad, never lie on top of it and make sure that you don't fall asleep while it's on. Severe burns can result! It may be smart to use a timer during the treatment. Check the directions on use carefully. Regularly inspect the pad for any cracks in the plastic cover.

Hydrocollator packs are canvas bags containing silicone gel that retain heat for a very long time. You can get them in different shapes at pharmacies. Some people like them because they lose heat more slowly than most moist compresses. The pack is heated in water, wrapped in 8 to 10 layers of heavy toweling and placed over the painful joint.

The pack is heated in a large pot of water and placed on heavy towels. Place the surface with the thickest layer of toweling over the part to be treated.

Remember that hydrocollator packs do have drawbacks. They are not practical if heat is required for several joints, because each pack can be used for just 1 part at a time. They are also awkward to use and may be too heavy placed over a painful joint. If your hands are affected by your arthritis, it may be hard for you to remove the heavy pack from the water with the tongs. That means you may need help. Again, you should be very careful about burns. If you choose to try such a pack, follow the manufacturer's directions carefully.

Microwaveable gel packs are popular. Follow the directions carefully or else the bag containing the gel may leak... or even worse burst and cause serious burns!

Physical therapists occasionally use melted paraffin as a means of applying heat, particularly to your hands. There are units available for home use as well. Because they involve high temperatures, paraffin baths should be used with caution. Patients with osteoarthritis or rheumatoid arthritis between the hands frequently find paraffin to be useful.

You can purchase nylon and spandex gloves that can decrease morning stiffness of their hands for many people when worn at night. The gloves are available in both men's and women's sizes.

It's important to wear adequate, warm clothing in cold weather. Some folks find that knitted, woolen or fleece pullover cuffs on painful joints, especially the knees, ankles and elbows are helpful in keeping the joints warm and more comfortable in cold weather.

Some people with arthritis find that heat doesn't help them. In fact, the reverse is often best-cold compresses. Cold may be especially effective when active inflammation produces acute pain and joint swelling. Just trying different modalities will enable you to learn which is right for you.

It's easy to make a cold pack by filling a small plastic bag with a couple ice cubes. A bag of frozen vegetables wrapped in a towel can be used. Place any cold pack over the painful joint with a layer of terry cloth toweling in between. The same precautions that apply to the use of heat ought to be observed when using cold. The maximum benefit is achieved in less than 20 minutes. You may want to repeat this application several times a day.

For many people with arthritis an effective approach is alternating warm and cold water applications, a procedure called contrast baths. It is most useful to get a hand or foot that can be dipped in a large pot full of water. If you choose to give it a try, use a thermometer to check temperatures.

1. Fill 1 container 2/3 full with 110 degree F water.

2. Fill a second container 2/3 full with 65 degree F water.

3. Place your hands or feet thoroughly into the warm water for three minutes; then place them in the cold water for a minute.

4. Repeat step #3 two more times.

5. End the treatment with three more minutes in the warm water; then carefully wash the hands or feet.

Finally. . .and very importantly... with acute musculoskeletal pain, and particularly with accidents, always use ice. The formula to remember is RICE...

- Rest

- Ice

- Compression

- Elevatio.