Should you apply a warm vs. cold compress to an area on the body for pain? It depends because cold and warmth produce two different results. Though both can reduce pain in joints and tissues, ice packs decrease blood flow, and warm compresses increase it. Cold compresses are useful for decreasing inflammation, while warm compresses are good for conditions like stiff tendons or relieving pain in the lower back.
It is simply something that can be used to apply heat to a spot on the body. A warm compress can be moist or dry. A warm compress encourages blood flow to a particular area by dilating blood vessels in the area where heat is applied. The increased blood circulation to tissues:
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People apply a hot compress after an injury, but applying heat before strenuous activity can relax muscles and ligaments to minimize the chance of aggravating a chronic injury or incurring muscle soreness. Apply the warm compress several times a day for best results.
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Some of the medical conditions treated with the application of warm compresses include osteoarthritis, back muscle strain, tendonitis, fibromyalgia, boils and headaches. One of the benefits of a warm compress used every couple of hours is that heat can penetrate to the underlying muscles.
When a cold compress is applied, the blood vessels contract which reduces localized inflammation and swelling. Cold temperatures also numb injured tissues, reducing pain. A cold compress should be applied immediately after an injury or when a joint becomes inflamed.
How do you know when to use a cold compress instead of a warm one? The first guideline is the cause of the pain. A cold compress for swelling brings relief when applied right away to an injury like an ankle sprain. Some of the conditions that can benefit from cold treatment include the following:
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There are a few guidelines to keep in mind. One is to only apply a cold or warm compress for a maximum of 20 minutes. Another guideline is to be careful to not damage the skin from a compress that is too hot or too cold. The skin should look pink and not red or white. The skin should be allowed to reach its normal temperature before reapplying a cold or hot compress. Finally, only use compresses on areas where the skin is not broken. If the compress does not bring pain relief, see a doctor for evaluation.Doctors and physical therapists often recommend hot and cold therapy to soothe the aching or stiff joints of rheumatoid arthritis (RA) and to increase mobility. Together, these methods to temporarily relieve RA pain are referred to as thermotherapy.
While there is little evidence that thermotherapy is medically beneficial, a review published in the Cochrane Database of Systematic Reviews of hot and cold treatment for rheumatoid arthritis concluded that superficial moist heat and cryotherapy (cold packs or baths) can be used as palliative, or supportive, therapy.
Still, hot and cold treatments won't prevent rheumatoid arthritis flares. “Using heat or cold can be helpful, relieving, and soothing. However, exercise, joint protection, and other forms of education, as well as protective splinting can be more beneficial, ” says Lisa Maggiore, a registered and licensed occupational therapist at Greenwich Hospital in Connecticut. And, of course, making sure you are taking the most appropriate medication.
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For someone with an inflammatory disease like RA, applying heat may seem counterintuitive. But since heat works to reduce muscle tension and stimulate blood circulation, many patients find that applying something warm — even if it just means warming your clothes in the dryer before dressing, or lying with a heated blanket prior to getting up in the morning — simply feels good on the joints.
According to the Arthritis Foundation, when you warm up a sore joint, the heat enlarges your blood vessels, allowing more blood, oxygen, and nutrients to be delivered to the tissues.
Although there aren’t recent studies for rheumatoid arthritis, researchers conducted a study on 35 people with chronic, nonspecific neck pain that was published in the International Journal of Environmental Research and Public Health in August 2020. They found that those receiving thermotherapy with a salt-pack for 30 minutes twice a day for five days (in addition to performing a neck stabilization exercise) improved stiffness more than the control group.
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Gentle heat in the morning can improve your range of motion, explains Katie Palmer, a physical therapist in Newtown, Pennsylvania. It can relieve some of the joint pain and the stiffness and prepare your body for exercise or to get up and get moving and out the door.
One version of hot therapy is the paraffin, or wax, bath, similar to what's used in nail salons to soften the skin and nails. The paraffin is heated to a prescribed temperature and then you dip in your hands, wrists, and fingers, and it forms a coating, Palmer explains. Then you wrap your paraffin-covered hands and wrists in a little towel, and it gives you a nice moist, deep heat that can help eliminate some of the pain and stiffness of RA.
Palmer recommends paraffin therapy for the hands when they're stiff, like first thing in the morning, but not when the joints are inflamed.
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In addition to putting heat on targeted areas, you can also warm up your whole body by taking a warm bath or shower or by swimming in a heated pool.
If your joints are inflamed, it makes sense that something cold could ease the inflammation and thus the pain. The main benefits of cold therapy are reducing inflammation, swelling, and soreness, as well as temporarily relieving joint pain caused by an arthritis flare.
Cold therapy is best during an acute flare, Maggiore says. “Cold therapy is helpful as it can lower joint temperatures, reduce pain, and decrease inflammation, ” she says.
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One simple method of cooling the joints is a cool-water soak in a tub. Just don't let the water get so cold that you become chilled.
Cold packs that you place directly on an aching joint include everything from common items — bags of frozen peas or gel packs found at the drugstore — to complete systems of coolers, cooling pads, and devices shaped to certain parts of the body, like the knees and back.
Others who should avoid or limit cold therapy are people with Raynaud's syndrome, a condition in which small blood vessels in the fingers or toes constrict when exposed to cold. If you have this syndrome, you probably should not use cold therapy on the affected parts of your body.
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If you're using one of these hot or cold methods and it doesn't bring relief, or it seems to make the rheumatoid arthritis symptoms worse, talk to your doctor.
Hot or cold packs, self-soothing practices, help from others, rest and gentle exercise, and taking quick action can all help to reduce your symptoms.
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