Heat or Cold Treatment - Whats Best for Arthritis?

Heat and Cold - Their Use in Managing Arthritis Pain

Superficial Heat

Superficial or surface heat has its greatest effect on the skin and subcutaneous tissues just beneath the skin. It is especially useful in circumstances where the goal is to heat joints that are covered by little soft tissue such as those in the hands and feet. Superficial heating agents are delivered by three mechanisms: conduction, convection, or conversion.

Conductive methods: Hot moist packs which warm body tissues more rapidly than dry heat through direct contact. Paraffin wax heats the outer joints of the upper and lower extremities. Heating pads, either are another alternative. Contrast baths involve alternating immersion of a limb into hot and cold water to produce force an super-abundance of blood to the area.

Convective methods: Hydrotherapy involves the use of water, either hot or cold, to treat conditions. Forms of hydrotherapy include whirlpool baths (partial body emersion), Hubbard tanks (whole body emersion), and contrast baths (short term immersion in hot and cold water) which are specifically used for Rheumatoid Arthritis, nerve based pain, sprains and strains, and mild peripheral vascular disease such as Reynard's disease and select other circulatory problems. . Fluidotherapy produces a warm, air-fluid mixture that is referred to as fluidotherapy. This produces a warm, air-fluid mixture that is referred to as fluidization. Presumed benefits include a massaging action and ability to perform range-of-motion exercises.

Conversion methods: Conversion methods include radiant heat, such as infrared heat lamps, and other forms of infrared radiation, mostly used for patients who cannot tolerate the weight of hot packs. The energy is absorbed by the skin and converted into superficial heat.

Deep Heat

Deep heating increases the tissue temperature at a deeper level without overheating skin and the fat layer below the skin. Examples of deep heating include ultrasound and diathermy (the use of high-frequency electromagnetic currents to induce heating of subsurface tissues), including shortwave and microwave.

Ultrasound is used in a variety of conditions, including joint contracture, scar tissue, inflammation, bursitis, muscle spasm and pain, and osteoarthritis. A form of ultrasound, phonophoresis, is proposed to aid in the movement of surface medications into the muscle tissue and the blood stream. The most commonly used are corticosteroids and local anesthetics. The main uses are the same as those in general therapeutic ultrasound use, as well as tendonitis, scar tissues, fasciitis, and bunching of tissues caused by inflammation.

Diathermy, both short wave and microwave involve similar principles. Short wave uses lower frequencies than microwave, and both use electromagnetic radiation to heat tissue. They are used to heat relatively superficial muscles and joints.

Cryotherapy (Cold Therapy)

Cold therapy has several physical effects that increase or decrease the normal responses to certain stressors. Blood flow effects include the constriction of blood vessels followed by delayed expansion of the vessels. Blood flow is first restricted then accelerated. The effects on the muscluar system include the slowing of your nerves transmission rate and the decreased rate of your muscles contractions. The effects in your joints take place by decreasing the activity of the compounds that cause inflammation of the fuilds and tissues surrounding your joints (synovial collagenase activity) General uses of cold include relief of muscle spasm, reduction of muscle spasms, and control of inflammation during the onset of swelling.

Superficial:

Most forms of cryotherapy are considered superficial include cold packs (conduction), and ice massage (conduction). Cold baths are meant for immersion of larger areas (e.g. immersion of an arm or leg), but are more uncomfortable.

Other: Sprays that rapidly cool the surface of the skin, (such as ethyl chloride or florimethane, are used for “spray and stretch” technique for areas of spasm.

Alternating with hot and cold packs is one of the easiest and most effective for home care for reducing acute arthritis pain and stiffness. (When alternating, allow body temperature to return to normal before switching pack treatments.) And nice hot showers or baths in the morning go a long way in helping loosen up those morning muscles and joints. A detailed look at the Use of Moist Heat for Arthritis

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