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When to Use Heat or Cold Treatments for pain relief


Using either heat or cold treatments can reduce the stiffness and pain of arthritis.

Cold packs numb the sore area. They are especially good for severe joint pain and swelling caused by a flare (a period during which disease symptoms return or become worse). Heat treatments relax your muscles. You can use dry heat methods, such as a heating pad or heat lamp, or moist heat methods, such as a bath or hydrocollator pack.


Tips for heat


Soak in a warm bath, shower, Jacuzzi, or whirlpool.

Place a heating pad on the painful area. Don't sleep with the heating pad on, because you might burn yourself.

Use an electric blanket or mattress pad. Turn it up before you rise, to combat morning stiffness.

Use flannel sheets. They feel warmer against your skin.

Use one of my soft-touch hot/cold packs on the painful area. The packs have cloth on the outside so they can be placed directly on the skin.

Before getting dressed, warm your clothes by placing them on top of the

Dip your hands in a paraffin bath. This is a mixture of melted paraffin and mineral oil. The warm coating soothes stiff, painful fingers. Ask your doctor or therapist about this method.

Use a combination of heat and cold. This is called a contrast bath (see figure 1). Soak your hand or foot in warm water, then cold water, then warm water again.


Tips for cold


Place one of my soft touch hot/cold packs in the freezer for several hours then apply to the painful area for 20-30 minutes.



Before and after treatments


Before using heat or cold:


Your skin should be dry and healthy.

Protect the skin over any bone that is close to the surface of your skin. Place extra padding over the area to prevent burning or freezing your skin.

After using heat or cold:

Check the area for any swelling or discoloration.

Carefully dry the area.

Gently move your joint to reduce stiffness.

Allow your skin to return to normal temperature before using another treatment.


Use heat or cold safely




Use either heat or cold for only 15-20 minutes at a time. Let your skin return to its normal temperature before using another application.

Always put a towel between your skin and any type of pack.

Always follow the advice of your physical therapist or doctor carefully when using these methods, specially heat.

Check your skin before and after using heat or cold.

Use milder temperatures for a child's skin, because it is more sensitive than an adult's skin.


Do not use either heat or cold if you have open cuts or sores.

Do not use cold packs if you have poor circulation or vasculitis.

Do not use heat that is too hot or cold that is too cold. It is normal for your skin to appear pink after using a hot or cold pack. If an area appears dark red or spotty red and white, there may be some skin damage. Blisters also appear if the pack was too hot or too cold.

Do not use creams, heat rubs, or lotions on your skin while using a hot or cold treatment.

Do not make your bath or shower water too hot. This may cause dizziness or fatigue.


For ice treatments, the following "Ice Protocol" may be found useful:


Ice is an effective tool in reducing inflammation, pain and/or spasm, and is important in your daily pain management routine.  You will be frequently reminded to use ice, in combination with other pain control measures prescribed.

It is not recommended that you use ice cubes or crushed ice. Not only are they uncomfortable to lay or lean on; but they melt quickly and make a mess.




Healthy Tips for a Healthy Spine


The following tips can help you take better care of your spine:



  1. Make sure you have a firm mattress that keeps the spine aligned and supports the spine's natural curve. The best sleeping positions are on your back or side.

  2. When standing for extended periods, rest one foot on a small stool to maintain spinal curvature and relieve pressure. The knees should be bent when bending forward. Low-heeled shoes may help by maintaining spinal curvatures and cushioning your weight.

  3. Use chairs that promote good posture and support your back. Placing a lumbar support in the lower portion of your back may help support your spine's natural curve. Readjust the seat of your car so that your knees are level with your hips.

  4. When bending forward, bend at the knees and hips, but keep your back straight. This will help to keep your spine's curvature in proper alignment. When lifting, keep your spine straight while using your legs to do most of the work. Hold the objects being lifted close to your body to keep the weight on your spine to a minimum.


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