Using Heat and Cold to Treat a Rheumatoid Arthritis Flare-Up

One of the simplest, safest ways to ease joint symptoms from a rheumatoid arthritis flare can be done at home. Applying a warm or cold compress may help relieve RA pain, swelling, and stiffness. This approach works because temperature changes can affect inflammation, blood flow, and nerve sensation.

Keep in mind that heat and cold therapy—referred to as thermotherapy by medical researchers—only affects the area where it is applied. It will not change overall rheumatoid arthritis disease activity or pain/discomfort in the other parts of the body.

How heat helps


Heat therapy helps to relieve pain and stiffness by dilating blood vessels (vasodilation), which increases blood flow and improves blood circulation.

When you want to relieve joint stiffness and encourage easy joint movement, heat therapy can help. Heat therapy increases blood flow to muscles and other tissues, helping relax muscles and ease pain.

You can use heat therapy first thing in the morning, when the joints are stiffest, or to help warm up joints before exercise or another activity.

See When and Why to Apply Heat to an Arthritic Joint

Heat therapy can be moist or dry. Moist heat may include applying a warm, damp compress or spending time in a shower, bath, or steam sauna. Dry heat may include applying heating pads or patches or spending time in a dry sauna.

Watch Video: How to Make a Homemade Heat Pack

Another form of heat therapy involves using a paraffin (hot wax) bath. A paraffin bath can be especially useful when hand or foot joints are painful. You can find paraffin bath supplies from beauty supply stores and major retailers.

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If you use a heating pad or patch, make sure it’s not too hot and limit its use to 10 to 20 minutes, 1 to 3 times a day. Using heat therapy that’s too hot or applying it too often can damage skin. (In rare cases, damage from repeated heat exposure can be permanent.1)

See 9 Easy Ways to Apply Heat to an Arthritic Joint

Avoid using heat on joints that are very swollen. In such cases, cold therapy is a better bet.

How cold therapy eases pain


Cold therapy can constrict blood vessels (vasoconstriction), which reduces blood flow. This may help reduce inflammation and swelling for an acute injury, or help ease chronic pain and stiffness.

Applying a cold pack can be helpful especially when an RA flare-up brings inflamed, swollen joints. Cold therapy typically2:

  • Constrains blood flow to joints, helping to ease inflammation
  • Reduces the production and accumulation of fluids in the joint, which can limit swelling
  • Slows down pain signals to the brain

Cold therapy is simple and can be low- or no-cost. Reusable and disposable cold packs are available for purchase. Cold-packs can also be made from items available at home, such as a bag of frozen vegetables or ice in a sealed plastic sandwich bag.

See 3 Types of Cold Packs for Arthritis

To prevent damage to your skin, limit cold therapy sessions to less than 20 minutes, and place a towel or other protective layer between your skin and the cold pack. You can use cold therapy a few times a day, but allow your skin to return to normal temperature before starting a new session.

Also, if you have Raynaud syndrome, gout, or nerve damage, avoid using cold therapy on the part of your body that’s affected.

See Applying Heat vs. Cold to an Arthritic Joint

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Many people choose to use a combination of heat and cold therapy to treat painful joints. For example, once the worst of your RA flare-up is over and you can return to exercising, you can use heat therapy to warm up your joints before exercise, then cold therapy to soothe joints afterward.

Learn more:

Rheumatoid Arthritis (RA) Treatment

5 Types of Medication That Treat Rheumatoid Arthritis (RA)

References

  • 1.Kettelhut EA, Traylor J, Roach JP. Erythema Ab Igne. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538250/
  • 2.Block JE. Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review. Open Access J Sports Med. 2010;1:105-113. Published 2010 Jul 7. doi:10.2147/oajsm.s11102

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