Many people diagnosed with rheumatoid arthritis (RA) take relief wherever and whenever they can find it. After all, this autoimmune disorder affects the joints and causes pain, discomfort, stiffness, and more. Through trial and error, many people find that hot or cold treatments (called thermotherapy) make their joints feel better.
Here’s what to know about using hot and cold methods to help manage your rheumatoid arthritis pain.
Others say that applying cold best soothes all things related to inflammation — like RA. Because applying something cold to reduce swelling works, it may indeed make inflammatory symptoms feel better.
|Read: How ice and heat can help with RA in the knees|
In the end, there is no proof that hot or cold care best suits the achy joints of a person with RA. Both can bring relief and increase overall wellness. But neither make lasting changes — at least none that can be measured scientifically. (To judge an RA treatment, researchers usually study things like the amount of inflammation, the extent of joint destruction, or the amount of pain experienced over time.)
That said, some people with RA swear that hot or cold care — or rotating both — works for them.
Many myRAteam members reach for cold packs when their joints grow painful. One member wrote, “I only take Tylenol and use ice packs when the pain is too much.” Another seconded that and said, “Ice packs do help with my excruciating, ongoing pain.”
Some outright prefer cold to hot. “Ice helps more than the heat I used to use,” said one myRAteam member. And they weren’t alone. “Honestly, ice packs seem to help me more than heat pads,” posted another member. Some even avoid heat altogether. Why? One member explained, “I don’t use heat on my joints as it makes them worse.”
On the flip side, other myRAteam members prefer heat. One myRAteam member shared these tips: “Try a hot water bottle or heat pack,” they suggested. “The heat tricks the brain into thinking there is less pain.” Another asked a member-friend in pain, “Have you applied heat? Sometimes that helps me.”
People who favor heat also share that staying warm overall helps their joints in general. As one member wrote, “The heat helps me a lot. When someone says ‘bone-chilling,’ that’s exactly what I feel without heating pads.”
Other members have noted that one temperature helps, but the other extreme hurts. “My heating pad helps me. Ice packs make my joints hurt,” one shared.
Many members alternate between hot and cold care. “Keep those heating pads available — and ice packs too!” one myRA team member told another. “Heat and ice work well for me sometimes,” chimed in a third.
Doctors may even suggest tag-teaming hot and cold therapy. One member wrote that their health care provider wanted them to do just that. The ‘prescription?’ "Ice and ice/heat contrast on my hands,” the member posted.
Both hot and cold care are safe to apply when used correctly. Still, you may want to talk to your doctor, rheumatologist, or additional health care provider to see what they recommend. Ask about specific products and application methods. You may need to try several different options find the ones that work best for you.
The key to using a cold treatment successfully (without damaging your skin or other tissue) is usually time. Apply a cold aid for about 10 minutes, then remove it for at least 10 more minutes. If this approach seems to help, repeat the cycle several times.
Sometimes trial and error proves best when learning exactly how to chill the spot where you hurt. Cold packs work well for many places. But applying cold packs directly to small joints, like those in the fingers and toes, can be difficult. Some myRAteam members post about their hunt for solutions. Others offer tips that worked for their own pain.
“I’m figuring out how to ice small joints — probably with ice frozen in paper cups?” wrote one member. Another shared, “If the pain is bad, then my hands go in a bowl of ice water.” A different member has another trick. “I use a bag of frozen veggies in a towel,” they said. A bag of frozen peas works wonders as an ice pack for smaller joints without being awkward, wet, messy, or expensive.
If several small joints hurt, or if your pain centers on a larger joint, big ice packs may be the answer. “Most days I sit with ice packs on my feet and around my neck and hands,” one member confirmed.
There are also products designed to deliver cold treatment right where you need it. “I have a pair of gel slippers, as well as a gel neck wrap and gel gloves,” posted one member. “All are kept in the freezer, and they all work great.” Another endorsed their favorite aids when they wrote, “I found ice gloves and socks helpful.”
If you can’t find these products, ask your rheumatologist for help, and always follow your body’s cues. That means paying attention when the area you are treating seems overly cold, or if your skin begins to hurt or go numb from exposure. When you sense such discomfort, stop any cold treatment immediately.
Heat-based treatments may dilate (widen) the blood vessels and increase blood flow to a painful, sore area. This increased blood circulation may help ease joint stiffness and other symptoms of RA.
You can usually leave heat-based aids on your body longer than cold ones, but you should still remove them after about 20 minutes. Also, know that moist heat methods reach their highest level of effectiveness 20 to 60 seconds after you apply them.
Hot packs, electric heating pads, or heated cushions get high marks from myRAteam members. “I find the heat cushions excellent for pain relief,” one member shared.
Whatever you try, choose products that cover the entire area that needs soothing. And yes, the style statement you make doing this might be absurd. But in times like that, you can always lean on your team members for a laugh. Take the myRAteam member who joked, “Walking around with heat packs strapped to me, I look like I’m about to start an obstacle course.”
And don’t forget everyday pain relief possibilities. Try taking a hot, steamy shower or soaking in a warm bath or a hot tub. You can also deliver moist heat with a heat pack. For a homemade pack, put a wet, rolled-up towel into a plastic zipper storage bag. Then warm it in the microwave until you like its temperature. Next, remove it and wrap that sealed bag in a second towel, and apply the bundle to your aching joints. (You can also buy moist heating pads from the drugstore. Look for “moist” in the name. Never wrap a traditional electric heating pad in anything wet or moist. That can lead to electric shock and injuries.) Some people recommend dipping your hands or feet in liquid paraffin wax for RA pain relief. While some spas and nail salons offer this as a paraffin “dip,” you can also buy an at-home machine online.
You might like rotating between hot and cold, too. Start by applying your cold care for 10 minutes, wait a few minutes, and then apply your hot care for 10 to 20 minutes. Repeat this approach, but do so within reason. It’s good to give your skin a break after several rounds.
One way to deal with your RA pain is to stay warm overall. Whether you are actually cold or are experiencing sensations of extreme cold doesn’t matter. Warming up might help your joint pain feel better — period. Yes, this tactic is different from soothing a single sore joint. But, hopefully, being warm overall puts you at a better starting point to treat any specific pains.
Many myRAteam members swear warming up all over helps when their RA pain gets bad. One explained how they ward off pain with a full-body defense. “I usually either take a long, hot shower or drink a cup of hot tea, which seems to help … not to mention I always wrap up in my trusty throw!” they posted. Another member agreed with this strategy. “I bought one of those heating blankets and it really helps me,” they wrote. “Try drinking something warm. That helps too,” they added.
Yet another myRAteam member shared on the subject, showing how you can weave warming tricks into your daily life. “I keep a small space heater for my feet,” they began, “and I always have some of the fingerless gloves with me in the winter. (I have short ones and a pair that go up my arm. I found this has helped me keep my hands warm and less achy.) A friend made me a bag with rice in it that I can warm up and use when I am really cold. And my electric blanket is a must in the winter when we are watching TV. Also, I made sure my car had seat warmers, and that has really helped me out.”
On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 186,000 members come together to ask questions, give advice, and share their experiences with others who understand life with RA.
Have you used heat or cold to help relieve RA pain? Share your experience and tips in the comments below or by posting on myRAteam.