Hot and Cold Therapy for Arthritis Joint Pain

How do you know when to use hot or cold therapy for joint and muscle pain, and what can help make these treatments work most effectively?

By Diana Rodriguez
Medically reviewed by Pat F. Bass III, MD, MPH

Sore, aching muscles often respond well to treatment with a heating pad. And when that bum knee or shin pain starts acting up, you can reach for a bag of frozen peas or an ice pack to help ease the pain and inflammation. Even though it's a different ailment, the pain caused by arthritis is similar to other aches and pains, and may be as effectively managed with hot and cold therapy. Hot and cold therapy is used to manage joint pain and stiffness naturally, using heat and ice.

Heat Therapy for Joint Pain

After a long day, soaking in a steaming shower or bathtub, sipping a cup of hot tea, or cozying up in a warm robe can make you feel comforted and soothed. There's a reason you reach for heat when you need relief from pain or stress: Heat is relaxing. Stiff, tense, and sore muscles can be relaxed and relieved with a little heat, and joints affected by arthritis pain are no different. Not only does heat relax muscles, it also stimulates blood flow and improves circulation, helps increases range of motion, and reduces stiffness in painful joints.

Cold Therapy for Joint Pain

When arthritis pain causes a sensation of burning, cool it off with cold — applying an ice pack or even a bag of frozen vegetables (easier to wrap around an area like a knee) can help to numb areas affected by joint pain. Cold therapy can reduce inflammation, a major cause of arthritis joint pain and stiffness. Placing a cold pack on a swollen joint can also help bring it back down to size, which will also lessen joint pain.

The Art of Using Hot and Cold Therapy

Hot and cold therapy each have their own appropriate uses. You should never apply heat to a joint that is already hot, red, and irritated, for example, nor should you apply cold to a joint that's stiff and not moving well. Remember, heat helps muscles relax; cold helps to minimize inflammation and pain.

It's also important to be careful when using hot and cold therapy to manage arthritis pain, or you might end up with damage to your skin from exposure to relatively extreme temperatures.

Here are suggestions for safely using heat therapy devices such as a heating pad, a heat pack, a hand towel soaked in hot water, a warm water soak, or a hot water bottle:
Make sure that the temperature is never uncomfortably high; you don't want to put your skin at risk for burns.
Place a cloth or towel between your skin and the heat source to prevent burns.
Don't apply heat to skin that is cut or injured in any way.
Never apply heat for longer than 20 minutes at a time.

Suggestions for safely using cold therapy devices such as a cold pack, a bag of frozen vegetables, or a bag of ice:
Use a cloth or towel between your skin and the cold source to prevent irritation or damage.
Avoid cold therapy if you have circulatory problems.
Never leave the cold application on your skin for longer than 20 minutes, and don't allow your skin to become too cold.
If you notice your skin becoming numb, blistered, bright red, or blotchy, remove the cold source immediately.

After using heat or cold on your joint pain, always evaluate your skin and look for any signs of damage like a change in color, rash, or blisters.

Switching between hot and cold therapy can offer excellent arthritis pain management benefits, as long as each one is used the full story at