Hot and Cold Therapies Explained

Treating pain, inflammation and injury with hot and cold therapies can be extremely effective and affordable. However, it’s important to know which situations call for hot, which call for cold and which may benefit from both treatments. Importantly, this kind of therapy is very good for arthritis and can help ease pain and stiffness that comes with the condition.

Cold Therapy

What is cold therapy?

Cold therapy reduces blood flow to the applied area, slows the rate of inflammation and reduces the risk of swelling and tissue damage. It can also temporarily numb sore tissues to help with pain.

Types of Cold Therapy

  • Ice packs – available to purchase, or use a plastic bag filled with ice or frozen vegetables and wrapping it in a dry cloth. As a general rule, ice packs are used for 20 minutes, removed for 1-2 hours, before being applied again.
  • Ice baths – body part is immersed in cold water (not freezing)
  • Ice massage – ice cube or ice pack is moved around the sore area or joint in a circular motion (for a maximum of 5 minutes to avoid ice burn)
  • Vaporizing sprays – very short term effect

Cold Therapy is Best for…

  • Acute stages of inflammation – such as a recent sprain or injury (within 48 hours of injury)
  • Gout
  • Tendinitis or irritation on the tendons – following activity


Heat Therapy

What is heat therapy?

Heat therapy dilates the blood vessels, stimulate blood flow and reduces muscle spasms.

Types of heat therapy

  • Heat Packs – available to purchase such as electric heating pads, hot water bottles, heat bags (heat up in microwave) – for up to 20 minutes at a time
  • Warm, moist wet towel – heated in the microwave – wrapped in plastic and cloth
  • Hydrotherapy – soaking in a hot bath, in a shower directing the warm water to the affected area or exercise in heated water. Arthritis NSW delivers a Warm Water Exercise program, visit here for more details.
  • Wax bath – immersion of body parts in warm wax, often used for hand
  • Medications – such as rubs or patches

Hot therapy is best for…

  • Warming up stiff muscles or tissues – heat can improve the flexibility and range of movement in the ligaments and muscles around your joints
  • Relieving pain or muscle spasms
  • Chronic muscle pain
  • Deep tissue joints – like the hip or back pain (cold therapy only reaches very superficial tissue and can aggravate muscle tension).


  • Hot or cold therapy should not be used on open wounds, damaged skin (that is hot, red or inflamed), or if you have skin conditions such as dermatitis or rashes. Also avoid using heat therapy over bruises.
  • If you suffer from high blood pressure, be careful as cold therapy can cause blood pressure to rise. For low blood pressure you should be careful with both hot and cold therapies. If you have cardiovascular disease, ask your doctor before using hot and cold therapies.
    Avoid cold therapy when there is a risk of cramping because it can make it worse.
  • Do not use hot and cold therapy if the person is insensitive to heat or cold (such as diabetic neuropathy) or is already cold.
  • Cold therapy should not be used if you have Raynaud’s disease (a disease that causes the blood vessels in hands to contract) or Cryoglobinaemia. (Cryoglobulinemia is a medical condition in which the blood contains large amounts of pathological cold sensitive antibodies called cryoglobulins proteins (mostly immunoglobulins themselves) that become insoluble at reduced temperatures.) There is the potential for people with Rheumatoid Arthritis or Systemic Lupus Erythematosus to develop the condition.

Overall, the benefits of heat and cold therapies for arthritis are yet to be proven by science, however these treatments are soothing and safe when used sensibly. It is up to personal preference, however heat therapy seems to be more effective than cold for treating chronic muscle pain and sore joints caused by arthritis as it reaches tissue that lies deep under the skin.

Information provided is of a general educational nature only and should not be relied upon as medical advice. Consult your health care professional about the treatment that is best for your particular case.


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Sources and Further Reading

Arthritis QLD: Tips for Using Hot and Cold Therapies

Medical News Today – Heat and cold treatment: Which is best?

Healthline – Treating Pain with Heat and cold 

Arthritis Foundation – Treating Pain with Heat and Cold

WebMD  – Heat and Cold Therapy for Arthritis Pain