A close up view of frosty-looking frozen peas

How to Use Heat and Cold Therapy for Psoriatic Arthritis Pain

By Beth W. Orenstein
Reviewed by Ethan T. Craig, M.D.
August 07, 2023

Applying heat or cold to swollen, achy, painful, and inflamed joints from psoriatic arthritis can often help provide some temporary relief. Each option works slightly differently to help relieve pain, so knowing which one to reach for can be important. If you’re looking for ways to make the most of your pain relief, here’s what to know.

When to Choose Heat or Cold

When it comes to relieving pain from psoriatic arthritis, heat and cold have different effects. So, the one you choose to use may depend on the type of pain you’re experiencing, says Alexis Ogdie-Beatty, M.D., a board-certified rheumatologist and the director of the Penn Psoriatic Arthritis Clinic at the University of Pennsylvania.

“In general, people whose joints are really inflamed and swollen will find ice to be more beneficial,” she says. That’s because cooling the area can help reduce blood flow and decrease swelling and inflammation, according to the Mayo Clinic.

But if you wake up in the mornings and find your joints are really stiff, heat can be the better option, Ogdie-Beatty says. That’s because warmth can increase blood flow and help loosen muscles, which helps ease stiffness.

Ultimately, both options are safe to use. Which one you pick is really up to your preference and what brings the most relief to your symptoms, says Lawrence Brent, M.D., board-certified rheumatologist at Temple University Hospital, in Philadelphia.

How to Apply Heat or Cold for Psoriatic Arthritis Pain Relief

Here are a few tips for using heat or cold therapy on painful joints.

Use a Barrier for Cold Packs

You can make a cold compress from a gel pack, a bag of frozen veggies, or ice cubes. Whichever you pick, wrap it in a cloth or kitchen towel to prevent direct contact with your skin. Indirect contact can help protect your skin from an ice burn while still allowing you to cool and soothe the joint.

Use Moist Heat

To avoid burning your skin, apply moist heat, Brent says. A good way to make a moist heating pad is to put a wet washcloth in a plastic freezer bag. Warm it in the microwave for up to 60 seconds. Taking a warm, steamy shower or bath is also a good way to use moist heat on achy joints.

Wear Warming Gloves or Mittens

These can help with stiff hands. “You can buy them online at places like Amazon or in stores like Bed, Bath & Beyond,” Ogdie-Beatty says. “You put them in the microwave to heat, and slip your hands in them.” These can cost about $30 to $40 for a pair, she notes.

Try Warm Paraffin Baths

Paraffin is a type of wax. “You can do a paraffin dip, and it does help with stiffness,” Ogdie-Beatty says. Like the gloves, you can find paraffin wax machines for sale online or in home stores.

A cheap and easy alternative is a rice bath, Ogdie-Beatty says. To make one, pour a bag of dry white rice in a microwave-safe bowl; then, heat it in the microwave for about a minute. Check to be sure it’s warm but won’t burn you before placing your entire hand or hands in the bowl.

Apply in Intervals

You can apply your source of heat or ice to your aching joint for about 15 to 20 minutes, Brent says. There’s no harm in applying it multiple times per day as needed. The Mayo Clinic recommends reapplying every four hours or so.

Alternate Your Use

Some people with arthritis find that both heat and cold are helpful for pain relief. In that case, it’s okay to alternate between applying heat and cold for your psoriatic arthritis—just be sure to give a couple of hours after using one therapy before switching to the other, according to the Arthritis Foundation. This may help protect your skin and blood vessels.

Other Ways to Relieve Pain

Applying heat or cold (or both alternately) to your joints may help relieve arthritis pain temporarily. Physical therapy and exercise also can help relieve pain and stiffness, the Arthritis Foundation says. But while these methods can help you manage arthritis symptoms, they likely don’t have a role in treating the underlying disease. You should seek the help of a rheumatologist for more lasting results, Brent says. “There are many medications that are effective in treating psoriatic arthritis,” he adds.

If you haven’t already, you can talk to your doctor about medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and immunomodulating drugs (including biologics and synthetic disease-modifying drugs). These options can help relieve pain while also preventing inflammation, which can give you the best chance of long-term relief from symptoms.

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