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Hot and Cold Therapy for Osteoarthritis of the Knee

9th April 2021

What is OsteoArthritis of the Knee?

Graphic of the knee showing the effects of osteoarthritis to the cartilage in the joint Osteoarthritis is the inflammation or loss of cartilage in the joints which is caused by wear and tear.

Osteoarthritis is the inflammation or loss of cartilage in the joints which is caused by wear and tear. Symptoms of Osteoarthritis of the knees include pain and stiffness, swelling, warmth, tenderness, and limited movement of the knees. There are different treatment modalities used to treat osteoarthritis. Hot and cold therapy is one inexpensive and effective treatment option for osteoarthritis of the knee.

Heat relaxes the muscles around the knee and also helps lubricate the knee joint. Moreover, it also helps relax the muscles and relieve joint stiffness.

Similar to Heat Therapy Cold Therapy also helps get rid of joint pain, but it does this by inflammation in the joint. It also decreases the swelling and pain related to knee arthritis.

Some people prefer only heat therapy or cold therapy while others prefer alternating heat and cold therapy. You can use heat therapy to warm up joints before physical exercise and use cold therapy after finishing exercise. You can also use heat therapy in the morning to relax the muscles and loosen up your knee and use cold therapy when you notice swelling in your knee. You can repeat the hot and cold therapy throughout the day, it should be carried out one to two times per day until the injury has healed. If you do not see improvements within two to three days, consult your doctor, as stronger treatments may be necessary. (ViveHealth.com)

Heat Therapy for OsteoArthritis

Image of a thermometer in front of a setting sun to signify a high temperature Heat Therapy for OsteoArthritis

Heat therapy is an inexpensive and easy way to relieve some stiffness and pain in your knee caused by osteoarthritis. Heat therapy has a lot of benefits including encouraging the healing of tissue around the knee, decrease joint stiffness, stimulate joint fluid (synovial fluid) and decrease pain.

The positive effects of heat treatment can also be seen in a study conducted on 18 females who had been diagnosed with osteoarthritis of the knee and were given local heat therapy as a therapeutic measure for their symptoms. After a period of 12 weeks, significant improvement was seen in these individuals, who not only have an improvement in their clinical symptoms but their walking abilities as well. (1)

Heat application is not recommended in few conditions which include dermatitis of the knee, deep vein thrombosis, peripheral vascular disease, or if there is an open wound.

There are different ways in which you can use hot therapy. Some methods use dry heat while others use moist heat. Following are some of the methods:

  • Using a Hot water bottle: This can be done by using a rubber or plastic bottle which is filled with hot water and is found to stay hot for at least 20 minutes.
  • Heat Pads: Heat Pads usually require electricity to heat up to a certain level and maintain that temperature.
  • Heated Gel Packs: The gel packs can also be used by heating them by placing them in a microwave oven or hot water. These gel packs usually maintain their heat for at least 30 minutes.
  • Disposable Heat Patches: Disposable Heat patches can be applied directly to the skin due to their adhesive ability and can provide a low degree of heat lasting for a few hours.
  • Rice Pillows: Rice pillows are usually made by filling a pure cotton bag with white rice, which can then be microwaved to heat the rice. A rice pillow can effectively provide heat to the body for at least 20 minutes.
  • Hot water therapies: Whether it is a hot tub, hot bath, or a steam sauna. A hot bath, hot tub or steam sauna, hot water, or steam therapies provide moist heat to the body which helps in relieving the excess heat. This may also assist in relaxing the muscles and loosening up the joints for adequate comfort and pain relief.
  • Paraffin Wax: The joints which may be affected by arthritis can either be dipped into or covered with hot paraffin wax for immediate relief from pain. However, it should be made sure that the temperature of the melted wax should be below 125-degree Fahrenheit to prevent burn marks.

Cold Therapy For OsteoArthritis

Image of 4 ice cubes in a row which are starting to melt Cold Therapy For OsteoArthritis

Cold therapy is another inexpensive, effective treatment that can be used many times a day or occasionally, as needed for osteoarthritis of the knee. Cold therapy decreases the inflammation and slows the production of joint fluid. Applying a cold compress to a resting joint can slow the production of excessive joint fluid and decrease the swelling and discomfort associated with arthritis.

Cold therapy for Osteoarthritis can be achieved by applying an ice pack to the affected area for at least 20 minutes at one time. This process can be repeated at least 7-10 times per day depending on how much an individual can tolerate without overwhelming themselves (Healthline).

The effectiveness of cold packs for osteoarthritis can also be seen in a study that was conducted on 100 patients diagnosed with osteoarthritis of the knee and treated with ifferent methods of pain relief. The results showed that those who received ice massage had superior results than those who were given a placebo as a control. (2)

Further safety precautions that may be taken while practicing cold therapy include:

  • Avoiding direct application of ice on the skin: The application of an ice pack should be practiced through a thick cloth, towel or resuable wraps/packs, which helps to act as an effective barrier between the skin and ice.
  • Limiting the application time: The cold therapy should not be conducted for longer than 20 minutes at a time to prevent any unwanted skin changes.

The Types of Cold Packs that may be used for OsteoArthritis of the Knee

Commercially available Reusable Packs

Commercially available reusable cold packs, as the name suggests, may be used again and again for the purpose of therapy. These are usually filled with gel, which may be placed in the freezer before it reaches the right temperature for use.

Homemade Cold Packs

Homemade cold packs may either include a plastic bag filled with rice, a towel or a wet sponge which is placed in the freezer for a few minutes, or a bag of frozen peas. The advantage of these homemade cold packs is that they can be made using easily accessible things at home and can be used again and again.

Disposable Ice Packs

The disposable ice packs are also known as instant ice packs – hence have to be disposed of after every use. The way in which these instant ice packs are activated is via a chemical reaction that produces a cooling effect immediately.


Osteoarhtiritis of the knees can be a highly uncomfortable condition, and impact greatly on your daily activities. Since Cold and Hot packs are scientifically proven to be effective fr Osteoarthritis, you should consult a health professional and include these therapies as a part of their everyday life for quick and efficient pain relief.

To find a local nutritionist:



  • Ochiai S, Watanabe A, Oda H, Ikeda H. Effectiveness of thermotherapy using a heat and steam generating sheet for cartilage in knee osteoarthritis. J Phys Ther Sci. 2014;26(2):281-284. doi:10.1589/jpts.26.281
  • Yurtkuran M, Kocagil T. TENS, electroacupuncture and ice massage: comparison of treatment for osteoarthritis of the knee. Am J Acupunct. 1999;27(3-4):133-40. PMID: 10729968.

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