These psoriatic arthritis treatments can be performed in a variety ways, whether by a physical therapist in an office setting or by the patient at home. But a general rule is that applying moist heat reduces muscle tension and stimulates blood circulation, while applying cold reduces soreness, inflammation, swelling, and joint pain during a flare, according to the Cleveland Clinic. Still, if a joint is really tender and swollen, it may be wisest to simply let it rest. “The best judge is the patient themselves," says Martin Bergman, MD, a clinical associate professor of medicine at Drexel University College of Medicine and chief of the division of rheumatology at Taylor Hospital in Philadelphia. “They know if things are stiff and achy or hot and swollen.” “Whatever makes you feel better is the right answer. There’s no harm in using a heating pad, and there’s no harm in using an ice pack, but if one’s not helping you, then you should try the other,” says Dr. Husni. “In general, we feel that if your joints are red, swollen, and hot, then an ice pack usually feels a little bit better,” she says. For people with psoriatic arthritis pain who have more muscle-related issues, it seems that a heating pad or warmth provides more relief, Husni says. There’s no hard and fast rule about how often to apply heat or cold therapy. “This is an adjunctive therapy to go along with any other psoriatic arthritis therapy that your doctor suggests,” says Husni. RELATED: 9 Myths About Psoriatic Arthritis Treatment, Debunked
How Heat Therapy Can Help With Psoriatic Arthritis Symptoms
Warming up a sore joint causes blood vessels to expand, which can allow more blood, oxygen, and nutrients to surround the injured tissues, according to the Arthritis Foundation. Safe heat sources for psoriatic arthritis treatment include the following:
Warm Baths or Showers Baths take pressure off joints and weight-bearing muscles, and a warm shower can ease morning stiffness. Dress warmly afterward to prolong the benefit.Heating Pads Look for models that have moist heat options (usually by inserting a wet washcloth inside). Or make your own pad by putting a damp towel in a microwave, then wrapping it in another towel. It should feel pleasantly warm — not too hot.Hot Water Bottles The old-fashioned kind are safe, reliable, and available in most drug stores.Paraffin Baths Once the province of professional manicurists and physical therapists, paraffin baths now come in kits for home use. After dipping your hands in the warm wax, cover them with plastic and a towel; then relax and let the heat penetrate for about 20 minutes before peeling off the wax. Talk to your physical therapist before using one to make sure it’s right for you.Water Exercise Many YMCAs, aquatic centers, and community pools offer warm-water exercise programs specifically for people with arthritis. Not only does the temperature of the water help relieve psoriatic arthritis pain but the low-impact workouts can improve joint strength and flexibility and boost cardiovascular fitness, according to CreakyJoints, an education and advocacy group for people with arthritis.
Safety Guidelines for Heat Therapy
To prevent burns, do not use heat for excessive lengths of time, and be careful to frequently check skin for redness while applying heat. If the heat starts to feel uncomfortable, discontinue immediately: The last thing you want to do is trigger a psoriatic flare by injuring your skin. RELATED: What Psoriatic Arthritis Really Feels Like
Cold Therapy for Psoriatic Arthritis Pain
If you overdo it on physical activity and experience sudden redness and swelling, cold therapy is usually the best option, according to the Arthritis Foundation. Cold therapy can reduce blood flow around the affected joint and help decrease inflammation. Safe cold sources for psoriatic arthritis treatment include these options:
Gel-Filled Cold Packs Available in most pharmacies, they’re inexpensive and available in different sizes and shapes. Keep one or two in the freezer.Bags of Ice or Frozen Vegetables Pliable, affordable, and convenient. Be sure to wrap ice or frozen vegetables in a towel before applying to the skin.
Safety Guidelines for Cold Therapy
To avoid frostbite, do not apply cold for more than 15 minutes at a time and allow your skin to return to normal temperature and color before reapplying. Be sure to put a barrier between the cold source and the skin to avoid ice burns, says Husni.
Why Heat and Cold Therapy Aren’t Enough on Their Own
Keep in mind that while heat and cold therapies may be good for temporary relief, they don’t address the underlying psoriatic arthritis causes. Psoriatic arthritis is a progressive disease that can lead to permanent injury to joints. “There’s a possibility of damage going on underneath the aches and pains," Dr. Bergman cautions. “Make sure you’re getting treated properly. That means seeing someone who knows what they’re doing: a specialist — in particular, a rheumatologist. That’s the place to start.”
