Heat Versus Ice: What's Really Best for Your Knee Arthritis?

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cold compress

Your knee aches after your epic shopping trip to the mall.

Yes, it was worth it as you managed to clean up at all the sales, but now you are paying the price: knee pain. If you are among the millions of people who live with knee osteoarthritis, you know your pain tends to worsen with and after activity. You also know that regular exercise including walking through your favorite mall is one of the best things you can do to improve your range of motion and flexibility as well as strength the muscles that surround your knee.

Enter heat and ice.

Both of these modalities can be super-effective pain relievers when used correctly. Other pluses: they are relatively inexpensive and mainly side-effect free. The trick is knowing when and how to use heat or cold to treat your knee pain.

Here’s a cheat sheet on heat versus ice for knee pain:

The Heat Is On Your Knees

Heating pads, warm baths, and other heat-based treatments tend to be best before activity. Applying heat to your knee before you hop on the treadmill or head out on a shopping excursion will improve blood flow, relax your muscles, and get your joints primed for action.

Wrap a moist heating pad in a towel and place it over your knee or knees for 15 to 20 minutes before exercise. For a do-it-yourself heating pad: Place a wet washcloth in a freezer bag and heat it in the microwave for one minute. Electric heating pads are another option for treating knee pain, provided they are not too hot.

Other ways to tap into the healing effects of heat include:

  • Warming your clothes in the dryer before getting dressed.

  • Turning your electric blanket up for a few minutes before getting out of bed. (Remember to turn it off when you get out of bed.)

There is one caveat to keep in mind when using heat therapy: Do not burn yourself. Avoid this by using heating pads for less than 20 minutes at a time and filling heating bottles with hot—not boiling—water.

Your Knees On Ice

Ice, ice packs and other cold therapies can help reduce knee pain and muscle spasms. Conventional medical wisdom suggests using ice to treat an acute injury or pain that occurs after activity. Put another way: Apply heat before your mall trip and cold after you return home. Cold can numb pain, decrease swelling, and block nerve impulses to the joint.

A review article comprising of six studies suggests cold therapy can be an effective way to relieve knee pain. One study showed that ice massage performed for 20 minutes, five days a week, for two weeks improved range of motion, function and knee strength among individuals with knee osteoarthritis. Fill a Styrofoam cup with water and freeze it. When removed, that rounded block of ice fits your hand perfectly for performing knee massage. Another study found that ice packs used for three days a week for three weeks improved pain just as well as no treatment.

Importantly, there were no side effects seen with cold therapy in any of these studies.

To explore the benefits of cold therapy for knee osteoarthritis:

  • Apply a bag of ice wrapped in a towel or a gel-filled cold pack to the painful area for about 10 minutes.

  • Wrap a towel around a bag of frozen vegetables and place it on sore joints for pain relief. Tip: frozen peas, or other vegetables, mold to your body, making them ideally suited for knee pain.

Remember, if your pain does not improve or seems to worsen, visit your doctor to find out what else you can do for your knee OA.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 1
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Head-cold for pain relief, Arthritis Foundation. http://www.arthritistoday.org/arthritis-treatment/natural-and-alternative-treatments/remedies-and-th...
  2. Bhatia D, et al. Current interventions in the management of knee osteoarthritis. Journal of Pharmacy And Bioallied Sciences. 2013 Jan-Mar; 5(1): 30–38. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612336/)
  3. Thermotherapy (heat treatment) for treating osteoarthritis of the knee. Cochrane Database of Systematic Reviews. 2011. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012852/
  4. Patient information: Osteoarthritis treatment (Beyond the Basics). UpToDate. http://www.uptodate.com/contents/osteoarthritis-treatment-beyond-the-basics