Whether arthritis or injury is causing your joint discomfort, you’ve probably received varying — and maybe even contradictory — advice on how to manage it at home. Hot and cold therapy are two of the most common treatments for joint relief, but when should each of them be used?
Here’s how to know whether to use ice or heat for joint pain.
What Causes Joint Pain?
Joint pain may be the result of:
- Arthritis.
- Bursitis.
- Cancer.
- An injury, such as a sprain, strain, or fracture.
- Tendonitis.
- Viral infection.
Arthritis is one of the most common causes of joint discomfort, encompassing more than 100 conditions.
Among the most typical forms of arthritis are:
Gout
Gout is a type of inflammatory arthritis that doesn’t cause body-wide inflammation like other forms of arthritis. Gout occurs due to hyperuricemia, a condition caused by high uric acid levels in the blood. This can cause crystals to form in the joints, leading to severe pain.
Psoriatic arthritis
Psoriatic arthritis (PsA) is an autoimmune inflammatory disease in which the immune system mistakenly attacks the body, particularly the skin and joints, resulting in skin rashes and joint pain. It typically occurs in people with the autoimmune condition psoriasis.
Osteoarthritis
Osteoarthritis (OA) is a joint disease in which cartilage and fluid break down, causing pain, stiffness, and difficulty moving. It often affects the knees, hips, hands, and spine, and may involve inflammation.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is an autoimmune disease in which the immune system attacks healthy joint tissue and other organs, causing inflammation.
Septic arthritis
Septic arthritis is a painful joint condition caused by an infection — usually from bacteria, but sometimes from viruses or fungi.
How to Treat Joint Pain
Whether to use a cold or hot treatment to provide relief depends on the source of the pain.
Hot and cold therapies work differently to treat injuries, so knowing their effects can provide clues as to which method would be most effective for your pain:
- Cold restricts blood flow, reducing swelling and inflammation. It also numbs pain around the affected area.
- Heat increases blood flow to an affected area, which promotes healing and relaxes muscle spasms.
Ice is better for inflammatory pain. You can tell if a joint is inflamed if it’s red, swollen, or warm to the touch. Relieve inflamed joints by applying a gel ice pack, cold pack, or even a bag of frozen peas wrapped in a T-shirt to the injured area.
Heat is better for joint pain not caused by inflammation, such as osteoarthritis. The Arthritis Foundation recommends placing a moist heating pad wrapped in a layer of cloth on the affected joint or soaking it in a warm bath. Heat treatments also can be effective for rheumatoid arthritis when you’re not having a flare-up.
When to Use Ice for Joint Pain
Ice minimizes inflammation and swelling
Try ice for:
- Acute injuries (those less than four weeks old), which include bumps, bruises, pulled muscles, sprains, and strains.
- Acute joint pain.
- Inflammation/swelling.
Cold therapy can reduce inflammation and bruising, promoting healing after an injury and preventing further tissue damage.
Cold treatments can come in the form of:
- Bag of frozen peas.
- Bag of ice cubes.
- Cold compresses/frozen washcloths.
- Gel packs.
- Ice caps.
When to Use Heat for Joint Pain
Heat works best for chronic pain or injuries that have lasted more than four weeks. It helps relax stiff joints and muscles, easing long-term discomfort.
Don’t use heat in the first few days after a new injury, as it can increase inflammation and make symptoms worse.
Heat is best for:
- Chronic joint pain.
- Muscle soreness/tightness.
- Noninflamed arthritis.
Heat treatments include:
- Chemical heat pads.
- Electric moist heating pads.
- Gel heat pads.
- Heat wraps.
- Hot-water bottles.
- Infrared heating pads.
- Microwaveable heating pads.
- Warm bath or soak.
FAQs
Is it better to use ice or heat for arthritis?
It depends.
- Ice is great for during times of arthritis flare-ups, such as when joints are painful, stiff, and swollen. These are signs of inflammation, and cold therapy can help reduce swelling and prevent further tissue damage.
- Heat therapy is great for loosening up stiff joints and easing aches and pains from chronic arthritis.
Can I alternate between ice and heat?
Yes. There are times when alternating between ice and heat can be helpful.
Try using both:
Before and after workouts
- Apply heat before exercising to loosen joints and warm up muscles.
- Use ice afterward to reduce inflammation and soothe sore muscles or joints.
- Avoid using ice before workouts—it can stiffen muscles and affect performance.
For arthritis relief
- Use ice during flare-ups with pain, swelling, or warmth — these are signs of inflammation.
- Apply heat for ongoing stiffness to help relax joints and ease discomfort.
For overuse injuries like tendonitis or tendinosis
- Ice is recommended early on when inflammation is likely.
- If symptoms last more than a month, either ice or heat may help, depending on what feels best.
How long should I apply heat or ice to a joint?
There’s no strict rule, but applying ice for 10 to 15 minutes is usually enough. After that, let your skin return to its normal temperature before reapplying as needed throughout the day.
Tips to note:
- Never place ice directly on your skin — it can cause burns. Always use a thin towel or cloth as a barrier. Similarly, never put a heat source directly on your skin. Always keep a layer between the heat source and your skin.
- If you have reduced sensitivity to heat or cold due to conditions like diabetes-related neuropathy or Raynaud’s syndrome, be especially careful. These conditions make it harder to feel cold, increasing the risk of skin damage, so always monitor how long the ice stays on to protect your skin.
- Do not fall asleep while heat is in place, as it can lead to burns.
What’s the best remedy for nighttime joint pain?
Joint pain often feels worse at night because inflammation tends to rise when the body is at rest and levels of natural anti-inflammatory hormones, like cortisol, drop. Reduced movement during sleep also lowers blood flow and affects joint lubrication, leading to stiffness and discomfort. Conditions such as arthritis, tendonitis, and past injuries can make this nighttime pain more intense.
You can use ice or heat immediately before bedtime, but do not fall asleep with either one in place. Falling asleep while using heat or ice can lead to prolonged exposure and skin damage.
Proper body positioning while sleeping at night can help alleviate joint pain. If you suffer from hip bursitis or shoulder pain, sleeping on your side can worsen that pain. Painful wrists? Sleeping with them bent underneath your body or head may cause more aches.
Depending on your arthritis pain points and sleep preferences, there are best practices to optimize any sleep position.
Finding Treatment for Severe Joint Pain
If you have severe joint pain or a chronic condition that interferes with your daily life, talk to your health care provider about treatment options to help with your pain.
UPMC Orthopaedic Care can help. Call 1-866-987-6784 or submit a form online for more information or to make an appointment.
Editor's Note: This article was originally published on , and was last reviewed on .