Thermotherapy For Arthritis

Arthritis is a condition that can affect anyone at any point in their lives. Due to the prevalence of the disease, it is important - where possible - to manage the symptoms of arthritis using non-invasive methods. This article aims to look at the use of one such method, known as thermotherapy, and discuss what it is and how it can help you manage arthritis.

What is thermotherapy?

The term ‘thermotherapy’ refers to the therapeutic application of heat or cold to an area of the body. Thermotherapy can be used in many different ways, but the most accessible way to use it at home is with heat packs.

Thermotherapy techniques such as heat packs have been used to rehabilitate injuries to joints and muscles, reducing stiffness and pain whilst increasing mobility in the affected area. Thermotherapy works by increasing the circulation of blood to the affected area as well as relaxing the muscle.¹

Understanding arthritis

Arthritis is an umbrella term used to describe conditions which cause inflammation and pain in a joint. There are over 100 types of arthritis, which can affect people of all races, sexes and ages. Some types are chronic conditions; for instance, the common conditions rheumatoid arthritis and osteoarthritis.² 

Types of arthritis

Osteoarthritis

In the UK, osteoarthritis is the most prevalent form of arthritis. It can lead to reduced function and a decrease and/or loss of quality of life.³ Osteoarthritis typically occurs in individuals in their mid-40s and older, with the risk increasing with age.

However, it can occur at any age, secondary to an injury, or in relation to other joint-related diseases such as rheumatoid arthritis or gout. It has been shown that there is a higher prevalence among females as well as those with a family history of arthritis, but a specific gene has not been found to be responsible for this disorder. Besides genetics, your risk of osteoarthritis can be increased by obesity, due to excess pressure it exerts on the joints. 

Osteoarthritis impacts the smooth cartilage lining of joints, leading to increased difficulty in movement, as well as pain and stiffness. As the cartilage lining deteriorates, tendons and ligaments face heightened strain, resulting in swelling and the development of osteophytes, or bony spurs.

Advanced cartilage loss may lead to bone-on-bone contact, altering the structure of the joint and displacing bones from their normal alignment. The hands, spine, knees, and hips rank among the most commonly affected joints. 

The main symptoms of osteoarthritis include:³

• Stiffness 
• Pain 
• Tenderness in the joints
• Limited range of joint movement
• Weakness
• Joints that look more “knobbly” than usual

Rheumatoid arthritis

When compared to osteoarthritis, rheumatoid arthritis is less prevalent. It generally develops between the ages of 30 and 50 years, with individuals assigned female at birth, smokers, and individuals with a family history of the disease being at increased risk. 

Rheumatoid arthritis is an autoimmune disease in which the immune system attacks the body. Specifically, the immune system attacks the outer layer (synovium) of the joint first, then spreads throughout the joint. Individuals with rheumatoid arthritis may experience issues with other tissues and organs. For instance, an increased risk of stroke or heart attack, carpal tunnel syndrome or inflammation in various organs such as the heart, eyes, and lungs.

Common symptoms include:⁴

• Pain
• Stiffness
• Swelling
• Redness
• Warmth in the affected joint
• High temperature
• Poor appetite
• Sweating
• Weight loss
• Fatigue 

Individuals with rheumatoid arthritis may experience flare-ups during which their symptoms are worse. 

Other types of arthritis and related conditions

There are many conditions that cause similar symptoms to arthritis. Some of these are listed below.

• Lupus is an autoimmune disease that results in joint pain, tiredness and skin rashes. It can affect a variety of tissues and organs⁵
• Reactive arthritis occurs shortly after a bowel, gut or throat infection. It leads to joint swelling and pain, extreme tiredness and sore eyes⁶
• Polymyalgia rheumatica is an autoimmune condition that causes stiffness and muscle pain across the top of the legs and the shoulders. It most commonly affects individuals over the age of 50 years⁷
• Fibromyalgia, also known as fibromyalgia syndrome (FMS), is a chronic condition which leads to pain spread over the entire body. It has been estimated that approximately 1 in 20 people experience this disorder to some degree⁸
• Enteropathic arthritis is linked to inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. It commonly affects the spine and lower limb joints by making them inflamed^9,10

Conventional treatments

Current conventional treatments include:

• Steroid hormones, which are used to suppress the immune system and reduce inflammation¹¹
• Non-steroidal anti-inflammatory drugs (NSAIDs), that reduce levels of inflammatory chemicals, known as prostaglandins, in the body¹²
• Disease-modifying antirheumatic drugs (DMARDs), that are used to slow or stop the progression of inflammatory types of arthritis¹³ 
• Medicines that reduce the levels of uric acid (gout)¹⁴
• Other related nutritional supplements - components of cartilage or fish oil (such as glucosamine and chondroitin) have been shown to have potent anti-inflammatory properties due to the presence of polyunsaturated omega-3 fatty acids¹⁵

Thermotherapy for osteoarthritis

Currently, there is no cure for osteoarthritis - and as such, medicine typically focuses on symptom management. Both cryo- (cold) and thermo- (heat) therapy have been considered as non-invasive therapies for arthritis.

Cryotherapy has been used to reduce pain, swelling, and inflammation in affected joints whilst improving mobility. Further, cryotherapy temporarily numbs areas by stopping nerve impulses and narrowing blood vessels, providing pain relief. This can be done through the use of ice packs over the affected areas. 

In contrast, thermotherapy reduces swelling and pain in joints by increasing blood circulation and muscle relaxation. However, it has been expressed that the use of heat therapy may lead to increased swelling and inflammation. There are various techniques for heat therapy, such as the use of superficial heat, heat packs, or diathermy, which utilises electromagnetic energy. 

Scientists have seen favourable results using ice massage for 2 weeks in patients with osteoarthritis in the knee. Following this treatment, patients showed between 8-29% improvement in function, range of movement, and quadricep strength.¹

It should be noted that other scientists have found that ice treatment is ineffective in treating arthritis.¹ The differences in these studies could be due to a number of reasons, including poor methodology, small sample groups, not delivering treatment for a long enough period of time, differences in the severity of patients’ disease, and differences between patients (for example, weight, lifestyle, age, gender or the use of multiple medications).

Nonetheless, ice massage has shown significant improvements for function and range of movement. Future research will require better designed studies prior to other conclusions being made about the use of thermotherapy for arthritis.¹ 

FAQ’s

Should I use thermotherapy?

Thermotherapy should be used with caution, and you should speak to a healthcare provider before using it. There are beneficial effects of this treatment, but it should be assessed on an individual case-by-case basis.

How can I do thermotherapy at home?

Heat packs and cold packs can be bought online or in person. It is not advised to put ice directly onto the skin.

Should I only use thermotherapy and stop other treatments?

No, thermotherapy should be used with other conventional treatments. This treatment offers a non-invasive method with very few side effects that can be easily done at home.

Summary

There is currently no cure for many types of arthritis. Researching new therapies is a long process which will take time, so the focus in the clinic is symptom management which allows an individual to maintain a good quality of life. Thermotherapy - the use of cold or heat to treat arthritis and injuries - is a simple and non-invasive way to help manage the main symptoms of pain and swelling found in most types of arthritis.