Heat and cold therapies for psoriatic arthritis (PsA) can provide some relief to symptoms. Though generally safe, use precaution with both methods and learn when it’s best to use either option.
Heat therapy works by loosening stiff joints. It does this by increasing blood flow to the joints and muscles around them. The relaxation of the joints and muscles can provide some relief to symptoms commonly associated with PsA like joint stiffness and achiness.
Cold therapy has the opposite effect. When you use cold therapy, you reduce blood flow to the muscles and joints. The limited blood supply helps reduce inflammation and swelling.
Generally speaking, both heat and cold therapies are safe as long as you follow recommendations for how to perform each one.
For example, you should only use direct heat treatments, such as warm compresses, for no more than 20 minutes at a time. Similarly, you should only use cold therapy for no more than 15 minutes at a time.
You’ll likely find that alternating between heat and cold therapies works best, but you should use care to not switch too quickly. Oftentimes, waiting a few hours or overnight is the safest way to go.
When using either method, you should use a barrier between the source of heat or cold and your skin. This can help prevent hurting your skin with direct contact.
Heat and cold have opposite effects on joints and surrounding muscles. This difference impacts when you should use one or the other.
Heat increases blood flow, which can reduce stiffness in the joints. You should avoid using heat if you:
Cold therapy causes reduced blood flow to the joints and surrounding muscles, which reduces inflammation and swelling. Cold therapy often works best when used during a flare-up of these PsA symptoms.
There are several ways to use heat therapy at home. Try one of the following.
A warm shower can provide gentle heat across most of the body. While showering, you can try to do small exercises to increase your range of motion and help stimulate the joints.
Similar to a shower, baths can provide gentle heat all over the body, but don’t stay in for too long. You can add salts and bath additives to help the skin, but make sure they are safe for psoriasis symptoms.
Swimming in a warm pool is a great way to help increase flexibility and strengthen your muscles. Being in a pool reduces the force of gravity on your body and can provide an additional range of motion.
Experts have found that swimming two or three times a week can reduce pain by as much as 40 percent.
Moist heat can be safer for applying heat directly to a specific joint. You can use a homemade wrap by putting a damp towel in the microwave for about 20 to 60 seconds.
You can also purchase heat wraps designed specifically for certain body types. Apply the heat with a cloth barrier directly to the joint for up to 20 minutes at a time.
If PsA affects your hands, try this simple method. First, rub mineral oil on your hands. When you’re ready, place them in a pair of rubber gloves and run warm water over them. You can do this for about 5 to 10 minutes.
You can use cold therapy at home during flares to soothe inflammation. Here are a few methods you might find helpful.
Ice packs don’t need to be fancy. You can get the same effect of a store-bought ice pack with common household items like a bag of frozen veggies, ice cubes, or a frozen towel. When using a towel, dampen it, place it in a freezer bag, and then freeze for at least 15 minutes.
Make sure to wrap your homemade ice pack in a thin piece of cloth, and do not place the item directly on the skin.
If you prefer not to use tomorrow’s dinner on your joints, you can purchase an ice or gel pack. When using a store-bought ice pack, make sure to wrap it in a cloth and avoid direct skin contact. One advantage of an ice or gel pack is it often conforms well to your joints.
You can also make your own ice or gel pack at home. You can place rice in a sealable bag and then freeze it for an easily reusable pack.
To make something similar to a gel pack, you can use a combination of dish detergent and water in a sealed bag. You can use both repeatedly.
You can make a single-use ice massager with a paper cup and water. Fill a paper cup with water and then freeze it. Once it is frozen solid, peel back the paper, leaving enough to hold onto, and rub the ice over the sore joints or muscles.
Though heat and cold therapies can provide temporary relief and improve your symptoms, you will need additional therapies to effectively treat PsA. If you suspect you’re experiencing PsA symptoms for the first time, visit your doctor.
There is no cure for PsA, but treatment can help with both reducing symptoms and slowing disease progression. Common treatments for PsAs that a doctor can help you with include:
Heat and cold therapies can help alleviate PsA symptoms. Heat therapy increases blood flow to loosen stiff joints, while cold therapy decreases blood flow to reduce swelling and inflammation.
You should only use both therapies for short periods of time each session. Skip the heat if you’re experiencing a flare of symptoms.
Neither therapy option needs to involve an expensive intervention. Often, you can do either one with items around the house or available at your local store, like a cold pack.
Last medically reviewed on April 8, 2022
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Margaret R. Li, MD, FACR
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