There is rather an interesting paradox frequently observed in osteoarthritis sufferers that can not only be a useful diagnostic tool but can also help to reduce pain and increase movement in stiff and sore joints. By definition, osteoarthritis means – osteo = bone; arthro = joint; itis = inflammation. So literally, it means inflammation of the bone aspect of the joint.But people suffering from osteoarthritis (OA) commonly remark that they feel less pain, and find it easier to move after having a hot shower or bath. They may also notice that in the cold of winter they are stiffer, and in more pain and discomfort. This is a very common scenario for osteoarthritis sufferers.
With inflammation, ‘heat, redness, swelling and pain’ are the key factors involved. So to treat inflammation we should use cold to soothe the inflammation: heat would irritate it. But the opposite occurs a lot of the time. What on earth is going on?
This is where we need to understand the huge effect muscles can have on the joint. Tight, shortened muscles (which are nearly always present in OA) around the affected joint will cause some or all of the pain and stiffness. The hot water will soften and help lengthen these muscles. As the muscle tension eases, the result will be less pain and easier movement.
The opposite usually holds true, too: cold weather or cold applications to the surrounding muscles will result in further contraction or tension in the muscles and can make the pain worse – or at least will not alleviate it.
The exception to this is if the joint involved is inflamed enough for the inflammation to be causing a lot of pain. Then a cold application to the joint will help ease some of the inflammation and thus reduce the pain. In this instance, heat will usually irritate the inflammation and make the pain worse.
Although this is not a conclusive method of testing and diagnosis, it does give us some very valuable insight into what is going on. Ideally, when both inflammation and muscles are causing pain, it will help if both hot and cold applications are used appropriately i.e. cold to the inflamed joint and heat to the tight muscles. A great way to administer these treatments is by using a mineral hot pack on the muscle and an ice pack/frozen peas to the joint.
However, if you are finding that soaking in a hot pool or similar is beneficial then it may mean that the inflammation is minimal and that muscle tension is significant. In my experience I have observed that the more the relief that heating the muscle provides, the more the muscles are contributing to the problem. Either way, it may well be a positive indicator that there is more that can be done to help the pain and stiffness.
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