Is heat therapy effective for rheumatoid arthritis?

DEAR DOCTOR K:

Is heat therapy an effective treatment for rheumatoid arthritis?

DEAR READER:

Rheumatoid arthritis (RA) is a long-lasting inflammatory disease that causes pain, stiffness, warmth, redness and swelling in joints. Over time, the affected joints may become misshapen, misaligned and damaged.

For many people with RA, drug treatment slows down the damaging effects of the disease. But non-drug treatments — including heat therapy — play an important role in pain relief, improved range of motion and enhanced strength.

Heat helps by reducing pain and relaxing muscles. You can try some heat-related techniques at home:

  • WARM BATH OR SHOWER. Soaking for 15 to 20 minutes in a warm bath exposes the body to warmth and allows the weight-bearing muscles to relax. A warm shower can also help reduce stiffness. You can install an inexpensive, adjustable showerhead massager to better control the intensity of your experience. Dress warmly after a shower or bath to prolong the benefit.
  • A HEATING PAD is another good idea, but keep in mind that moist heat penetrates more deeply. You can purchase hot packs and moist/dry heating pads. Or create a homemade hot pack by heating a damp folded towel in a microwave oven for 20 to 60 seconds, or in an oven set to 300 degrees F for five to 10 minutes. To prevent burns, test the heated towel on the inside of your arm before applying to a joint: It should feel comfortably warm, not hot.

Heat-based treatments are also a standard part of physical therapy:

  • ULTRASOUND produces heat in deep body tissues. Physical therapists may use it to reduce inflammation and relieve pain and stiffness in joints affected by RA. The physical therapist will first apply a gel on the skin over the affected joint. He or she will then rub a wand-like instrument over the area to transmit the ultrasonic waves.
  • DIATHERMY uses electromagnetic waves to deliver heat deep into the tissues. Diathermy should not be used on actively inflamed joints.
  • PARAFFIN BATH. In this technique, you dip your hands or feet into wax melted in an electric appliance that maintains a safe temperature. After the wax hardens, the therapist wraps the treated area in a plastic sheet and blanket to retain the heat. Treatments generally take about 20 minutes, after which the wax is peeled off. Paraffin bath kits are also available for home use.

In the past 25 years, powerful new medicines made possible by breakthroughs in immunology research have become available to treat rheumatoid arthritis. They do a better job than any previous treatments of slowing or stopping the destruction of joints by rheumatoid arthritis.

A patient of mine had a lot of joint damage before the treatments were available, but has had no further damage since. She once told me: “I’m very grateful for these new drugs that science has made possible. I can see how much they have helped. But if you ask me which treatments I like the most, it’s the paraffin baths. They give me such relief.”