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The effect of local heat and cold therapy on the intraarticular and skin surface temperature of the knee

updated

Tags: ice heat, biology, devices, rehab, injury, pain problems, self-treatment, treatment

Three articles on PainSci cite Oosterveld 1992: (1) Icing for Injuries, Tendinitis, and Inflammation(2) Complete Guide to Plantar Fasciitis(3) Icing, Heating & Tissue Temperature

PainSci summary of Oosterveld 1992: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible.

One of two similar experiments (Oosterveld 1992 and Oosterveld 1994) testing heating and cooling methods on knees, with or without arthritis. This test measured the effect of ice chips, ligno-paraffin (hot wax), short-wave diathermy, and nitrogen-cold air on healthy knees.

All methods changed the temperature inside healthy knees, by as much as several degrees. Cooling had a greater impact than heating, with temperatures inside the joint dropping as much as 9˚C very cold air. Hot wax increased intrarticular temperature by 3.5˚C in this experiment (but only 1.7˚C in the 1994 test).

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To evaluate the effects of local application of ice chips, ligno-paraffin, short-wave diathermy, and nitrogen-cold air on skin and intraarticular temperature.

METHODS: Forty-two healthy subjects were divided into 4 treatment groups. A temperature probe was inserted into the knee joint cavity and another placed on the overlying skin, and changes in temperature over 3 hours, by treatment group, were recorded.

RESULTS: The mean skin surface temperature dropped from 27.9 degrees C to 11.5 degrees C after application of ice chips, and from 28.8 degrees C to 13.8 degrees C after application of cold air. The mean intraarticular temperature decreased from 31.9 degrees C to 22.5 degrees C and from 32.9 degrees C to 28.8 degrees C, respectively, after these 2 treatments. Shortwave diathermy increased skin temperature by 2.4 degrees C; intraarticular temperature was increased only 1.4 degrees C by short-wave diathermy. Treatment with ligno-paraffin increased the skin surface temperature 8.9 degrees C; the temperature in the joint cavity was increased 3.5 degrees C.

CONCLUSION: The use of short-wave diathermy and superficial heat packs in the treatment of patients with arthritis may potentially cause harm by increasing intraarticular temperature. This may have major implications regarding treatment policy for patients with arthritis.

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