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Effects of local heat and cold treatment on surface and articular temperature of arthritic knees

PainSci » bibliography » Oosterveld et al 1994
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Tags: ice heat, biology, devices, rehab, injury, pain problems, self-treatment, treatment

Two articles on PainSci cite Oosterveld 1994: 1. The Complete Guide to Patellofemoral Pain Syndrome2. Icing, Heating & Tissue Temperature

PainSci commentary on Oosterveld 1994: ?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 wherever 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), nitrogen-cold air, and placebo short wave diathermy on 39 arthritic 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 6.4˚C with ice chips (similar but different from the 1992 experiment). Hot wax increased intrarticular temperature by 1.7˚C in this experiment (compared to 3.5˚C in the 1992 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 and compare the effects of locally applied heat and cold treatments on skin and intraarticular temperature in patients with arthritis.

METHODS: Thirty-nine patients with arthritis of the knee were divided at random into 4 treatment groups (ice chips, nitrogen cold air, ligno-paraffin, and placebo short wave). A temperature probe was inserted into the knee joint cavity and another placed on the overlying skin, and changes in temperature over 3 hours were recorded for each treatment group.

RESULTS: The mean temperature of the surface of the skin dropped from 32.2 degrees C to 16.0 degrees C after application of ice chips and from 32.6 degrees C to 9.8 degrees C after application of nitrogen cold air; the mean intraarticular temperature decreased from 35.5 degrees C to 29.1 degrees C and from 35.8 degrees C to 32.5 degrees C, respectively, after these treatments. Treatment with ligno-paraffin increased the surface temperature by 7.5 degrees C and the temperature in the joint cavity by 1.7 degrees C. No significant changes were observed with placebo short wave diathermy.

CONCLUSION: The traditional model, that intraarticular temperature is decreased by superficial heat and increased by superficial cold, must be discarded. In arthritis patients, intraarticular temperature is increased by superficial heat and decreased by superficial cold. This has clear consequences for treatment policy.

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