A bathtub with hot pink water flowing into it.

Heat Therapy for Joint Pain

Spending an hour soaking in a nice hot bubble bath with a good book is one of my favorite ways to relax and destress, especially on a blustery winter or early spring evening. But with a condition that causes significant discomfort and pain in the lower back area, sitting on a hard surface for any length of time usually isn’t a good idea.

Still, there’s something about moist heat that soothes away (well, not completely away) my joint pain. Heat therapy in general is more comfortable for me than applying an ice pack to my aching knee or hip. But is heat therapy effective at easing joint pain, or is this a fallacy?

Heat therapy for joint pain

Personally, I prefer using heat to calm stiff and painful joints over cold therapies. Applying heat to aching joints is soothing, so it just feels better than ice packs. But there are also some concrete reasons for utilizing heath therapy.

For example, heat actually stimulates receptors in the skin, thereby decreasing pain signals to the brain. If heat is applied to painful areas, it actually activates thermoreceptors which “in turn block the effect of chemical messengers that cause pain to be detected by the body.”1

Heat can also dilate blood vessels and increase the flow of oxygen in the body, as well as increase muscle pliability and help decrease joint stiffness. With that said, it’s best not to opt for some type of cold therapy during a flare-up, since cold can actually help reduce inflammation.

My feelings on warm baths

Lately, I take my heat therapy in the form of a warm bubble bath. It’s become almost ritual, soaking the warmth of the bath water into my joints several times a week, especially before bed. But I have a complicated relationship with baths (well, more so with bathtubs). Even though I’m soaking in water, I’m still sitting on the hard surface of my bathtub which increases that lower back pain and discomfort.

This begs the question: do hot baths help relieve axial spondyloarthritis pain? Technically, the question lends itself to a "yes" or "no" answer. For me, the answer is more of an "it depends" or even "it’s complicated." There’s evidence out there that “moist heat modalities...cause much faster heat penetration than dry heat”2, so yes baths help. Baths can reduce AxSpA pain with the help of the right tools.

I use a folded hand towel to cushion the tub surface so I’m not sitting directly on hard acrylic, enamel, or fiberglass. I use a second towel behind my back (there are lots of different bath cushions to buy that will serve the same purpose). I also pay attention to the angle that I’m sitting at, since sitting straight up tends to put more pressure on my lower back and cause extreme discomfort.

Dry heat for localized pain

One of the many benefits of a bath is that you can heat many of the joints in your body while you soak. But if baths are not possible, an electric heating pad or a heat pack is the next best thing! I use my heating pad almost daily to soothe lower back and hip pain. In fact, I use my heat pad so often that I bought one that I leave in my chair at work.

Heat therapy is not a cure-all for AxSpA pain in any way, but it’s a great tool to help manage daily localized pain. In fact, I’ve spent the last 5+ years collecting tools and techniques to help manage this beast of a disease like someone would collect stamps or baseball cards. Sometimes I feel like that’s all I can ask for.

How do you feel about heat therapy for AxSpA pain and stiffness?

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