One of the most effective relief strategies for people to relieve arthritis pain and stiffness in their hands is the use of contrast baths.  What are contrast baths?  Alternating warm and cool water, which is easy and essentially free!  To the nay sayers, I would tell you that my clients are almost unanimous in their endorsement of contrast baths to relieve arthritis pain.  Most people with arthritis use a long warm shower on rising to get moving.  In principle, contrast baths are only a slight modification.  The only clients that don’t swear by contrast baths are those who didn’t try them! 

Contrast baths decrease swelling, stiffness and pain, and increase movement and circulation. This is the only “heat modality” you can safely assume will not cause swelling, and in fact it is a proven method for decreasing swelling. Warm water dilates, expands or opens up the blood vessels, thereby increasing blood flow. Cold water constricts blood vessels, or makes them smaller. The alternating warm and cold water acts as a pump to get fluid out. Warm water alone may cause swelling.

Contrast baths are great for swelling, pain &/or stiffness associated with arthritis. Virtually all of my clients with arthritis in the fingers, hands &/or wrists do contrast baths faithfully first thing in the morning and again at the end of day. I have physical therapy colleagues who recommend contrast baths for arthritic foot pain and stiffness.

Contrast baths are a great option when your therapist or doctor recommends ice for inflammation but your arthritis does not like the cold! Use contrast baths as an acceptable alternative to ice for inflammatory conditions such as tendonitis or Carpal Tunnel Syndrome.

Contrast baths work great for hand swelling and carpal tunnel syndrome with pregnancy. They dramatically reduce swelling for clients with injuries such as wrist or hand fractures.

Two plastic basins or two sinks.

Warm water should be 100-105 F, or to tolerance.

Cold water should be 50-60 F, or to tolerance.

An aquarium thermometer can be used to monitor the water temperature, but common sense works too.

1. Fill one plastic basin or sink with warm water.

2. Fill second basin or sink with cold water.

3. Place hands and wrists in warm water for 3 minutes. Open and close the hand or gently squeeze a sponge or washcloth if desired.

4. Alternate to cold water for one minute.

5. Return back to warm water for 3 minutes.

6. Repeat the process for a total of 3 rotations of warm and cold.

7. End with 3 minutes in warm water.

Perform contrast bath treatments 2 to 5 times a day as needed. Performing 30 to 60 second cycles for 2 to 5 minutes between full sessions can be helpful.

Water temperatures should be moderate. See temperature ranges above, but use common sense. Warm water should be like pleasantly warm bath water. Cold water may need a few ice cubes if it’s summer and you live in Texas. If you live in Maine, in the winter you may have to add some warm water to your “cold. Water temperature should not be ice cold.

Contrast baths are not suitable for clients with open wounds, Raynaud’s or congestive heart failure.

Clients with Raynaud’s phenomenon are sensitive to extremes of temperature, especially cold. I have had some Raynaud’s clients do contrast baths with slightly cool water, and mildly warm. Basically, their contrast baths were a little less contrasty! Clients with Raynaud’s, especially if newly diagnosed, should discuss with their doctor or therapist.

Clients with congestive heart failure should consult their physician for clearance. This is especially true with using this modality for the feet. As contrast baths are extremely effective at reducing swelling, this can overload the heart.

These strategies are wildly popular with my clients! Bathing and kitchen clean-up variations are used almost universally by my clients.

There are many variations of contrast baths in the literature, such as 1 minute warm and cold water cycles. Exact time is not critical, just start and end with warm water. Most clients with arthritis prefer the longer 3 minute warm water cycles. The point is, you don’t have to carefully watch the clock.

Use your bathtub or Jacuzzi for warm cycles, then have a basin with cold water outside of the tub. Or after a long warm shower, put hands under alternating warm and cold water at the bathroom sink for 3 to 5 minutes when you get out of the shower.

Yet another way to incorporate the principle of contrast baths into your routine is during morning grooming and hygiene. While you are at the sink brushing your teeth, combing your hair, putting on makeup, or shaving, alternate hands under warm and cold water. You can run cold water and have a small pan of warm water on the counter or vice versa.

Incorporate the principle of contrast baths into your dishwashing or kitchen clean-up routine. Even if you prefer to wash and rinse your dishes in warm water, you can have a small bowl of cold water nearby.

Try alternating warm and cool packs or compresses. This may be less messy and more convenient at work. You could take in a cold pack each day in a small soft-sider cooler. Specific tips and recommendations will be in a forthcoming hub!

If you are sensitive to cold water, try starting with less contrast. Use warm water and tepid or cool water, or warm and cool packs.

Abbreviated sessions are good for when you’re at work, shopping, traveling, or otherwise away from home. Even at home, they are good to keep pain and stiffness at bay if you only have time to do two full sessions a day.

If you have relatively private restroom facilities or a kitchen at work, use two adjacent sinks or one sink and a plastic basin for a quick session. Even 30-60 second cycles for 5 minutes can be helpful. In a pinch, use one sink and alternate the warm and cold water, 30 to 60 second cycles, for 1 to 3 minutes. You can do this in a rest area or fast food restaurant restroom.

People with arthritis in their hands can benefit greatly from the use of contrast baths.  By using alternating warm and cool water, especially on waking and at the end of day, hand pain and joint stiffness can be significantly reduced.  With a little practice, routine daily activities can be modified for these valuable thermal sessions.