As the parent of a child with juvenile arthritis, you already know many methods of easing your child’s pain. You probably find yourself reaching into your medicine cabinet to make life easier for your little one, but have you ever considered hitting the kitchen cabinet instead?
Doreen T. Stiskal, PT, PhD, chair of the Department of Physical Therapy at Seton Hall University in South Orange, N.J., says relieving your child’s pain can sometimes be as simple as hot and cold. “Thermal agents have many benefits,” she explains. “They relieve pain, improve circulation and reduce stiffness.”
The Heat is On
Heat therapy is most successful when used on children prior to activity to warm up the joints, ease stiffness and increase circulation. When your child’s joints are stiff, apply heat as soon as she gets up in the morning to loosen joints and make daily activities less painful. Wake your child up a few minutes early so that she can take her time and use heat to relax tight muscles and joints, as well as stimulate blood flow and increase range of motion.
While heat has its benefits, Stiskal doesn't recommend heat for joints that are noticeably hot and swollen because it can worsen discomfort. “Use heat with caution on inflamed joints,” she warns.
One benefit of heat therapy is that it can be applied easily and inexpensively using items in your own kitchen. For example, you can create moist heat, which penetrates more deeply than dry heat, simply by soaking towels in hot water or warming damp towels in a microwave. Moist heat packs that provide longer lasting relief are available for purchase at drug and discount stores. Always test the heat before applying to skin to avoid burns.
Many children enjoy warm baths and find that they are especially effective in easing pain. The bonus? You can relieve pain and and get bath time over with all in one simple step.
Make your own dry heat packs at home by placing dry rice or beans into a sock. Tie off the open end of the sock and place it in the microwave for 30 seconds. Remove the sock from the microwave, shake it to balance the heat then microwave it for 30 seconds. Always place a towel between the heat source and your child’s skin.
Cold therapy is best used at the onset of your child’s flare to reduce swelling and numb the joints. It's also useful after a period of activity. Cold numbs the sore area and reduces inflammation and swelling by constricting blood vessels.
It also overrides the pain sensation. “Cold therapy slows down the conduction of pain signals to the brain,” Stiskal explains. “The feeling of cold is preferable to the feeling of pain. It bombards the system with more pleasant things.”
As with heat, you can create cold packs at home. Fill a plastic bag with ice chips, a bottle with ice or cold water or grab a bag of frozen vegetables for an instant cold pack. Prepare your child’s painful joint by drying it. Place a dry cloth over the area to prevent direct contact between skin and the cold pack. Apply the cold pack for 15 to 20 minutes. Repeat the application every one to two hours.
During cold therapy, your child’s skin will pass through four stages of sensation: cold, burning, aching and numbness. Remove the ice pack when your child tells you her skin feels numb.
Whether or not your child likes cold therapy may depend on her age. “Many young children may not like cooler temperatures and would prefer warmer temperatures, as in a bath,” Stiskal explains. “It is hard to determine how children will respond to cold. Older children, about 12 years old and above, tend to tolerate the localized cold better, and I often use this on the inflamed joints.”
Keep Sensitive Skin Safe
Children’s skin often is more sensitive than adult skin to extreme temperatures. The following tips will help keep your child’s skin safe.
- Use an extra layer of toweling to prevent direct contact between heat or cold, and your child’s skin.
- When trying heat or cold with your child, first test it on yourself and then try it with your child in small increments for short periods of time (five to 10 minutes). Apply a few times during the day to determine your child’s tolerance.
- Check your child’s skin for redness every few minutes. The skin should be slightly pink, as when the child is taking a bath or shower.
- As with any treatment, consult your child’s doctor before experimenting with heat or cold therapy.