What’s Better For A Swollen Knee: Ice or Heat?

Written By on August 26, 2022 — Medically Reviewed By Mitch Torres (PT)

Written by on — Medically Reviewed By: Mitch Torres (PT)

two thermometers showing hot/cold temperatures

Not-so-fun fact: 27% of individuals will experience knee swelling at some point. (1) When that time comes, the first thing that pops to mind is: “what’s best for a swollen knee – ice or heat?”

Well, it boils down to how long your knee has been swelling. Ice therapy is usually best for recent injuries. But if it’s been a week, heat therapy may do the trick.

I’ll get into more detail further down, along with other things to boost what ice and heat therapy already do. Here are the topics covered, navigate through them by tapping on any of the links here:

When to use ice for your swollen knee joint?

Use cold if the swelling is caused by a recent knee injury.

See, this inflammation is a natural response from your body to repair the injured tissue. (2) Fortunately, icing the joint can tone this down in two ways.



First, applying ice to the knee narrows the superficial blood vessels in the area. (3) This can limit how much fluid gets into your joint, preventing its build-up and “squeezing” the excess out.

Lastly, cold can temporarily numb the pain caused by swelling, making it easier for you to move the joint. (3) Doing this also helps with inflammation, as the muscles pump out the excess fluid too.

Now, the RICE protocol is your go-to for reducing knee pain and swelling at home.

This acronym stands for rest, ice, compression, and elevation. You can do it during the first few days of your injury by:

  • Resting your knee from overuse and strenuous activities.
  • Place an ice pack over your knee for 10 minutes at a time.
  • Apply a compression bandage to further reduce swelling.
  • Elevate your leg as often as possible to drain the excess fluid.

Try it: How to do RICE for knee pain the right way?

What about heat – when to use it for knee swelling?

Applying heat during the days after an injury can exacerbate the inflammatory process. (3) That’s why it’s best to hold off until at least a week of icing before trying it.

See, doing heat therapy does the opposite effect of cold – it widens blood vessels. This in turn improves circulation. (3)

So, if the excess fluid is “stuck” on your joint for more than a week or two, hot therapy may help flush it out.

You can do this with a warm bath or applying moist heat to the area. But if the swelling gets worse, ditch the heat and move back to icing your knee instead.

6 other ways to decrease knee swelling

These are the other options you can use to bring your knee back to its normal size. Feel free to pair them along with your ice therapy:

1) Try pain relievers

Mild forms of non-steroidal anti-inflammatory drugs (NSAIDs) are usually accessible over the counter. Ibuprofen and naproxen are just a few examples.

NSAIDs usually work by suppressing the production of enzymes needed for inflammation. (4) This mechanism, in turn, could potentially halt the fluid buildup around your knee.

But taking too many NSAIDs can impair your healing.

Those same enzymes are also needed for tissue repair. So, you should consider taking NSAIDs if ice/cold therapy isn’t helping with symptoms, or if your swollen knee bothers your daily life.

It’s also a good idea to consult your doctor before trying these if you have any previous health risks or concerns.

Related: Medicines that help with knee pain.

2) Take turmeric supplements

If you are looking for a more natural option, you might want to try turmeric supplements.

See, the curcumin found in turmeric contains natural anti-inflammatory properties. It’s best suited for those with chronic conditions, like knee osteoarthritis or rheumatoid arthritis. (5)

It won’t provide quick anti-inflammatory effects, though – turmeric’s benefits are cumulative.

But if you want to give it a try, consider taking about 1000 mg of turmeric extract per day.

Research shows that this dosage has the same anti-inflammatory effects compared to popular NSAIDs, like ibuprofen. (5)

Learn more: Turmeric for knee pain – all you need to know.

3) Get a massage

a massage therapist doing a massage on their client's knee

Manual lymphatic drainage is a type of massage that specializes in reducing swelling.

The idea here is to flush out the inflammatory wastes around your target area. This is done through light rhythmic strokes that stimulate fluid circulation. (6)

You can try to learn and do this technique at home. But to make sure you get the results you want, it’s best to get an appointment with a qualified massage therapist.

4) Use a thermal knee sleeve

This is a portable ice therapy tool that helps you continue your treatment on the go. They also combine compression (one part of the RICE protocol) which also reduces inflammation and improves your sense of balance.

Our recommendation: The Cocoon Knee Flex Pro thermal sleeve.

5) Improve your blood flow with exercises

These usually include joint-friendly physical activities like walking and light strengthening.

See, walking helps improve your blood circulation, which in turn can reduce inflammation. Make sure to use your symptoms as a guide to gauge how much you can walk.

Meanwhile, strengthening your leg muscles in elevated positions can speed up fluid drainage.

Quadricep holds is a safe exercise you can try at home to reduce inflammation.

Here’s how to do it:

  • Lay down and place your knee over a large pillow.
  • Contract your front thigh muscle by squeezing your knee down the pillow.
  • Hold the contraction for 10 seconds and relax.
  • Do this for 10 repetitions.

6) Go to physical therapy for chronic pain and swelling

If your swollen knee isn’t getting any better with the home remedies above, consider going to your physical therapist (PT).

We have vast knowledge and experience in treating soft tissue injuries and their symptoms, like swelling. We can help you with:

  • Figuring out what caused your swollen knee.
  • Mending it with skilled manual and therapeutic exercises.
  • Teach you curative strategies you can continue at home.

When should you see your doctor?

Sometimes your swollen knee may be caused by other underlying factors. These can often come from infection or inflammatory conditions. (1)

To be on the safe side, seek the care of your doctor if you are experiencing any of these (1):

  • Fever.
  • Difficulty placing weight on your affected leg.
  • Loss of pulse below your knee.
  • Loss of sensation along your shin.

FAQs

Can icing a swollen knee make it worse?

Icing a swollen knee shouldn’t make it worse. It should help with it by providing joint pain relief and swelling reduction. (7)

Does icing your knee reduce swelling?

Yes, icing your knee can reduce swelling.

Ice or heat: which is best for a swollen knee?  

Ice is best for a swollen knee, especially after an acute injury. But for chronic pain and swelling that’s been happening for weeks, try heat instead.



Conclusion: What is better for a swollen knee: heat or ice?

If you plan to use heat or ice, consider the timeframe of your swollen knee.

Go with cold therapy if it’s a fresh injury. This will help out in decreasing swelling and dealing with any sharp pain in your knee.

But if it’s a chronic injury, like knee osteoarthritis, try heat instead. You can also give it at least a week after the injury to promote healing.

Resources

  1. Gerena LA, DeCastro A. Knee Effusion. [Updated 2022 May 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532279/
  2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What is an inflammation? 2010 Nov 23 [Updated 2018 Feb 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279298/
  3. Behrens, Barbara J et al. “Physical Agents: Theory and Practice.” F. A. Davis Company, Jul 11, 2005. https://books.google.com.ph/books?id=ndjaAAAAQBAJ&source=gbs_book_similarbooks
  4. Ghlichloo I, Gerriets V. Nonsteroidal Anti-inflammatory Drugs (NSAIDs) [Updated 2022 May 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547742/
  5. Daily, James W et al. “Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.” Journal of medicinal food vol. 19,8 (2016): 717-29. doi: 10.1089/jmf.2016.3705
  6. Vairo, Giampietro L et al. “Systematic review of efficacy for manual lymphatic drainage techniques in sports medicine and rehabilitation: an evidence-based practice approach.” The Journal of manual & manipulative therapy vol. 17,3 (2009): e80-9. DOI: 10.1179/jmt.2009.17.3.80E
  7. Malanga, Gerard A et al. “Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury.” Postgraduate medicine vol. 127,1 (2015): 57-65. DOI: 10.1080/00325481.2015.992719

Author
Paolo Sarmiento (PT)
Paolo is a physical therapist, educator and fitness enthusiast. He shares his knowledge and experience in helping people deal with health issues, especially with the knee. As health-conscious as he can be, he enjoys long bicycle rides, early morning runs, and a good slice of pizza with extra pepperoni.

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