Effects of Cold Pack Application with Contrast Hydrotherapy on Patients Suffering from Knee Pain Due to Osteoarthritis

Background: Knee osteoarthritis is a prevalent degenerative condition characterized by chronic pain and functional limitation. While thermotherapy and cryotherapy are widely used non-pharmacological interventions, direct comparative evidence, particularly in South Asian populations, remains limited. Objective: To compare the effects of cold pack application and contrast hydrotherapy on pain intensity and active knee range of motion in individuals with mild to moderate knee osteoarthritis. Methods: This single-blind randomized controlled trial was conducted at four physiotherapy centers in Faisalabad, Pakistan, enrolling 50 adults aged 30–60 years with clinically diagnosed mild to moderate knee osteoarthritis. Participants were randomized into two groups: cold pack therapy (Group A) or contrast hydrotherapy (Group B), administered thrice weekly over three weeks. Both groups performed standardized knee mobility exercises. Pain and range of motion were measured using the Visual Analogue Scale and goniometry, respectively. Statistical analysis was performed using SPSS v25.0, applying paired and independent t-tests with significance set at p < 0.05. Ethical approval was obtained from The University of Faisalabad’s IRB in accordance with the Declaration of Helsinki. Results: Both groups showed significant within-group improvements in pain and ROM (p < 0.001). Between-group comparisons favored contrast hydrotherapy, with greater pain reduction (ΔVAS -5.9 vs -4.6, p < 0.001) and ROM gain (+18° vs +12°, p < 0.001). Conclusion: Contrast hydrotherapy was more effective than cold pack therapy in reducing pain and improving mobility, supporting its use as a safe, accessible, and clinically superior intervention for managing knee osteoarthritis.