Abstract—Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I: An interviewing questionnaire. It comprised of three parts covering sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II: Knee Injury and Osteoarthritis Outcome Score (KOOS). It consists of five main parts. Tool II1: 0-10 Numeric pain rating scale. Results: revealed that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy. Keywords—Knee Osteoarthritis, Cold, Warm and Contrast Therapy. I. INTRODUCTION STEOARTHRITIS (OA) is the far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint, being the most prevalent form of joint disease which does not lead to systemic involvement without associated mortality [1]. It affects the weight bearing joints in the knees, hips and hands. Osteoarthritis of knee is a common and progressive condition. It is reported that 6% of adults suffer from clinically significant knee osteoarthritis with the prevalence increasing with each decade of life [2]. It can be classified according to its causes or predisposing factors as either primary or secondary. The primary one (idiopathic) is the most common type and has no identifiable causes rather than genetic predisposition while several disorders are well recognized as causes for secondary OA. They can be grouped into four basic categories such as, metabolic as calcium crystal deposition and acromegaly; Amal E. Shehata and Manal E. Fareed are with the Adult Health Nursing, Faculty of Nursing, University of Menoufia. anatomic as leg length inequality and congenital hip dislocation; traumatic as fractures and sprains and inflammatory as ankylosing spondylitis and septic arthritis [3]. Patients suffering from osteoarthritis often complain of dull ache pain on movement, typically occurring when movement is initiated. As osteoarthritis progresses, the pain becomes continuous, and the functionality of the joint is severely impaired [2]. However, among community residents, it has been found that articular pain is the most important problem affecting daily life. Patients have a tendency to avoid activity due to a fear that it will cause more pain. Moreover, knee OA sufferers often show joint stiffness, tenderness, crepitus, joint enlargement, deformity, muscle weakness, limitation of joint motion, impaired proprioception, and disability. Patients may experience a serious impact to daily activities due to difficulty in walking, moving, climbing stairs, getting in and out of a car and/or sitting in a chair that is caused by instability or buckling of the joints together with weakness of thigh muscles [4], [5]. It is not a curable disease, as the mechanism by which it arises and progress remains incompletely understood. Therefore, the goal of treatment is to alleviate the signs and symptoms of the disease and if possible to show its progression. Multiple treatment options are available for patients with OA of the knees including the use of superficial heat or cold, obesity management, exercises, oral pharmacological therapy, injection of corticosteroid or ultimately knee joint replacement surgery [6], [7]. There are risks and side effects associated with medications and surgery that are not associated with some remedies such as superficial heat or cold applications. Furthermore, not all treatment options meet the same results, supporting individualized patient management approaches; the benefits of others such as injections of corticosteroid don't last indefinitely and must be repeated. The periodic application of superficial heat or cold is relatively safe and low cost treatment that can be recommended in isolation or in combination with other treatment. Contrast therapy involving intervals of warm and cold application within a treatment session offers yet another option in the management of many different musculoskeletal conditions including knee OA [8], [9]. Warm may work by improving circulation and relaxing muscles so decreasing pain, while cold may numb the pain, decrease swelling, constrict blood vessels and block nerve impulses to the joint [10]. The usual sources of warm and/or Effect of Cold, Warm or Contrast Therapy on Controlling Knee Osteoarthritis Associated Problems Amal E. Shehata and Manal E. Fareed O World Academy of Science, Engineering and Technology International Journal of Medical and Health Sciences Vol:7, No:9, 2013 518 International Scholarly and Scientific Research & Innovation 7(9) 2013 scholar.waset.org/1307-6892/16635 International Science Index, Medical and Health Sciences Vol:7, No:9, 2013 waset.org/Publication/16635