The short-term efficacy of heat therapy for osteoarthritis of the hands: a systematic review and meta-analysis
DOI:
https://doi.org/10.2340/jrm.v58.45883Keywords:
Osteoarthritis of the hand, Heat therapy, Meta-analysis, Randomized controlled trials, Pain managementAbstract
Objective: To systematically evaluate the clinical efficacy of heat therapy for hand osteoarthritis.
Design: Systematic review and meta-analysis of randomized controlled trials (RCTs).
Subjects/Patients: 9 RCTs (n = 627) from 13 identified studies included in meta-analysis.
Methods: Databases were searched up to 19 December 2025. Risk of bias was assessed via RoB 2.0. Standardized mean differences (SMD) and meta-regression were calculated using Stata 17.0.
Results: Heat therapy significantly reduced Visual Analog Scale (SMD = −0.60, p = 0.01), Australian/Canadian Osteoarthritis Hand Index – Pain Score and Health Assessment Questionnaire (p < 0.05), and improved grip strength (SMD = 0.43, p = 0.01). No significant changes were observed for other outcome indicators. Subgroup analysis showed multimodal therapy (paraffin: heat + mechanical compression; mud: heat + chemical/mechanical stimulation) outperformed monotherapy (-heated gloves: pure thermal) for pain (SMD = –0.85) and grip strength (SMD = 0.55). Additionally, meta--regression analysis found that longer single -treatment duration (p = 0.03) and higher weekly t-reatment frequency (p = 0.04) were key moderators for better grip strength recovery.
Conclusion: Heat therapy, especially multimodal approaches, effectively alleviates short-term pain and improves grip strength in hand osteoarthritis. Clinicians may ensure adequate treatment frequency and duration to optimize outcomes.
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Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, et al. EULAR evidence-based recommendations for the diagnosis of hand osteoar-thritis: report of a task force of ESCISIT. Ann Rheum Dis 2009; 68: 8–17. DOI: https://doi.org/10.1136/ard.2007.084772
Marshall M, Watt FE, Vincent TL, Dziedzic K. Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol 2018; 14: 641–656. DOI: https://doi.org/10.1038/s41584-018-0095-4
Bean MB, Favero M, Ramonda R, Scanzello CR. Erosive hand osteoarthritis: recent advances and future treatments. Curr Rheumatol Rep 2024; 26: 103–111. DOI: https://doi.org/10.1007/s11926-023-01130-9
Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoar-thritis. Osteoarthritis Cartilage 2005; 13: 769–781. DOI: https://doi.org/10.1016/j.joca.2005.04.014
Eaton CB, Schaefer LF, Duryea J, Driban JB, Lo GH, Roberts MB, et al. Prevalence, incidence, and progression of radiographic and symptomatic hand osteoarthritis: The Osteoarthritis Initiative. Arthritis Rheumatol 2022; 74: 992–1000. DOI: https://doi.org/10.1002/art.42076
Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College Of Rheumatology/Arthritis Foundation guideline for the management of -osteoarthritis of the hand, hip, and knee. Arthritis Care Res 2020; 72: 149–162. DOI: https://doi.org/10.1002/acr.24131
Kroon FPB, Carmona L, Schoones JW, Kloppenburg M. Efficacy and safety of non-pharmacological, pharmacological and surgical treatment for hand osteoarthritis: a systematic literature review informing the 2018 update of the EULAR recommendations for the management of hand osteoarthritis. RMD Open 2018; 4: e000734. DOI: https://doi.org/10.1136/rmdopen-2018-000734
Richey RE, Hyldahl RD, Kaiser BW, Geiger PC, Halliwill JR, Minson CT. Heat therapy: targeting health, disease, and disability. Compr Physiol 2026; 16: e70089. DOI: https://doi.org/10.1002/cph4.70089
Klemm P, Schulz N, Boettger P, Lange U. Heat therapy in rheumatic and musculoskeletal diseases: an overview of clinical and molecular effects. Int J Hyperthermia 2024; 41: 2322667.
Kim SG, Kang JW, Boo JH, Jin DU, Choi SJ, Song GG, et al. Effectiveness of paraffin bath therapy for the symptoms and function of hand diseases: a systematic review and meta-analysis of randomized controlled trials. J Hand Ther 2023; 36: 706–712. DOI: https://doi.org/10.1016/j.jht.2022.10.005
Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgrad Med 2015; 127: 57–65. DOI: https://doi.org/10.1080/00325481.2015.992719
Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College Of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol 2020; 72: 220–233. DOI: https://doi.org/10.1002/art.41142
Courties A, Daste C, Homs AF, Kouki I, Alliot-Launois F, Bialé L, et al. French Societies of Rheumatology and of Physical and Rehabilitation Medicine recommendations for the management of people living with hand osteoarthritis. Joint Bone Spine 2026; 93: 106000. DOI: https://doi.org/10.1016/j.jbspin.2025.106000
Ye L, Kalichman L, Spittle A, Dobson F, Bennell K. Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review. Arthritis Res Ther 2011; 13: R28. DOI: https://doi.org/10.1186/ar3254
Kjeken I, Bordvik DH, Osteras N, Haugen IK, Aasness Fjeldstad K, Skaalvik I, et al. Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review. RMD Open 2025; 11: e004963. DOI: https://doi.org/10.1136/rmdopen-2024-004963
Follmann D, Elliott P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol 1992; 45: 769–773. DOI: https://doi.org/10.1016/0895-4356(92)90054-Q
Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014; 14: 135. DOI: https://doi.org/10.1186/1471-2288-14-135
Bland JM, Altman DG. Statistics notes: measurement error proportional to the mean. BMJ 1996; 313: 106. DOI: https://doi.org/10.1136/bmj.313.7049.106
Aksanyar B, Yılmaz H, Karaarslan F, Yılmaz R, Karpuz S. Comparison of the effectiveness of peloid and paraffin treatment for symptomatic hand osteo-arthritis in women: a single-blind randomized controlled study. Int J Biometeorol 2022; 66: 1841–1851. DOI: https://doi.org/10.1007/s00484-022-02324-z
Aksoy M, Altan L, Eröksüz R, Ökmen B. The efficacy of peloid therapy in management of hand osteoarthritis: a pilot study. Int J Biometeorol 2017; 61: 2145–2152. DOI: https://doi.org/10.1007/s00484-017-1419-9
Bartholdy C, Døssing A, Stisen ZR, Nielsen SM, Christensen R, Danneskiold-Samsøe B, et al. Effect of heated mittens on physical hand function in people with hand osteoarthritis: randomised controlled trial. BMJ 2024; 387: e078222. DOI: https://doi.org/10.1136/bmj-2023-078222
De Azevedo F, Souza Filho A, Nunes R, Silveira CR, Fonseca JE, Castro Rocha FA. Paraffin bath reduces pain in patients with hand osteoarthritis. Ann Rheum Dis. 2023; 82: 1817. DOI: https://doi.org/10.1136/annrheumdis-2023-eular.5688
Dilek B, Gözüm M, Şahin E, Baydar M, Ergör G, El Ö, et al. Efficacy of paraffin bath therapy in hand osteoarthritis: a single-blinded randomized controlled trial. Arch Phys Med Rehabil 2013; 94: 642–649. DOI: https://doi.org/10.1016/j.apmr.2012.11.024
Fioravanti A, Tenti S, Giannitti C, Fortunati NA, Galeazzi M. Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. Int J Biometeorol 2014; 58: 79–86. DOI: https://doi.org/10.1007/s00484-012-0627-6
Gyarmati N, Kulisch Á, Németh A, Bergmann A, Horváth J, Mándó Z, et al. Evaluation of the effect of hévíz mud in patients with hand osteoarthritis: a randomized, controlled, single-blind follow-up study. Isr Med Assoc J 2017; 19: 177–182.
Horváth K, Kulisch Á, Németh A, Bender T. Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study. Clin Rehabil 2012; 26: 431–441. DOI: https://doi.org/10.1177/0269215511425961
Kasapoğlu Aksoy M. Short-term efficacy of paraffin therapy and home-based exercise programs in the treatment of symptomatic hand osteoarthritis. Turk J Phys Med Rehabil 2018; 64: 108–113. DOI: https://doi.org/10.5606/tftrd.2018.1535
Öncel A, Küçüksen S, Ecesoy H, Sodali E, Yalcin S. Comparison of efficacy of fluidotherapy and paraffin bath in hand osteoarthritis: a randomized control-led trial. Arch Rheumatol 2021; 36: 201–219. DOI: https://doi.org/10.46497/ArchRheumatol.2021.8123
Savaş BB, Alparslan GB, Korkmaz C. Effect of flaxseed poultice compress application on pain and hand functions of patients with hand osteoarthritis. Clin Rheumatol 2019; 38: 1961–1969. DOI: https://doi.org/10.1007/s10067-019-04484-7
Uçar D, Paker N, Bugˇdayci DS, Yalçinkaya EY. Comparison of the efficacy of whirlpool and paraffin treatments in women with symptomatic hand osteo-arthritis. Turk Fiz Tip Rehab Derg 2011; 57: 124–127. DOI: https://doi.org/10.4274/tftr.75437
Ustun I, Çaglar S. Comparison of the effect of prolotherapy and paraffin wax for hand osteoarthritis. Eur Rev Med Pharmacol Sci 2023; 27: 9510–9520.
Klemm P, Schulz N, Boettger P, Lange U. Heat therapy in rheumatic and musculoskeletal diseases: an overview of clinical and molecular effects. Int J Hyperthermia 2024; 41: 2322667. DOI: https://doi.org/10.1080/02656736.2024.2322667
Cataldo A, Ferrè ER, Haggard P. Thermonociceptive interaction: Interchannel pain modulation occurs before intrachannel convergence of warmth. J Neurophysiol 2019; 121: 1798–808. DOI: https://doi.org/10.1152/jn.00341.2018
Threlkeld AJ, Currier DP. Osteoarthritis: effects on synovial joint tissues. Phys Ther 1988; 68: 364–370. DOI: https://doi.org/10.1093/ptj/68.3.364
Siviero P, Limongi F, Gesmundo A, Zambon S, Cooper C, Dennison EM, et al. Minimal clinically important decline in physical function over one year: EPOSA study. BMC Musculoskelet Disord 2019; 20: 227. DOI: https://doi.org/10.1186/s12891-019-2593-1
Fries JF, Krishnan E. What constitutes progress in assessing patient outcomes? J Clin Epidemiol 2009; 62: 779–780. DOI: https://doi.org/10.1016/j.jclinepi.2008.12.001
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