Local Heat Applications as a Treatment of Physical and Functional Parameters in Acute and Chronic Musculoskeletal Disorders or Pain.

Abstract

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of local heat applications (LHAs) in individuals with acute or chronic musculoskeletal disorders. An electronic search was conducted on MEDLINE, Cochrane Controlled Register of Trials, Current Nursing and Allied Health Literature, and the Physiotherapy Evidence databases up to December 2019. Studies incorporating adults with any kind of musculoskeletal issues treated by LHA compared with any treatment other than heat were included. Two authors independently performed the methodological quality assessment using the Cochrane Risk of Bias tool. LHA showed beneficial immediate effects to reduce pain vs no treatment (P<.001), standard therapy (P=.020), pharmacologic therapy (P<.001), and placebo/sham (P=.044). Physical function was restored after LHA compared with no treatment (P=.025) and standard therapy (P=.006), whereas disability improved directly after LHA compared with pharmacologic therapy (P=.003) and placebo/sham (P<.028). Quality of life was improved directly after LHA treatment compared with exercise therapy (P<.021). Range of motion increased and stiffness decreased after LHA treatment compared with pharmacologic therapy (P=.009, P<.001) and placebo/sham (P<.001, P=.023). The immediate superior effects of LHA on muscular strength could be observed compared with no treatment (P<.001), cold (P<.001), and placebo/sham (P=.023). Individuals with acute musculoskeletal disorders might benefit from using LHA as an adjunct therapy. However, the studies included in this meta-analysis demonstrated a high heterogeneity and mostly an unclear risk of bias.