Implications for practice
This review has shown neither positive nor detrimental effects of heat therapy on important outcomes or on joint destruction in RA patients. The reviewers conclude that thermotherapy can be used as needed by patients with RA, as a palliative therapy and an adjunct therapy combined with exercises. However, these conclusions are limited by the poor methodological quality of the trials available and the large number of borderline values. This review has shown that thermotherapy can be used as an adjunct and palliative therapy. No harmful side effects were reported.
Implications for research
More sensitive and valid clinical outcomes should be used in studies on thermotherapy to reflect the physiological effects found in the scientific literature. Detailed information regarding the temperature, duration of application and mode of application is needed in order to determine the optimal characteristics of the therapeutic application of thermotherapy for RA at different human joints.
Acknowledgements
The authors thank Sarah Milne, Michael Saginur, Jessie McGowan, Shannon Rees, Guillaume Léonard, Marie-Andrée Ouimet, and Catherine Lamothe for their work on this project and comments in earlier drafts.