The short-term efficacy of heat therapy for osteoarthritis of the hands: a systematic review and meta-analysis.

Only 9 trials (627 patients) were pooled, which limits statistical power, especially for subgroup comparisons. All follow-up periods were 3 months or less, so nothing is known about whether the pain and strength gains persist. Four of the 13 included studies were rated high risk of bias, and the authors downgraded certainty for this reason. Outcome measures were not fully consistent across studies, introducing measurement heterogeneity. The multimodal-versus-monotherapy comparison is based on a small number of trials in each subgroup; the authors themselves describe the superiority of multimodal therapy as tentative. The Egger test for grip strength was borderline (p = 0.055) with only 6 studies, leaving a possible small-study effect unexcluded.

The authors declared no conflicts of interest. No funding source is named in the text provided.

Do not read the overall 'heat therapy is effective' conclusion as meaning any form of heat will improve hand function. The disease-specific hand-function score (AUSCAN total) was not significantly different from control (p = 0.67), and the positive pain and grip-strength results were driven by the multimodal subgroup (paraffin, mud baths), not by simple heat alone. The authors themselves note that the multimodal advantage is tentative given the small number of trials in each subgroup.