Musculoskeletal pain: heat therapy is a valid remedy according to European experts

AP24 G 1030 Terapia Calore
  • Published: 8 Apr 2024

This is the result of an international survey among a multidisciplinary group of experts around Europe. The work was coordinated by Prof. Thilo Hotfiel, from the Friedrich-Alexander University of Erlangen-Nuremberg, and Prof. Jurgen Freiwald, from the Bergische Universitat of Wuppertal (Germany), and the results were published in the scientific Journal of Bodywork & Movement Therapies.

Types of musculoskeletal pain and the use of heat therapy

Musculoskeletal conditions are the leading contributor to disability worldwide, with low back pain being the single leading cause of disability in 160 countries. Musculoskeletal conditions significantly limit mobility and dexterity, leading to early retirement from work, lower levels of well-being and reduced ability to participate in society. According to the Global Burden of Diseases, in 2019 approximately 1.71 billion people lived with musculoskeletal conditions worldwide.

Heat therapy, which consists of applying an external source of heat to a specific area of the body to increase tissue temperature, is one of the oldest non-pharmacological treatments in medicine.

Heat therapy has long been used for thousands of years for therapeutic purposes in musculoskeletal disorders with proven efficacy and safety. Moreover, it can have a positive impact on quality of life, physical, psychological, and socio-economic aspects of musculoskeletal injuries/disorders-related pain.

Heat therapy is recommended as non-invasive and non-pharmacological treatment by guidelines in the treatment of low back pain, neck pain and osteoarthritis. Indeed, in some clinical studies, it was demonstrated to be more effective than drugs commonly used for MSK pain.


Survey among experts on the importance of heat therapy in the treatment of pain in the daily clinical practice

Due to its value and availability, heat therapy has become a very popular choice in daily practice, frequently recommended by different kinds of experts. Even though the physiological mechanisms of heat therapy are well known and there is scientific evidence on its clinical utility, there is a lack of guidance on its use, particularly on indications and contraindications, dosage, frequency, and precautions.

Therefore, there is a need to develop an international consensus on recommendations on the clinical utility of heat therapy in musculoskeletal pain.

To obtain an overview of the use of heat therapy for the treatment of musculoskeletal pain in Europe, an international multidisciplinary group of experts including physiatrists, sports medicine specialists, physiotherapists, pharmacists, orthopaedics, and general practitioners, was established to develop a survey. The survey was distributed to a broad panel of experts from 5 European countries, with the collaboration of several scientific societies and associations. Two hundred eighty-two answers were obtained widely distributed throughout Europe.


 The benefits of heat therapy according to experts

  • The use of heat therapy is recommended by 86.5% of respondents.
  • Heat therapy is administered to about 50% of patients, with a higher percentage administered to those affected by low back pain (92%) and neck pain (84%).
  • Heat therapy is more frequently recommended in chronic disorders.
  • Heat therapy is primarily recommended due to its relaxation effect, high safety profile and enhancement of tissue perfusion.
  • It was observed that general practitioners, orthopaedics, sports medicine specialists and physiatrists recommend the use of heat therapy more than others.
  • Heat therapy is generally recommended in combination with other therapies.



Experts indicated that heat therapy represents a valid therapeutic choice and is widely used in Europe. There is a compelling need for patients to be informed about heat therapy as a valuable and straightforward self-management therapy option.


Reference: Hotfiel T. et al. Importance of heat therapy in the treatment of pain in the daily clinical practice. Journal of Bodywork & Movement Therapies 38 (2024) 263–268