Importanceofheattherapyinthetreatmentofpaininthedailyclinicalpractice

Musculoskeletal pain affects millions of people worldwide, creating significant disability and economic burden. Heat therapy is one of the most traditional and commonly used treatments for various musculoskeletal conditions, but there's a lack of international consensus on its clinical use, particularly regarding indications, dosage, frequency, and precautions. Despite scientific evidence supporting its effectiveness, healthcare professionals lack standardized guidance on how to best implement heat therapy in daily practice.

An international advisory board of experts from five European countries developed a web survey using a two-cycle Delphi method to reach consensus on 13 key questions about heat therapy use. The survey was distributed through ten European scientific societies and associations between November 2021 and January 2022. Questions covered three main areas: characteristics of respondents, patient and pain characteristics, and pain management approaches. The survey targeted healthcare professionals who provide direct patient care, including general practitioners, orthopedic surgeons, pharmacists, physiotherapists, and sports medicine specialists.

A total of 282 valid responses were analyzed from healthcare professionals across Europe, with most having extensive experience (72% had more than 10 years). The results showed that heat therapy is used in approximately 50% of patient treatments, with significantly higher usage for low back pain (92%) and neck pain (84%). Healthcare professionals primarily choose heat therapy for its relaxation effects, high safety profile, and ability to enhance tissue perfusion. Personal clinical experience (mean score 8.0/10) and scientific evidence (7.9/10) were the most important factors influencing treatment decisions.

The majority of respondents (86.5%) recommend heat therapy, with 65.9% recommending it in specific cases and 20.6% always recommending it. Prescribing professionals (general practitioners, orthopedic surgeons, sports medicine specialists) were more likely to recommend heat therapy compared to non-prescribing professionals.

This study provides the first comprehensive European perspective on heat therapy use in clinical practice, validating it as a widely accepted and valuable treatment option for musculoskeletal pain. The high recommendation rate and frequent use by experienced healthcare professionals supports heat therapy as an effective, safe intervention, particularly for low back and neck pain. The emphasis on patient advice-giving (scored as the top management approach) suggests that educating patients about heat therapy as a self-management option could be highly beneficial. The findings support developing standardized guidelines and patient education materials to optimize heat therapy use in clinical practice.