OBJECTIVE: To provide an overview on the therapeutic application of paraffin wax to the hands of people with rheumatoid arthritis and to examine critically whether paraffin wax is efficacious for this condition in light of this information. METHODS: A systematic database search using the MeSH heading 'rheumatoid arthritis' combined with the terms: 'therapeutic use of heat' and 'therapeutic use of cold' was implemented. All relevant basic studies, clinical trials examining the effect paraffin wax has on hand tissue temperature, and randomised controlled clinical trials specifically examining the use of paraffin wax for treating rheumatoid arthritis, and their methodological quality were rigorously assessed according to standardised criteria. RESULTS: Of the four randomised trials identified concerning the outcome of paraffin wax applications to rheumatoid arthritic hands, one yielded equivocal results, while three reported that after three to four weeks, paraffin wax applications were accompanied by significant improvements in rheumatoid arthritic hand function when followed by exercise. The modality also relieves pain and stiffness immediately after its application with no documented detrimental effects on the disease process, even though paraffin wax temporarily raises joint temperature. CONCLUSIONS: As a whole our data suggest there may be some benefit with few side-effects in the application of paraffin wax to the hands of people with non-acute rheumatoid arthritis prior to exercise. However, the data are insufficient and preclude any definitive conclusions concerning the efficacy of paraffin wax for treating painful hand arthritis.

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A brief summary and a critical assessment of this review may be available at DARE