OBJECTIVES: The aim of this systematic review and meta-analysis was to evaluate the effectiveness of local heat applications (LHAs) in individuals with acute or chronic musculoskeletal disorders. DATA SOURCES: An electronic search was conducted on Medline, Cochrane Controlled Register of Trials, Current Nursing and Allied Health Literature, and the Physiotherapy Evidence databases up to December 2019. STUDY SELECTION: Studies incorporating adults with any kind of musculoskeletal issues treated by LHA compared with any treatment other than heat were included. DATA EXTRACTION: Two authors independently performed the methodological quality assessment using the Cochrane risk of bias tool. DATA SYNTHESIS: LHA showed beneficial immediate effects to reduce pain versus no treatment (p < 0.001), standard therapy (p = 0.020), pharmacologic therapy (p < 0.001), and placebo/sham (p = 0.044). Physical function was restored after LHA compared with no treatment (p = 0.025) and standard therapy (p = 0.006), whereas disability improved directly after LHA compared with pharmacologic therapy (p = 0.003) and placebo/sham (p < 0.028). Quality of life was improved directly after LHA treatment compared with exercise therapy (p < 0.021). Range of motion increased and stiffness decreased after LHA treatment compared with pharmacologic therapy (p = 0.009, p < 0.001) and placebo/sham (p < 0.001, p = 0.023). The immediate superior effects of LHA on muscular strength could be observed compared with no treatment (p < 0.001), cold (p < 0.001), and placebo/sham (p = 0.023). CONCLUSIONS: Individuals with acute musculoskeletal disorders might benefit from using LHA as an adjunct therapy. However, the studies included in this meta-analysis demonstrated a high heterogeneity and mostly an unclear risk of bias.

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