A Cochrane review (abstract «»1, review «Thermotherapy for treatment of osteoarthritis»2) included 3 studies with a total of 179 patients. In one trial (n=100, 25 receiving ice massage), ice massage compared to control had a statistically beneficial effect on range of motion (8% relative difference), function and knee strength (29% relative difference). In another trial, cold packs decreased swelling. Hot packs had no beneficial effect on edema compared with placebo or cold application.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by imprecise results (few patients and wide confidence intervals).