A comparative study to determine the immediate effects of paraffin wax and moist heat therapies on pain, joint range of movement and grip ability in adults with rheumatoid arthritis afffecting the hands.

Abstract

Physiotherapists use many treatment modalities in the management of rheumatoid arthritis of the hand. Two commonly used heating modalities are moist heat and paraffin wax therapy. The aim of this study was thus to compare the immediate effectiveness of moist heat therapy and paraffin wax therapy in the management of the rheumatoid hand. A quantitative, pretest – posttest design was used to compare the effects of paraffin wax and moist heat therapy on pain, joint range of movement and grip ability in adults with stage II rheumatoid arthritis, affecting the hands. One hundred and fifteen subjects at a district/regional provincial health care institution in the Ethekwini metro district were randomly allocated to two groups. Fifty six subjects in Group 1 were treated with paraffin wax therapy, using the drip-wrap method and active hand exercises and in Group 2, fifty nine subjects were treated with moist heat therapy and active hand exercises. Pre- and posttest measurements were taken in all subjects. Pain was measured using the numerical pain rating scale and intrinsic hand joint range of movement was measured using a metal short arm goniometer and the dorsal approach. Hand span and grip ability were also measured. Results revealed that both treatment modalities were effective in helping moderate pain, increase joint range of movement and improve grip ability in the adult rheumatoid hand. Paraffin wax improved joint range of movement significantly more than moist heat therapy in 25% of joints (p≤0.05). Right hand span was also significantly improved (p=0.013) by the application of wax. No statistically significant differences were found between the effects of paraffin wax and moist heat therapy on pain and grip ability however the findings of this study suggest clinical significance as both modalities improved pain perception and grip ability in the rheumatoid hand.