<![CDATA[This systematic review and meta-analysis sought to evaluate the efficacy of cold (20-25°C) versus heated (33-40°C) water hydrotherapy in individuals with persistent low back pain (LBP). A thorough search was performed across PubMed, EMBASE, Cochrane Library, Web of Science, and additional databases for pertinent papers published from January 2018 to May 2025. Eighteen studies (n=1,547 people) satisfied the inclusion criteria. Compared to controls, warm water hydrotherapy significantly reduced pain (SMD=-0.82; 95% CI: -1.13 to -0.51; p<0.001) and increased physical function (SMD=0.76; 95% CI: 0.48 to 1.04; p<0.001). Cold water hydrotherapy also helped with discomfort (SMD=-0.65; 95% CI: -0.92 to -0.38; p<0.001), although it didn’t help with physical function as much. A direct comparison showed that warm water hydrotherapy was better for physical function (SMD=0.52; p<0.001), but cold water worked faster to relieve pain. Both methods work well for treating persistent low back pain, but the choice of treatment depends on how the patient presents and how they respond to water temperature.]]>
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