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Passive Care Research
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Heat & Cryotherapy - Low Back Pain
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1. French, SD et al. A Cochrane review of superficial heat or cold for low back pain. Spine. 2006 Apr 20; 31(9):998-1006.
Heat and cold are commonly used in the treatment of low back pain.
The objective of this review of the literature was to assess the effects of superficial heat and cold therapy for low back pain in adults.
- Heat wrap therapy significantly reduced pain after 5 days, compared with oral placebo.
- Heated blanket significantly decreased pain immediately after application
- Adding exercise to heat wrap and found that it reduced pain after 7 days.
2. Melzack, R et. al. Ice massage and transcutaneous electrical stimulation: comparison of treatment for low-back pain. Pain.1980 Oct; 9(2):209-17.
The purpose of this study was to examine the relative effectiveness of ice massage and TENS for the relief of low-back pain.
Patients suffering chronic low-back pain were treated with both ice massage and TENS.
- Both methods are equally effective at relieving pain.
- The results indicate that ice massage is an effective therapeutic tool, and appears to be more effective than TENS for some patients.
3. Nadler, SF et al. The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain Physician. 2004 Jul; 7(3):395-9.
Cryotherapy and thermotherapy are useful adjuncts for the treatment of musculoskeletal injuries.
Through a better understanding of these modalities, clinicians can optimize their present treatment strategies.
- Both modalities provide significant pain relief with a low side-effect profile.
- Contrast therapy
, which alternates between hot and cold treatment modalities, provides no additional therapeutic benefits compared with cryotherapy or thermotherapy alone.
4. Nadler, SF et al. Continuous low-level heat wrap therapy provides more efficacy than Ibuprofen and acetaminophen for acute low back pain. Spine. 2002 May 15;27 (10):1012-7.
The objective of this study was to compare the efficacy of continuous low-level heat wrap therapy [40 C, 8 hours/day] with that of ibuprofen [1200 mg/day] and acetaminophen [4000 mg/day] in subjects with acute nonspecific low back pain.
- Day 1 pain relief for the heat wrap was higher than for ibuprofen or acetaminophen. Extended mean pain relief (Days 3 to 4) for the heat wrap also was higher than for ibuprofen or acetaminophen.
- Flexibility was improved with the heat wrap during treatment vs. acetaminophen and ibuprofen. The results were similar on Day 4.
- Day 1 reduction in muscle stiffness with the heat wrap was greater than with acetaminophen.
- Disability was reduced with the heat wrap as compared with ibuprofen and acetaminophen on Day 4.
Continuous low-level heat wrap therapy was superior to both acetaminophen and ibuprofen for treating low back pain.
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