Continuous low-level heat wrap therapy provides more efficacy than ibuprofen and acetaminophen for acute low back pain

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2002-05, Vol.27 (10), p.1012-1017
• Main Authors: NADLER, Scott F, STEINER, Deborah J, ERASALA, Geetha N, HENGEHOLD, David A, HINKLE, Robert T, GOODALE, Mary Beth, ABELN, Susan B, WEINGAND, Kurt W
• Format: Article
• Language: English
• Subjects: Acetaminophen - therapeutic use; Acute Disease; Adolescent; Adult; Analgesics, Non-Narcotic - therapeutic use; Biological and medical sciences; Diseases of the osteoarticular system. Orthopedic treatment; Female; Follow-Up Studies; Hot Temperature - therapeutic use; Humans; Ibuprofen - therapeutic use; Low Back Pain - pathology; Low Back Pain - therapy; Male; Medical sciences; Middle Aged; Muscle Cramp - therapy; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Severity of Illness Index; Single-Blind Method; Treatment Outcome
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/00007632-200205150-00003

A prospective, randomized, single (investigator) blind, comparative efficacy trial was conducted. 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. The efficacy of topical heat methods, as compared with oral analgesic treatment of low back pain, has not been established. Subjects (n = 371) were randomly assigned to heat wrap (n = 113), acetaminophen (n = 113), or ibuprofen (n = 106) for efficacy evaluation, or to oral placebo (n = 20) or unheated back wrap (n = 19) for blinding. Outcome measures included pain relief, muscle stiffness, lateral trunk flexibility, and disability. Efficacy was measured over two treatment days and two follow-up days. Day 1 pain relief for the heat wrap (mean, 2) was higher than for ibuprofen (mean, 1.51; P = 0.0007) or acetaminophen (mean, 1.32; P = 0.0001). Extended mean pain relief (Days 3 to 4) for the heat wrap (mean, 2.61) also was higher than for ibuprofen (mean, 1.68; P = 0.0001) or acetaminophen (mean, 1.95; P = 0.0009). Lateral trunk flexibility was improved with the heat wrap (mean change, 4.28 cm) during treatment (P