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

Abstract

STUDY DESIGN:

A prospective, randomized, single (investigator) blind, comparative efficacy trial was conducted.

OBJECTIVE:

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.

SUMMARY OF BACKGROUND DATA:

The efficacy of topical heat methods, as compared with oral analgesic treatment of low back pain, has not been established.

METHODS:

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.

RESULTS:

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 </= 0.009 vs acetaminophen [mean change, 2.93 cm], P </= 0.001 vs ibuprofen [mean change, 2.51 cm]). The results were similar on Day 4. Day 1 reduction in muscle stiffness with the heat wrap (mean, 16.3) was greater than with acetaminophen (mean, 10.5; P = 0.001). Disability was reduced with the heat wrap (mean, 4.9), as compared with ibuprofen (mean, 2.7; P = 0.01) and acetaminophen (mean, 2.9; P = 0.0007), on Day 4. None of the adverse events were serious. The highest rate (10.4%) was reported in the ibuprofen group.

CONCLUSION:

Continuous low-level heat wrap therapy was superior to both acetaminophen and ibuprofen for treating low back pain.

• Authors: Scott F Nadler, Deborah J Steiner, Geetha N Erasala, David A Hengehold, Robert T Hinkle, Mary Beth Goodale, Susan B Abeln, Kurt W Weingand
• Journal: Spine (Spine (Phila Pa 1976)) Vol. 27 Issue 10 Pg. 1012-7 (May 15 2002) ISSN: 1528-1159 [Electronic] United States
• PMID: 12004166 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Non-Narcotic
• Acetaminophen
• Ibuprofen

Topics

• Acetaminophen (therapeutic use)
• Acute Disease
• Adolescent
• Adult
• Analgesics, Non-Narcotic (therapeutic use)
• Female
• Follow-Up Studies
• Hot Temperature (therapeutic use)
• Humans
• Ibuprofen (therapeutic use)
• Low Back Pain (pathology, therapy)
• Male
• Middle Aged
• Muscle Cramp (therapy)
• Prospective Studies
• Severity of Illness Index
• Single-Blind Method
• Treatment Outcome