Contact: Tom Capezzuto
UMDNJ-New Jersey Medical School
Researcher Finds Heat Wraps More Effective than Analgesics
for Low Back Pain Relief
Study Published in May 15 Issue of the Journal Spine
Low level heat wrap
therapy is more effective than over-the-counter oral medications
for relieving low back pain, according to the results of a nationwide
study led by a sports medicine researcher at the University of Medicine
and Dentistry of New Jersey (UMDNJ).
In the six-month study
involving 371 patients, participants were given the maximum recommended
non-prescription dosages of ibuprofen and acetaminophen or low level
wrap heat therapy for two days to treat acute low back pain.
The results showed that
the low level heat wrap therapy provided significantly more pain
relief beginning on the first day of treatment than the oral analgesics
and that the effects lasted more than 48 hours after the treatment
"Although clinical guidelines
in the U.S. have recommended the use of self-administered heat,
this is the first study to compare the effectiveness of topical
heat treatment versus oral analgesics for treating muscle pain and
stiffness," according to Dr. Scott F. Nadler, director of sports
medicine at UMDNJ-New Jersey Medical School in Newark and co-investigator
of the study.
"Confirming that this
treatment is effective is important to patients because it gives
them a treatment option that does not have the potential risk to
the liver, kidneys, and gastrointestinal tract that can accompany
analgesic usage," said Dr. Nadler, who is also an associate professor
of physical medicine and rehabilitation at the medical school.
The study, which is
published in the May 15 issue of Spine, was conducted at
11 test sites nationwide in a randomized, active-controlled clinical
Low back pain is the
leading cause of disability in people under age 45 and the cost
to society is estimated to range from $20 to $50 billion per year,
according to statistics provided by the Agency for Healthcare Policy
and Research of the U.S. Department of Health and Human Services.
The participants in
the study were between the ages of 18 and 55 years of age and were
evaluated to be experiencing at least moderate back pain. They were
assigned to one of five groups and underwent treatment continuously
over two days.
One group was given
400 milligrams of ibuprofen three times a day and one dose of oral
placebo. A second group was given 1000 milligrams of acetaminophen
four times a day. A third group was given only oral placebos.
The fourth group wore
a heat wrap around the lumbar region of the torso. Called ThermaCare®,
the heat wrap was developed by the Procter & Gamble Health Sciences
Institute in Cincinnati, Ohio. It heats to 104F degrees within 30
minutes of exposure to air and maintains this temperature continuously
for at least an eight-hour period of wear. The fifth group was assigned
an unheated heat wrap.
The researchers found
that the heat wrap group showed significant improvements in pain
relief, lateral trunk flexibility, muscle stiffness and disability
compared with the patients taking ibuprofen or acetaminophen.
"On the first day of
treatment, the heat wrap gave patients greater pain relief-33 and
52 percent, respectively-when compared to ibuprofen and acetaminophen,"
Dr. Nadler said. "The heat wrap also improved trunk flexibility--71
and 48 percent, respectively--compared with ibuprofen and acetaminophen
after just two days of treatment."
Dr. Nadler attributed
this difference in part to the continuous use of heat combined with
the ability of individuals wearing the heat wrap to continue to
maintain normal activity levels. "The wraps are not bulky and can
be worn under clothing while people work, exercise or relax," he
said. "They not only provide pain relief but they may also help
many patients return to normal activity. In some instances, they
may enable people with low back pain to resume normal exercise activities
to relieve muscle stiffness and improve strength and flexibility
of the spine and extremities."
"ThermaCare heat wrap
treatment for low back pain proved to be better than oral analgesics
because it goes beyond pain relief to provide muscle relaxation
and increased flexibility," said Dr. Deborah J. Steiner of Research
Testing Laboratories, Inc., of Great Neck, N.Y., who was a co-investigator
with Dr. Nadler in the study.
The UMDNJ-New Jersey
Medical School is one of three medical schools of the University
of Medicine and Dentistry of New Jersey. UMDNJ comprises New Jersey's
only medical schools, the state's only dental school, a nursing
school, a graduate school of biomedical sciences, a school of health
related professions and a school of public health on campuses in
Newark, Piscataway/New Brunswick, Camden, Stratford and Scotch Plains.
It is affiliated with more than 200 health care and educational
institutions throughout the state.