• Scott F Nadler, Deborah J Steiner, Geetha N Erasala, David A Hengehold, Robert T Hinkle, Mary Beth Goodale, Susan B Abeln, and Kurt W Weingand.
• Department of Physical Medicine and Rehabilitation, UMDNJ-NJ Medical School, the; Research Testing Laboratories, Newark, NJ 07103, USA. sfnadler@cs.com
• Spine. 2002 May 15; 27 (10): 1012-7.

Study DesignA prospective, randomized, single (investigator) blind, comparative efficacy trial was conducted.ObjectiveTo 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 DataThe efficacy of topical heat methods, as compared with oral analgesic treatment of low back pain, has not been established.MethodsSubjects (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.ResultsDay 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 ConclusionContinuous low-level heat wrap therapy was superior to both acetaminophen and ibuprofen for treating low back pain.

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