Health: WebMD

Heat Wrap May Help Back Pain

January 23, 2006 / 2:45 PM EST / WebMD

About half of all working-age Americans experience low back pain in any given year, costing the U.S. economy between $20 and $50 billion annually in lost productivity.

But an over-the-counter approach to controlling back pain just may help get some of these people back to work quicker, researchers from the Johns Hopkins University School of Medicine are reporting.

In their study, hospital employees seeking treatment for work-related low back pain reported significantly less pain when continuous low-level heat wraps were used along with standard treatment.

The study was paid for by Procter & Gamble, manufacturer of the ThermaCare HeatWrap.

"The people who used the heat wraps had more mobility with less pain," researcher Edward J. Bernacki, MD, tells WebMD. Bernacki directs the division of occupational medicine at Baltimore's Johns Hopkins School of Medicine.

Measuring Pain Intensity

The small study included 43 patients treated at the occupational injury clinic for acute low back pain. People with a history of chronic back pain or back problems, other chronic body pains, or back surgery were not included in this study.

Eighteen of the patients received education regarding back therapy and pain management alone. The other 25 received the same intervention along with the heat wraps, worn on the lower back for eight hours during the day for three consecutive days.

People in both groups took pain relief medications as needed.

Both groups were assessed for pain intensity and pain relief four times each day during the three treatment days. Pain was also measured during follow-up visits about one and two weeks later.

The researchers reported that the heat-wrap-treated patients "had significantly reduced pain intensity, increased pain relief, and improved disability scores during and after treatment."

The study appeared in the December 2005 issue of The Journal of Occupational and Environmental Medicine.

Heat Wraps Don't Heal Damage

Although most adults experience low back pain at some point in their lives, in about 90% of cases the pain resolves on its own within two months, regardless of treatment, pain treatment expert John Loeser, MD, tells WebMD.

"Voltaire said it best," Loeser says. "He said, 'Nature cures, but doctors get the credit.' That is really the way it is with back pain."

An effective treatment minimizes pain but doesn't necessarily shorten the course of the injury, he says, adding that many patients get a good deal of pain relief with heat wraps.

"Heat wraps don't heal damaged tissue, but they do make many people feel better," he says. "And that allows them to resume their normal activities. If a treatment controls pain while nature solves the problem, it is worthwhile."

Other Approaches for Pain Relief

Internationally known for his work in pain management, Loeser is a professor of neurosurgery and anesthesiology at Seattle's University of Washington School of Medicine. His other recommendations for treating acute low back pain include.

Use non-narcotic, anti-inflammatory pain drugs as recommended by your doctor.

Get back to a normal range of activities as quickly as you can, and minimize bed rest. "There is no organ in the human body that becomes healthier with bed rest," he says. "From your brain to your back, the best evidence we have is that activity is more therapeutic than bed rest."

Exercise wisely. "Don't go out and move pianos, or even swing a golf club aggressively," he says. "You want to do repetitive exercise that doesn't involve a lot of sudden twisting or lifting." He says walking, jogging, swimming, and even cycling are good choices for someone with a sore back.

Fire or ice. Some people swear by ice to control the pain of back strain, while heat works better for others. "Whatever works for you," Loeser says.

Likewise, many other treatments, from massage to acupuncture, may help control back pain. But no single treatment has been shown to heal an injured back quicker, he says.

"Nobody has been able to prove that a specific treatment makes you better quicker, because most people get better anyway within 60 days," Loeser says. "You can't beat nature."

SOURCES: Tao, X. G. The Journal of Occupational and Environmental Medicine, December 2005; vol 47: pp 1298-1306. Edward J. Bernacki, MD, MPH, director, division of occupational and environmental medicine, Johns Hopkins School of Medicine, Baltimore. John Loeser, MD, professor of neurological surgery and anesthesiology, University of Washington, Seattle.

By Salynn Boyles
Reviewed by Louise Chang, MD
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