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