Heat wraps can reduce back pain

The evidence base for using hot and cold therapies to relieve back pain is poor. There is moderate evidence that heat provides a short-term reduction in pain, but there are no good data showing whether or not cold therapy has any effect.

These findings are published in the latest update of The Cochrane Library.

Low-back pain is a common complaint and different studies report that it may affect up to 84% of the population. Heat and cold treatments are frequently recommended, inexpensive and simple to use. Traditionally ice has been used for recent injuries and heat for long-term complaints.

Review Authors located nine trials involving 1,117 participants. By studying all of the data, they concluded that while the techniques were frequently used, there was little hard evidence to prove their effectiveness. They found limited evidence that there was a small effect for short term relief using a specific heat wrap therapy, but they only found three poor-quality trials that assessed the effects of cold treatment.

“Given the number of people who have low-back pain and subsequently use these treatments, there is a need for high-quality randomised controlled clinical trials that will let us know whether they are effective,” says lead author Simon French, a Research Fellow at the Australasian Cochrane Centre and Institute of Health Services Research at Monash University, Australia.

Future research should focus on areas where there are few or no trials, for example, simple heat applications like hot water bottles; ice massage versus no cold; and heat versus cold treatment.

Heat treatments include hot water bottles, soft heated packs filled with grain, poultices, hot towels, hot baths, saunas, steam, heat wraps, heat pads, electric heat pads and infra-red heat lamps.

Cold treatments include ice, cold towels, cold gel packs, ice packs and ice massage.