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Chiropractic Research Review

Heat Plus Exercise: Best Treatment for Acute LBP?

While chiropractic adjustments are considered one of the most effective forms of care for the treatment of low back pain (LBP), health care practitioners often employ other methods for back pain relief.

Among the more common techniques are the application of heat and specific exercises that help strengthen the back and improve range of motion. However, little is known about whether a combination of these treatments may be more effective than a single intervention.

In this randomized, controlled trial, 100 individuals with LBP lasting less than three months were allocated to one of four groups: a heat wrap therapy group (in which patients wore a disposable low-level heat wrap eight hours per day for five consecutive days); an exercise group (consisting of flexion and extension exercises performed one time every hour while the patient was awake for five consecutive days); a heat-plus-exercise group; and a control group that received an educational booklet on acute low back problems. At baseline, the participants were examined by a practitioner for assessments on functional ability, disability levels, pain intensity and pain relief. The same assessments were performed 2 days, 4 days and 7 days after randomization.

By day 7, patients in the heat-plus-exercise group experience significant improvements in function, disability and pain relief compared to the other groups. Functional improvement for heat-plus-exercise patients was 84%, 95% and 175% greater than patients in the heat wrap, exercise and control groups, respectively. Pain relief among the heat-plus-exercise patients was 70% greater than in the exercise patients, and 143% greater than the control patients.

The researchers stated that the combination of heat and exercise "provided superior functional improvement, disability reduction, and pain relief" compared to single interventions. They added that health care providers "should consider using continuous low-level heat wrap therapy in conjunction with exercise therapy during the early stages of care for acute low back pain in order to achieve optimal functional improvements during recovery."

Mayer JM, Ralph L, Look M, et al. Treating acute low back pain with continuous low-level heat wrap therapy and/or exercise: a randomized controlled trial. The Spine Journal 2005;5:395-403.

Chiropractic Research Review

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