Heat wraps can reduce back pain, but evidence for cold treatment is sparse

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 (Issue 1, 2006).

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. 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.

The Cochrane 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.

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.

The Cochrane Library contains high quality health care information, including Systematic Reviews from The Cochrane Collaboration. These Reviews bring together research on the effects of health care and are considered the gold standard for determining the relative effectiveness of different interventions. The Cochrane Collaboration (http://www.cochrane.org) is a UK registered international charity and the world’s leading producer of systematic Reviews. It has been demonstrated that Cochrane Systematic Reviews are of comparable or better quality and are updated more often than the Reviews published in print journals. The Cochrane Library can be accessed at www.thecochranelibrary.com. Australian users get free access due a national licence purchased by the Australian Commonwealth Government.

Reference:
French SD, Cameron M, Walker BF, Reggars JW & Esterman AJ. Superficial heat or cold for low back pain. The Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD004750