Properties of Thermal Analgesia in a Human Chronic Low Back Pain Model

The Effectiveness of Thermal Neuromodulation Using Precise Heat in the Treatment of Chronic Low Back Pain Over 60 Days: An In-Home User Trial

PURPOSE

Two previous independent double-blind randomized studies demonstrated that thermal neuromodulation using high temperature pulsed heat reduced pain in subjects with chronic low back pain. The present study examined the effects of high temperature pulsed heat via an experimental device in a real-world In-Home Use Trial (IHUT) over a sixty-day period.

MATERIALS AND METHODS

This in-home study recruited 34 subjects with chronic low back pain, provided them with an experimental device that delivered treatment session of high temperature pulsed heat up to 45°C, and followed them for eight weeks. Subjects were allowed to use the device as needed. Primary outcome was pain rating as measured by the 11-point Numeric Pain Scale at baseline, four and eight weeks of treatment. The secondary outcome measures were the interference with daily living components of the Brief Pain Inventory at baseline versus eight weeks of treatment.

RESULTS

Thirty-two subjects completed the study. Pain levels were 5.81 at baseline, 2.79 at four weeks and 2.25 at eight weeks. All changes in pain levels between baseline and four weeks, baseline, and eight weeks and between four and eight weeks were statistically significant (p < 0.05). At eight weeks, the seven components of pain interference with activities of daily living and pain interference with walking were statistically reduced (P < 0.05). About 72% of subjects reported a single 30-minute treatment session produced over 3 hours of pain relief.

CONCLUSION

An eight-week in-home trial of high-temperature thermal modulation devices produced significant reductions in pain and pain interference with activities of daily living, an important measure of function. Efforts were made to control and reduce study contamination. This study provides important initial data for long-term outcome studies of thermal neuromodulation using high temperature pulsed heat to treat low back pain and to improve subject function and demonstrated that individuals with chronic pain can effectively self-manage pain.

The effects of Biofreeze and superficial heat on masticatory myofascial pain syndrome

Purpose:

This study aims to assess the influence of superficial heat and Biofreeze on pain, mouth opening (mm), and quality of life in patients with masticatory myofascial pain syndrome (MPS).

Materials and methods:

52 patients with MPS were included in the study. They were randomly divided into two groups. Patients in the Biofreeze group (n = 26) applied 3.5% menthol gel to the masseter and temporal muscles twice a day for seven days, while the other group applied superficial heat. Baseline, 7th, and 21st days of VAS, mouth opening (mm), and Oral Health Impact Profile-14 (OHIP-14) scores of the patients were evaluated statistically.

Results:

The mouth opening increased by 4.27 ± 3.80 mm in the Biofreeze group and 2.58 ± 2.16 mm in the superficial heat group. In each group, a significant decrease in VAS and OHIP-14 scores was observed on the 7th day compared to the baseline values (p<0.001). There was no statistically significant difference between the two applications on myofascial pain, mouth opening (mm), and OHIP-14 total score variables. The favorable effects of both applications on these parameters were limited to the duration of use.

Conclusion:

Biofreeze and superficial heat in MPS were found to increase the quality of life, but the limited effectiveness of these applications underlines the importance of the underlying factors.

A Role for Superficial Heat Therapy in the Management of Non-Specific, Mild-to-Moderate Low Back Pain in Current Clinical Practice: A Narrative Review

Low back pain (LBP) is a leading cause of disability. It significantly impacts the patient's quality of life, limits their daily living activities, and reduces their work productivity. To reduce the burden of LBP, several pharmacological and non-pharmacological treatment options are available. This review summarizes the role of superficial heat therapy in the management of non-specific mild-to-moderate LBP. First, we outline the common causes of LBP, then discuss the general mechanisms of heat therapy on (LBP), and finally review the published evidence regarding the impact of superficial heat therapy in patients with acute or chronic non-specific LBP. This review demonstrates that continuous, low-level heat therapy provides pain relief, improves muscular strength, and increases flexibility. Therefore, this effective, safe, easy-to-use, and cost-effective non-pharmacological pain relief option is relevant for the management of non-specific mild or moderate low back pain in current clinical practice.