From the Guidelines
Heat therapy is a recommended treatment for back pain, as it has been shown to moderately improve pain relief and disability, according to moderate-quality evidence from the American College of Physicians guideline published in 2017 1. When using heat therapy for back pain, it is essential to apply a warm but not scalding temperature to the affected area for 15-20 minutes at a time, several times a day. This can be achieved with a heating pad, hot water bottle, or warm towel. Commercial heat wraps like ThermaCare can also provide continuous low-level heat for up to 8 hours, allowing for mobility during treatment. Key benefits of heat therapy include:
- Increasing blood flow to the affected muscles
- Relaxing muscle tension
- Reducing stiffness
- Blocking pain signals
- Promoting healing by delivering nutrients and removing waste products from injured tissues It is crucial to note that heat therapy is particularly effective for chronic back pain, muscle spasms, and stiffness. However, it should be avoided in cases of open wounds, skin conditions, circulatory problems, or if the area is swollen or inflamed. If back pain persists beyond two weeks, worsens, or is accompanied by concerning symptoms like numbness or weakness, consultation with a healthcare provider is necessary for proper evaluation.
From the Research
Heat Therapy for Back Pain
- Heat therapy has been shown to be effective in reducing back pain, with studies demonstrating its superiority over other treatments such as ibuprofen and acetaminophen 2.
- A study published in 2002 found that continuous low-level heat wrap therapy provided more efficacy than ibuprofen and acetaminophen for acute low back pain, with improvements in pain relief, muscle stiffness, lateral trunk flexibility, and disability 2.
- Another study published in 2023 found that simultaneous heat massage combined with conventional physical therapy was effective in improving lower back pain, although it was not superior to conventional physical therapy alone 3.
- The mechanisms of heat therapy include increasing blood flow, metabolism, and elasticity of connective tissues, which can help to reduce pain and promote healing 4.
- A randomized controlled trial published in 2005 found that combining continuous low-level heat wrap therapy with directional preference-based exercise improved functional ability and reduced disability in patients with acute low back pain 5.
- Heat therapy has also been shown to be effective in improving pain relief, range of motion, and compliance with home exercise in patients with nonspecific neck pain, when used as an adjunct to physical therapy 6.
Types of Heat Therapy
- Continuous low-level heat wrap therapy has been shown to be effective in reducing back pain and improving functional ability 2, 5.
- Simultaneous heat massage combined with conventional physical therapy has also been shown to be effective in improving lower back pain 3.
- Low-level continuous heat (LLCH) has been shown to be effective in reducing pain and improving range of motion in patients with nonspecific neck pain, when used as an adjunct to physical therapy 6.
Comparison with Other Treatments
- Heat therapy has been shown to be superior to ibuprofen and acetaminophen for acute low back pain 2.
- Heat therapy has also been shown to be effective in improving functional ability and reducing disability in patients with acute low back pain, when combined with directional preference-based exercise 5.
- Simultaneous heat massage combined with conventional physical therapy was not superior to conventional physical therapy alone in improving lower back pain, although it did have a better effect on autonomic nerve function and underlying moods 3.