Paraspinal Musculature and Skin Temperature Changes: Comparing the ThermaCare HeatWrap, the Johnson & Johnson Back Plaster, and the ABC Warme-Pflaster

Abstract

Study Design: Prospective, randomized, crossover design. Objectives: To compare the effectiveness of the Johnson & Johnson Back Plaster, the ABC Warme-Pflaster, and the ThermaCare HeatWrap on skin and paraspinal muscle temperature. Also, to compare the subjects' heat perception for the 3 products. Background: Heat therapy is a common treatment for low back pain and disability. There are a number of products on the market that are suggested to relieve low back pain by providing warmth to the back; however, their effectiveness for increasing tissue temperature compared with heat sensation has not been tested. Methods and Measures:To measure paraspinal muscle temperature, 1 thermocouple monofilament was inserted into the paraspinal muscle 2 cm from the skin surface at the L3 level using a 20-gauge 1.25-in (3.15-cm) sterile catheter. To measure skin interface temperature, 2 thermocouples were placed on the skin at distances of 5 cm and 7 cm from the insertion site. The Isothermex was used to record temperatures to the nearest 0.1°C for 120 minutes. The subjects also rated heat perception using a 10-cm visual analog scale at 0, 30, 60, 90, and 120 minutes. Analysis of covariance models were used for statistical analysis. Results: There was a significant product × time interaction (F 14,231 = 3.77, P Ͻ.0001) at the intramuscular site, but there was not a significant product × time interaction (F 14,231 = 1.03, P = .4228) at the skin site. Both the main effects for product (F 2,33 = 41.59, P Ͻ.0001) and time (F 3,51 = 19.02, P Ͻ.0001) were significant for the visual analog scale data. The ThermaCare HeatWrap produced significant increases in both skin and intramuscular temperatures with less heat sensation. The Johnson & Johnson Back Plaster and the ABC Warme-Pflaster increased temperature at the skin surface and provided the greatest heat sensations, but they did not provide intramuscular heat. Conclusions: The ThermaCare HeatWrap is more effective at increasing temperature at a 2-cm depth with less perceived heat compared to the Johnson & Johnson Back Plaster and the ABC Warme-Pflaster. The latter 2 products provide a sensation of heat but do not actually provide a muscle temperature change at a depth of 2 cm.

Effect of diathermy on muscle temperature, electromyography, and mechanomyography

“…However, most previous studies on the efficacy of heating modalities have investigated the calf, 16 knee, 26 or lowback. 45 Less is known about the intramuscular temperature changes in larger muscles such as the vastus lateralis.Several recent thermal studies have reported increases in passive joint range of motion 36,38 ; however no studies have examined the electrical and mechanAbbreviations: ANOVA, analysis of variance; EMG, electromyography; ICC, intraclass correlation coefficient; IMF, instantaneous mean frequency; MMG, mechanomyography; MVC, maximal voluntary contraction; 2 , eta squared statistic (effect size); SEM, standard error of measurement; SD, standard deviation …”

Continuous Low-Level Heatwrap Therapy Relieves Low Back Pain and Reduces Muscle Stiffness

“…20 In addition to increasing the temperature on the surface of the skin, the most extensively studied of these devices also produces a rapid increase in intramuscular temperature of approximately 1°C over baseline at a depth of 2 cm for 30 minutes postapplication. [20][21][22] This is in contrast to capsaicin or capsicum-containing back plasters or menthol-containing patches, which do not produce an increase in intramuscular temperatures. 20-22 Numerous clinical studies with this heatwrap have demonstrated the effectiveness of continuous low-level heat therapy in relieving pain, muscle stiffness, and disability, and in improving lateral trunk flexibility in people with LBP.…”

The Case for Over-the-Counter Shortwave Therapy: Safe and Effective Devices for Pain Management

“…However, the temperature increases at this level are unlikely to cause the desired effects of heat therapy, namely higher tissue temperatures, which produces vasodilation, increasing the supply of oxygen and nutrients and the elimination of carbon dioxide and metabolic waste. By contrast, heat wrap therapy and the continuous application of heat for 8-12 h has been shown to be therapeutic in a number of studies [40,41]. The temperature increases with heat wraps has been reported to be 2°C at depths of 2 cm [40,42], which are clearly not achieved with low-dose PSWD devices.…”