Abstract
Michlovitz S, Hun L, Erasala GN, Hengehold DA, Weingand KW. Continuous low-level heat
wrap therapy is effective for treating wrist pain. Arch Phys Med Rehabil 2004;85:1409–16.
Objective
To evaluate the efficacy of continuous low-level heat wrap therapy for the treatment
of various sources of wrist pain including strain and sprain (SS), tendinosis (T),
osteoarthritis (OA), and carpal tunnel syndrome (CTS).
Design
Prospective, randomized, parallel, single-blind (investigator), placebo-controlled,
multicenter clinical trial.
Setting
Two community-based research facilities.
Participants
Ninety-three patients (age range, 18–65y) with wrist pain.
Intervention
Subjects with moderate or greater wrist pain were randomized and stratified to 1 of
the following treatments: efficacy evaluation (heat wrap, n=39; oral placebo, n=42)
or blinding (oral acetaminophen, n=6; unheated wrap, n=6). Data were recorded over
3 days of treatment and 2 days of follow-up.
Main outcome measures
The primary comparison was between the heat wrap and the oral placebo group among
SS/T/OA subjects for pain relief. Outcome measures included pain relief (0–5 scale),
joint stiffness (101-point numeric rating scale), grip strength measured by dynamometry,
and perceived pain and disability (Patient Rated Wrist Evaluation [PRWE]); subjects
with CTS also completed the Symptom Severity Scale and Functional Status Scale.
Results
Heat wrap therapy showed significant benefits in day 1 to 3 mean pain relief (P=.045) and increased day 3 grip strength (P=.02) versus oral placebo for the SS/T/OA group. However, joint stiffness and PRWE
results were comparable between the 2 treatments. For the CTS group, heat wraps provided
greater day 1 to 3/hour 0 to 8 mean pain relief (P=.001), day 1 to 3 mean joint stiffness reduction (P=.004), increased day 3 grip strength (P=.003), reduced PRWE scores (P=.0015), reduced symptom severity (P=.001), and improved functional status (P=.04). In addition, the heat wrap showed significant extended benefits through follow-up
(day 5) in the CTS group.
Conclusions
Continuous low-level heat wrap therapy was efficacious for the treatment of common
conditions causing wrist pain and impairment.
Keywords
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Article info
Footnotes
☆Supported by the Procter & Gamble Health Sciences Institute.
Identification
Copyright
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
