Uninterrupted Low-temperature Packing Therapy in the Therapy of Acute Lower Back Pains Exerting Higher Efficiency than Ibuprofen and Acetaminophen

Česká verzia

Authors: S. F. Nadler; D. J. Steiner; G. N. Erasala; D. A. Hengehold; R. T. Hinkle; M. B. Goodale; S. B. Abeln; K. W. Weingand
Published in the journal: Rehabil. fyz. Lék., 21, 2014, No. 4, pp. 227-235.
Category: Review Article

Summary

Study design:
A prospective, randomized, single-blind (for the examining physicians) comparative study of efficiency. The effectiveness of the topical thermal therapy was compared with the treatment with oral analgesics in the treatment of lower back pains has not been established so far.

Objective:
The comparison of effectiveness of the continuous packing therapy (40°C, 8 h/day) and effectiveness of ibuprofen (1.200 mg/day) and acetaminophen (4.000 mg/day) in subjects with acute nonspecific lower back pains.

Methods:
The subjects (n=371) were randomly divided into groups treated with thermal packing (n=113), acetaminophen (n=113) and ibuprofen (n=106) with the objective to determine effectiveness and to compare these kids of therapy with oral placebo (n=20) or a cold packing of the back (n=19) considering the blinded character of the treatment. The target indices included the relief of pain, muscular tightness, mobility of lateral trunk and a degree of invalidity. The effectiveness was determined on the course of two days of therapy and two days of observation.

Results:
The pain relief with the thermal packing on day 1 of the therapy (mean = 2) was higher than in the group treated with ibuprofen (mean 1.51: P = 0.007) or acetaminophen (mean 1.32; P = 0.0001). A prolonged pain relief (day 3 and 4) for the thermal packing (mean 2.61) was also more pronounced than for ibuprofen (mean 1.68; P=0.0001) or acetaminophen (mean 1.95; P=0.0009). The flexibility of lateral trunk improved in the thermal packing (mean change 4.28 cm) during the therapy (P=0.009 vs. acetaminophen [mean change 2.93cm], P=0.001) vs. ibuprofen [mean change 2.51cm]). The results were similar on day 4 of the study. On day one of the study the mitigation of the muscular tightness (mean 16.3) was higher than with acetaminophen (mean 10.5; P=0.001). Invalidity decreased on day 4 in the group treated with the thermal packing (mean 4.9) in comparison with ibuprofen (mean 2.7; P=0.01) and acetaminophen (mean 2.9; P=0.0007)/ None of these undesirable effect was significant. The highest degree (10.4) was reported in the group treated with ibuprofen..

Conclusion:
The uninterrupted low temperature packing therapy proved to be more effective than acetaminophen and ibuprofen in the therapy of lower back pains.

Keywords:
acetaminophen, analgesia, thermal packing, ibuprofen, lower back pains, muscular skeletal, thermotherapy

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