Michlovitz, Susan et al.
Archives of Physical Medicine and Rehabilitation , Volume 85 , Issue 9 , 1409 - 1416
Thursday, 5 March 2015
Continuous low-level heat wrap therapy is effective for treating wrist pain.
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
Prospective, randomized, parallel, single-blind (investigator), placebo-controlled, multicenter clinical trial.
Two community-based research facilities.
Ninety-three patients (age range, 18-65 y) with wrist pain.
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
MAIN OUTCOME MEASURES:
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.
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.
Continuous low-level heat wrap therapy was efficacious for the treatment of common conditions causing wrist pain and impairment.