Continuous Low-Level Heat Wrap Therapy Is Effective for Treating Wrist Pain

Arch Phys Med Rehabil. 2004 Sep;85(9):1409-16. doi: 10.1016/j.apmr.2003.10.016.

Abstract

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, 18-65 y) 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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaminophen / therapeutic use
  • Activities of Daily Living
  • Adolescent
  • Adult
  • Aged
  • Analgesics, Non-Narcotic / therapeutic use
  • Bandages / standards*
  • Carpal Tunnel Syndrome / complications
  • Female
  • Hand Strength
  • Hot Temperature / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / complications
  • Pain / diagnosis
  • Pain / etiology
  • Pain Management*
  • Pain Measurement
  • Prospective Studies
  • Severity of Illness Index
  • Single-Blind Method
  • Sprains and Strains / complications
  • Tendinopathy / complications
  • Treatment Outcome
  • Wrist Joint*

Substances

  • Analgesics, Non-Narcotic
  • Acetaminophen