Infrared therapy for chronic low back pain

Infrared therapy for chronic low back pain: A randomized, controlled trial

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539004/

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DISCUSSION

Back pain is the most common cause of disability in North America, and it accounts for 64% of new consultations at this pain clinic (RPMC); many of these patients have had failed back surgery.

The present study demonstrated significantly greater pain relief in the IR-treated group than in the placebo group. Both groups continued with their prestudy treatment such as antide-pressants, opioids and palliative nerve blocks, and this may account for the small decrease of pain in the control group.

Alternatively, actually wearing the lumbar belt without the IR may have been beneficial. There was only one dropout from the placebo group. The reduction in pain in the treated group was progressive over seven weeks, with a 50% pain reduction in the entire group (Figure 2), while the control group achieved an approximately 15% reduction in pain.

Electrical stimulation with the TENS has been shown to provide a 50% pain reduction in only 50% of patients in one study (3), and was found to be no better than placebo in another (4). It is therefore probable that IR is more effective than TENS.

Pain relief with IR has been shown for Arthritis of the knee (10). Other beneficial effects documented are increased wound healing (7–9), blood flow (14,15), endorphin levels (11) and bioactivation of neuromodulators (11–13).

Because IR warms the tissues, it may be prudent to avoid its use in cases with documented malignant hyperthermia and also scleroderma, because some forms of that condition deteriorate in sunlight, which has a wavelength close to IR. Also, many forms of prolonged heat therapy have produced a skin condition known as erythema ab igne; this is a potential theoretical risk, even though it has never been reported with IR.

Another hazard is thermal injury in very thin individuals or those with bony prominences, even though the device will automatically shut off if the skin temperature in contact with the IR unit reaches 42°C. No adverse effects of any sort were found in the present study, as was the case with the extensive use of the MSCT IR unit in animals, principally horses (S Wolfe, personal communication).

The MSCT IR unit can conveniently provide prolonged therapy because it is light and portable, and when charged, the batteries provide IR therapy for 10 h while the wearer remains active during the day or resting at night.

One weakness of the blinding procedure in the present study was that IR energy could have caused heating, but the inactivated placebo unit did not. We may have overcome this problem by explaining to the subjects that warming is not always felt because of a variable response of the tissues, thus leaving open the issue of whether warming occurred or not. In any future study, the IR unit will be compared with a heat unit.

CONCLUSION

In a double-blind, placebo-controlled trial, the IR wrap has clearly demonstrated that it is easy to use, safe and effective, and reduced chronic back pain by 50% over six weeks. Contraindications are rare (possibly malignant hyperthermia and scleroderma), and the risks of thermal injury are low and are minimized by the use of an automatic shut-off when the unit in contact with the skin rises to a temperature of 42°C. Other units such as lasers may not have such a safety device. Tweet