title: Continuous low-level heat wrap therapy is effective for treating wrist pain.
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).
  
  
  METHODS
  Prospective, randomized, parallel, single-blind (investigator), placebo-controlled, multicenter clinical trial.
  
  
  METHODS
  Two community-based research facilities.
  
  
  METHODS
  Ninety-three patients (age range, 18-65 y) with wrist pain.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Physical Therapy, Temple University, Philadelphia, PA 19140, USA. susan.michlovitz@temple.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Michlovitz
authors.forename: Larysa
authors.initials: L
authors.lastname: Hun
authors.forename: Geetha N
authors.initials: GN
authors.lastname: Erasala
authors.forename: David A
authors.initials: DA
authors.lastname: Hengehold
authors.forename: Kurt W
authors.initials: KW
authors.lastname: Weingand
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D001458:Bandages / Q000592:standards*; D002349:Carpal Tunnel Syndrome / Q000150:complications; D005260:Female; D018737:Hand Strength; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013180:Sprains and Strains / Q000150:complications; D052256:Tendinopathy / Q000150:complications; D016896:Treatment Outcome; D014955:Wrist Joint
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen