title: Paraspinal musculature and skin temperature changes: comparing the Thermacare HeatWrap, the Johnson & Johnson Back Plaster, and the ABC Warme-Pflaster.
abstract: METHODS
  Prospective, randomized, crossover design.
  
  
  OBJECTIVE
  To compare the effectiveness of the Johnson & Johnson Back Plaster, the ABC Warme-Pflaster, and the ThermaCare HeatWrap on skin and paraspinal muscle temperature. Also, to compare the subjects' heat perception for the 3 products.
  
  
  BACKGROUND
  Heat therapy is a common treatment for low back pain and disability. There are a number of products on the market that are suggested to relieve low back pain by providing warmth to the back; however, their effectiveness for increasing tissue temperature compared with heat sensation has not been tested.
  
  
  METHODS
  To measure paraspinal muscle temperature, 1 thermocouple monofilament was inserted into the paraspinal muscle 2 cm from the skin surface at the L3 level using a 20-gauge 1.25-in (3.15-cm) sterile catheter. To measure skin interface temperature, 2 thermocouples were placed on the skin at distances of 5 cm and 7 cm from the insertion site. The Isothermex was used to record temperatures to the nearest 0.1 degrees C for 120 minutes. The subjects also rated heat perception using a 10-cm visual analog scale at 0, 30, 60, 90, and 120 minutes. Analysis of covariance models were used for statistical analysis.
  
  
  RESULTS
  There was a significant product x time interaction (F14,231 = 3.77, P<.0001) at the intramuscular site, but there was not a significant product x time interaction (F14,231 = 1.03, P = .4228) at the skin site. Both the main effects for product (F2,33 = 41.59, P<.0001) and time (F3,51 = 19.02, P<.0001) were significant for the visual analog scale data. The ThermaCare HeatWrap produced significant increases in both skin and intramuscular temperatures with less heat sensation. The Johnson & Johnson Back Plaster and the ABC Warme-Pflaster increased temperature at the skin surface and provided the greatest heat sensations, but they did not provide intramuscular heat.
  
  
  CONCLUSIONS
  The ThermaCare HeatWrap is more effective at increasing temperature at a 2-cm depth with less perceived heat compared to the Johnson & Johnson Back Plaster and the ABC Warme-Pflaster. The latter 2 products provide a sensation of heat but do not actually provide a muscle temperature change at a depth of 2 cm.
authors.affiliation: Brigham Young University, Provo, UT, USA. ctrowbridge@uta.edu
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Trowbridge
authors.forename: David O
authors.initials: DO
authors.lastname: Draper
authors.forename: J Brent
authors.initials: JB
authors.lastname: Feland
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Jutte
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Eggett
mesh_terms: D000328:Adult; D001415:Back / Q000502:physiology; D002370:Casts, Surgical; D018592:Cross-Over Studies; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D009132:Muscles / Q000502:physiology*; D011446:Prospective Studies; D012881:Skin Temperature / Q000502:physiology*; D013131:Spine / Q000502:physiology; D013997:Time Factors