title: Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effects of continuous low-level heat wrap therapy for the prevention and early phase treatment (ie, 0-48 h postexercise) of delayed-onset muscle soreness (DOMS) of the low back.
  
  
  METHODS
  Two prospective randomized controlled trials.
  
  
  METHODS
  Outpatient medical facility.
  
  
  METHODS
  Sixty-seven subjects asymptomatic of back pain and in good general health (mean age, 23.5+/-6.6 y).
  
  
  METHODS
  Participants performed vigorous eccentric exercise to experimentally induce low back DOMS. Participants were assigned to 1 of 2 substudies (prevention and treatment) and randomized to 1 of 2 treatment groups within each substudy: prevention study (heat wrap, n=17; control [nontarget muscle stretch], n=18) and treatment study (heat wrap, n=16; cold pack, n=16). Interventions were administered 4 hours before and 4 hours after exercise in the prevention study and between hours 18 to 42 postexercise in the treatment study.
  
  
  METHODS
  To coincide with the expected occurrence of peak symptoms related to exercise-induced low back DOMS, hour 24 postexercise was considered primary. Pain intensity (prevention) and pain relief (treatment) were primary measures, and self-reported physical function and disability were secondary measures.
  
  
  RESULTS
  In the prevention study, at hour 24 postexercise, pain intensity, disability, and deficits in self-reported physical function in subjects with the heat wrap were reduced by 47% (P<.001), 52.3% (P=.029), and 45% (P=.013), respectively, compared with the control group. At hour 24 in the treatment study, postexercise, pain relief with the heat wrap was 138% greater (P=.026) than with the cold pack; there were no differences between the groups in changes in self-reported physical function and disability.
  
  
  CONCLUSIONS
  In this small study, continuous low-level heat wrap therapy was of significant benefit in the prevention and early phase treatment of low back DOMS.
authors.affiliation: U.S. Spine & Sport Foundation, San Diego, CA 92123, USA. jmayer2@san.rr.com
authors.forename: John M
authors.initials: JM
authors.lastname: Mayer
authors.forename: Vert
authors.initials: V
authors.lastname: Mooney
authors.forename: Leonard N
authors.initials: LN
authors.lastname: Matheson
authors.forename: Geetha N
authors.initials: GN
authors.lastname: Erasala
authors.forename: Joe L
authors.initials: JL
authors.lastname: Verna
authors.forename: Brian E
authors.initials: BE
authors.lastname: Udermann
authors.forename: Scott
authors.initials: S
authors.lastname: Leggett
mesh_terms: D000328:Adult; D015444:Exercise; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D017116:Low Back Pain / Q000517:prevention & control* / Q000628:therapy*; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*