1. The effects of repeated (Far Infrared) thermal therapy for patients with chronic pain.

Masuda A, Koga Y, Hattanmaru M, Minagoe S, Tei C.

Psychother Psychosom. 2005;74(5):288-94.

Source: Nishi Kyusyu University, Saga, Japan. masudaak@m.kufm.kagoshima-u.ac.jp


BACKGROUND: It has been reported that local thermal therapy with a hot pack or paraffin relieves pain. We hypothesized that systemic warming may decrease pain and improve the outcomes in patients with chronic pain. The purpose of this study was to clarify the effects of systemic thermal therapy in patients with chronic pain.

METHODS: Group A (n = 24) patients with chronic pain were treated by a multidisciplinary treatment including cognitive behavioral therapy, rehabilitation, and exercise therapy, whereas group B (n = 22) patients were treated by a combination of multidisciplinary treatment and repeated thermal therapy. A far-infrared ray dry sauna therapy and post-sauna warming were performed once a day for 4 weeks during hospitalization. We investigated the improvements in subjective symptoms, the number of pain behavior after treatment and outcomes 2 years after discharge.

RESULTS: The visual analog pain score, number of pain behavior, self-rating depression scale, and anger score significantly decreased after treatment in both groups. After treatment, the number of pain behavior was slightly smaller (p = 0.07) and anger score was significantly lower in group B than those in group A (p = 0.05). Two years after treatment, 17 patients (77%) in group B returned to work compared with 12 patients (50%) in group A (p < 0.05).

CONCLUSION: These results suggest that a combination of multidisciplinary treatment and repeated (Far Infrared) thermal therapy may be a promising method for treatment of chronic pain.

Lower Back Pain

1. Overnight use of continuous low-level heatwrap therapy for relief of low back pain.

Arch Phys Med Rehabil. 2003 Mar;84(3):335-42.

Nadler SF1, Steiner DJ, Petty SR, Erasala GN, Hengehold DA, Weingand KW.


OBJECTIVE: To evaluate of the efficacy and safety of 8 hours of continuous, low-level heatwrap therapy administered during sleep.

PARTICIPANTS: Seventy-six patients, aged 18 to 55 years, with acute, nonspecific low back pain.

INTERVENTIONS: Subjects were stratified by baseline pain intensity and gender and randomized to one of the following treatments: evaluation of efficacy (heatwrap, n=33; oral placebo, n=34) or blinding (unheated wrap, n=5; oral ibuprofen, n=4). All treatments were administered for 3 consecutive nights with 2 days of follow-up.

RESULTS: Heatwrap therapy was significantly better than placebo at hour 0 on days 2 through 4 for mean pain relief (P=.00005); at hours 0 through 8 on days 2 through 4 for pain relief (P<.001); at hour 0 on day 4 and at hour 0 on day 5 for mean pain relief (P<.001); on day 4 in reduction of morning muscle stiffness (P<.001); for increased lateral trunk flexibility on day 4 (P<.002); and for decreased low back disability on day 4 (P=.005). Adverse events were mild and infrequent.

CONCLUSIONS: Overnight use of heatwrap therapy provided effective pain relief throughout the next day, reduced muscle stiffness and disability, and improved trunk flexibility. Positive effects were sustained more than 48 hours after treatments were completed.

Continuous low-level heatwrap therapy was shown to provide significant therapeutic benefits in patients with acute nonspecific LBP, as indicated by increased pain relief and trunk flexibility, and it provided decreased muscle stiffness and disability when compared with placebo. No serious or significant adverse effects were observed during the use of the heatwrap.

Research is under way to evaluate heatwrap therapy in college and elite athletes, as well as in recreational golfers, with LBP. This study supports the efficacy of continuous low-level heatwrap therapy in the treatment of acute nonspecific LBP.

2. Continuous low-level heat wrap therapy provides more efficacy than Ibuprofen and acetaminophen for acute low back pain.

Spine (Phila Pa 1976). 2002 May 15;27(10):1012-7.

Nadler SF, Steiner DJ, Erasala GN, Hengehold DA, Hinkle RT, Beth Goodale M, Abeln SB, Weingand KW.


OBJECTIVE: To compare the efficacy of continuous low-level heat wrap therapy (40 C, 8 hours/day) with that of ibuprofen (1200 mg/day) and acetaminophen (4000 mg/day) in subjects with acute nonspecific low back pain.

SUMMARY OF BACKGROUND DATA: The efficacy of topical heat methods, as compared with oral analgesic treatment of low back pain, has not been established.

METHODS: Subjects (n = 371) were randomly assigned to heat wrap (n = 113), acetaminophen (n = 113), or ibuprofen (n = 106) for efficacy evaluation, or to oral placebo (n = 20) or unheated back wrap (n = 19) for blinding. Outcome measures included pain relief, muscle stiffness, lateral trunk flexibility, and disability. Efficacy was measured over two treatment days and two follow-up days.

RESULTS: Day 1 pain relief for the heat wrap (mean, 2) was higher than for ibuprofen (mean, 1.51; P = 0.0007) or acetaminophen (mean, 1.32; P = 0.0001). Extended mean pain relief (Days 3 to 4) for the heat wrap (mean, 2.61) also was higher than for ibuprofen (mean, 1.68; P = 0.0001) or acetaminophen (mean, 1.95; P = 0.0009). Lateral trunk flexibility was improved with the heat wrap (mean change, 4.28 cm) during treatment (P </= 0.009 vs acetaminophen [mean change, 2.93 cm], P </= 0.001 vs ibuprofen [mean change, 2.51 cm]). The results were similar on Day 4. Day 1 reduction in muscle stiffness with the heat wrap (mean, 16.3) was greater than with acetaminophen (mean, 10.5; P = 0.001). Disability was reduced with the heat wrap (mean, 4.9), as compared with ibuprofen (mean, 2.7; P = 0.01) and acetaminophen (mean, 2.9; P = 0.0007), on Day 4. None of the adverse events were serious. The highest rate (10.4%) was reported in the ibuprofen group.

CONCLUSION: Continuous low-level heat wrap therapy was superior to both acetaminophen and ibuprofen for treating low back pain. According to the findings, continuous low-level topical heat wrap therapy is superior to both acetaminophen and ibuprofen, supporting its recommendation as a first-line therapy for the treatment of acute muscular low back pain.

Far Infrared (FIR) Therapy for Fibromyalgia

1. Efficacy of Waon (Far Infrared-FIR) therapy for fibromyalgia.

Intern Med. 2008;47(16):1473-6. Epub 2008 Aug 15.

Matsushita K, Masuda A, Tei C.


OBJECTIVE: Fibromyalgia syndrome (FMS) is a chronic syndrome characterized by widespread pain with tenderness in specific areas. We examined the applicability of Waon (Far Infrared) therapy (soothing warmth therapy) as a new method of pain treatment in patients with Fibromyalgia Syndrome.

METHODS: Thirteen female Fibromyalgia Syndrome patients (mean age, 45.2+/-15.5 years old; range, 25-75) who fulfilled the criteria of the American College of Rheumatology participated in this study. Patients received Waon (Far Infrared) therapy once per day for 2 or 5 days/week. The patients were placed in the supine or sitting position in a far infrared-ray dry sauna maintained at an even temperature of 60 degrees C for 15 minutes, and then transferred to a room maintained at 26-27 degrees C where they were covered with a blanket from the neck down to keep them warm for 30 minutes. Reductions in subjective pain and symptoms were determined using the pain visual analog scale (VAS) and fibromyalgia impact questionnaire (FIQ).

RESULTS:  All patients experienced a significant reduction in pain by about half after the first session of Waon therapy (11-70%), and the effect of Waon (Far Infrared) therapy became stable (20-78%) after 10 treatments. Pain VAS and FIQ symptom scores were significantly (p<0.01) decreased after Waon (Far infrared) therapy and remained low throughout the observation period.

CONCLUSION: Waon(Far Infrared)  therapy is effective for the treatment of fibromyalgia syndrome.

Knee Replacement – Post Operative Pain Relief

The analgesic effect of thermal therapy after total knee arthroplasty.

J Altern Complement Med. 2012 Feb;18(2):175-9. doi: 10.1089/acm.2010.0815.

Wong CH, Lin LC, Lee HH, Liu CF.

Source: Graduate Institute of Clinical Medical Sciences, Tao-Yuan, Taiwan.


OBJECTIVES: Pain induced by surgery is a dynamic symptom, which may be quite variable even in the same surgical procedures. The purpose of this study was to investigate the analgesic effect of far infrared rays on the patients during the postoperative period of total knee arthroplasty (TKA). The selection and application of analgesic methods after the orthopedic surgery are therefore valuable for advanced studies.

DESIGN: The quasi-experimental design with a total five consecutive days of far infrared ray (FIR) thermal therapy was employed in this study.

SUBJECTS: The study involved 41 participants assigned by register code entry on computer to either the intervention or the control group.

INTERVENTION: The FIR pads were applied on the acupoints of ST37 (Shang Chu Hsu), ST38 (Tiao Kou), ST39 (Hsia Chu Hsu), and ST40 (Feng Lung) of the patients involved in the experimental group from the third day to the fifth day after the TKA. Outcome measures: The analgesic effect was evaluated via the pain intensity of the numeric rating scale (NRS) level and serum concentration of interleukin-6 (IL-6) and endothelin-1 (ET-1).

RESULTS: The far infrared rays (FIR) showed that the significant effects are on relieving pain and lowering the levels of IL-6 and ET-1. The results cannot only be the reference for the postoperative pain relief of TKA, but it can also be the database of another clinical application.

CONCLUSIONS: This study demonstrated that thefar infrared rays (FIR)can lower the numeric rating scale of pain and thus reduce the discomfort experienced by the patient. Findings indicated that effective application of far infrared rays (FIR) decreased the serum level of IL-6 and ET-1, which represent the subjective indicator of pain. The results may not only indicate FIR for the postoperative pain relief of total knee replacement (arthroplasty), but it also may be used as a guide for other clinical applications.

Phantom Limb Pain

1. Phantom limb pain treated by far infrared ray.

Conf Proc IEEE Eng Med Biol Soc. 2009;2009:1589-91. doi: 10.1109/IEMBS.2009.5334124.

Huang CY, Yang RS, Kuo TS, Hsu KH.

Source: Department of Electrical Engineering, Biomedical Group, National Taiwan University, Taipei, 10617 Taiwan. chiyuhuang@ntu.edu.tw


We have treated a patient with severe phantom limb pain by a novel far infrared ray (FIR) therapy. The patient has suffered persistent and progressively worsening phantom limb pain after amputation ten years ago. He also experienced severe muscle spasm and twitch of stump during the attacks. His phantom limb pain was excruciating and was rated up to 9 by the Visual Analog Pain Scale. Various pain treatment modalities have been used but in vain, including medications and rehabilitation. He also underwent two episodes of sympathectomy, only achieving short-term effects for three months. Then he underwent our new treatment method.

We applied FIR to the amputated limb site instead of the stump of the patient for 40 minutes for each treatment session twice a week. One month after the FIR treatment, he felt much improved and rated his phantom pain at 4, and down to 2-3 after two months of treatment.

The duration of each phantom limb pain attack has significantly reduced from over 24 hours to only a few minutes or seconds after five months of FIR treatment. During a six-month post-treatment follow-up, his phantom limb pain occurred seldom for only a few seconds at a low 1-2 rating on the pain scale.

The analgesic effect of FIR treatment has prevented him from the scheduled third sympathectomy and the risk of heart attack followed by severe twitch of stump. The results of this study demonstrate an easy, non-invasive and effective treatment modality for phantom limb pain.