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The effect of cryotherapy vs dynamic compression on pain and range of motion in acute low back pain patients following short-term Physical Therapy?

Jena Etnoyer-Slaski, Jay Greenstein, Robert Topp

Background: Low Back Pain (LBP) is a common and persistent health problem with increasing prevalence. Treatment for this condition commonly includes physiotherapy with the complimentary therapies of cryotherapy or massage. External Pneumatic Compression (EPC) devices have been developed to administer massage-like therapy. Both cryotherapy and massage have been demonstrated to reduce pain and may improve joint range of motion. Purpose: The purpose of this study was to compare pain and back Range of Motion (ROM) measures among patients with LBP who received either cryotherapy or EPC immediately following three sessions of physiotherapy. Methods: A randomized 2-group pretest-posttest study design examined LBP patients who received either cryotherapy (n=20) or EPC (n=16) immediately following their first three weekly sessions of physiotherapy. Back pain and four measures of back ROM were measured prior to beginning physiotherapy and immediately following the third session of physiotherapy. Immediately following each supervised physiotherapy sessions all participants participated in either cryotherapy or EPC. The cryotherapy group had a cryotherapy pack placed on their low back for 20 minutes. EPC group members were placed in an EPC hip attachment which fit over their lower back, pelvis, and thighs bilaterally. This device produced intermittent compression massage of the quads, hamstrings, IT bands, glutes, and lower back for 20 minutes. Results: Most of the participants in the cryotherapy (75%) and the EPC (80%) groups reported declines in pain beyond the minimal clinically important difference although only the cryotherapy group exhibited a statistically significant decline (p=.01) in their back pain. The cryotherapy group did not change ROM while the EPC group improved (p<0.05) all four of the back ROM measures over the duration of the study. Conclusion: Both cryotherapy and EPC following physiotherapy sessions can produce clinically important reductions in pain while only EPC resulted in improvements in back ROM.