Ice massage and transcutaneous electrical stimulation: Comparison of treatment for low-back pain

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Abstract
Ice massage of the web between the thumb and index finger was recently used to produce significantly greater relief to dental pain than a placebo control procedure. Ice massage may be comparable to transcutaneous electrical stimulation (TES) and acupuncture and may be mediated by similar neuronal mechanisms. The relative effectiveness of ice massage and TES for the relief of low-back pain was investigated. Patients suffering chronic low-back pain were treated with ice massage and TES. The order of treatments was balanced and changes in the intensity of pain were measured with the McGill Pain Questionnaire (MPQ). Both methods were equally effective; based on the pain rating index of the MPQ, 67-69% of patients obtained pain relief greater than 33% with each method. Ice massage apparently is an effective therapeutic tool and seemed more effective than TES for some patients. It may serve as an additional sensory-modulation method to alternate with TES to overcome adaptation effects. Evidence that cold signals are transmitted to the spinal cord exclusively by A-.delta. fibers and not by C fibers suggests that ice massage provides a potential method for differentiating among the multiple feedback systems mediating analgesia produced by different forms of intense sensory input.