Effects of Biofreeze vs. ice on acute, noncomplicated neck pain

Barton Bishop, DPT; Jay Greenstein, DC, CCSP; Bob Topp, PhD, RN

Bart Bishop, DPT, of Sport and Spine Rehab in Rockville, Md., compared Biofreeze topical analgesic and ice application to patients with bilateral neck pain. Bishop stated, “We’ve used both ice and Biofreeze in our neck patients, but never had any evidence to support using one versus the other.”

He found that both modalities reduced pain significantly, but patients preferred the Biofreeze application 8-to-1 compared to ice. The Biofreeze treatment lasted longer in nine out of 10 patients, with twice as much pain reduction compared to ice.

“Now that we know how effective Biofreeze is, we are going to continue including it as a standard treatment for neck pain patients and start investigating its effectiveness in other patient populations. We also think that using Biofreeze can help improve patient compliance and retention as so many more of them felt comfortable with the treatment.”

Dr. Bishop presented his findings at the TRAC 2009 meeting in Cancun, Mexico.

Methods: Fifty-one males and females between the ages of 19 and 65 (37 +/- 11.2 years) with bilateral nonradicular, acute neck pain (myalgia) were given both ice and the topical analgesic Biofreeze on each side of the neck. The patients had no history of surgery in the neck nor had received a cortisone injection in the neck in the last year.

The study was randomized so that the ice was on the left side of the neck and Biofreeze Pain Reliever was on the right side or vice versa. Thus, both sides of the neck had one cryotherapy modality. The patients were asked to rate their pain on a zero to 10 visual analog scale (VAS) for each side of the neck both before and immediately following the 10-minute treatment.

In addition, the patients were asked to answer two questions about which modality they would use in the future for pain control and the level of comfort of each modality during its application on a five-point scale (1 = very unlikely or very uncomfortable and 5 = very likely or very comfortable).

Finally, the patients were asked the following day to pick whether they preferred ice or Biofreeze and to pick which modality had a longer lasting effect.

Results:  Overall, when asked to rate the comfort and preference, patients preferred Biofreeze 8-to-1 (p=0.000). The average score on the five-point Likert scale was 4.20 for Biofreeze and 2.57 for ice.

In addition, nine out of 10 subjects reported that Biofreeze lasted longer (p=0.000). Further, the average score on the five-point Likert scale was 4.47 to 2.63 for Biofreeze and ice respectively. For actual levels of pain change, the average pre-treatment VAS score went from 6.24 to 3.65 for Biofreeze and from 6.31 to 5.00 for ice.

A paired t-test demonstrated that both ice and Biofreeze had a significant reduction on pain levels (p = 0.000); however, there was nearly two times the reduction of pain on the Biofreeze side.

Conclusions:  Both ice and Biofreeze significantly decreased pain levels; however, Biofreeze decreased pain nearly two times as much as ice.

In addition, it was rated as substantially more comfortable, patients preferred it, and it lasted longer nine out of 10 times. This is the first study to evaluate solely the immediate effects of two different cyrotherapy methods and as such it is not unexpected that the results of this study would differ slightly from other published studies evaluating menthol products.

Conservative care specialists are often looking for methods to improve patient satisfaction and compliance and with the results significantly favoring Biofreeze this is recommended as the primary method of cryotherapy application on the first visit.

Future considerations: More studies are needed to determine whether this short term effect can be extrapolated to long term improvement in outcomes, improved patient satisfaction and improved patient compliance.

This research was provided by Hygenic/Performance Health

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