Heat Tones Down Central Nervous System Pain

by Kristin Thorson, Fibromyalgia Network Editor
Posted: October 31, 2007

Intuitively, heat is soothing for sore muscles, it helps them relax. In fact, heat was the number two nondrug therapy identified in a 2004 survey of Fibromyalgia Network Members. But, can the application of heat realistically tone down the central nervous system pain that is the hallmark of fibromyalgia? Based on recently published data on patients with low back pain, the answer is “yes” and heat will even help with sleep.1

A team in Germany used brain electroencephalogram (EEG) activity as an objective measure of the amount of noxious signals bombarding the brain due to the painful muscles in the lower back. By recording EEG activity, the researchers were able to detect whether the pain processing load in the central nervous system declined with use of heat applied to the lower back. This is of particular interest for people with fibromyalgia because signals entering the central nervous system are amplified, leading to an enhanced pain state. Although medications that target this central nervous system pain are usually prescribed, side effects often limit the dose that fibromyalgia patients can tolerate.

Identifying nondrug therapies that are capable of reducing the noxious signals into the central nervous system, but with little or no side effects, would greatly benefit people with fibromyalgia. Such therapies could be used in addition to medications to help tone down the pain.

The study consisted of two groups, each with 15 people complaining of low back pain. The control group received a bottle of a nonsteroidal anti-inflammatory drug (NSAID, such as ibuprofen) and were told they could take the medication for pain, if needed. The treatment group received four heat wraps, one to be worn each day for up to 8 hours during the next four consecutive days. In addition, this group also received the same NSAID with instructions that they may take it for pain, if needed. Subjects also completed questionnaires each day to evaluate pain, sleep, stress, work performance, and relaxation level.

All participants returned to the study center on day 2 and day 4 so that the researchers could measure their EEG activity. The amount of brain activity detected by the EEG at the highest end of the frequency range was tallied for each participant. Brain signals at the high frequency represent alerting and stressful stimuli, which is an objective measure of the relative degree of pain a person is experiencing. A drop in this value indicates that fewer noxious signals are entering a person’s central nervous system to produce pain.

Not only did the high frequency EEG values drop significantly for the heat wrap group, this objective reduction in pain occurred mostly during the first two days. Compared to the control group, the authors state, “the heat wrap therapy was more effective in reducing pain, decreasing stress at work, and increasing quality of sleep.”

Although people with fibromyalgia hurt all over, a patient’s most painful area can be the driving factor for determining a person’s overall pain level.2 Applying heat to the region of most intense pain may not only “feel good,” it can also bring down your fibromyalgia pain to more tolerable levels. And, if the widespread pain is keeping you awake at night, take a long hot bath or shower just before bedtime (better yet, sit in a hot tub). For local pains, apply topical heat to the area during the day or at night (e.g., microwavable heat wraps, heating pads, or ThermaCare wraps by Procter and Gamble).

1. Kettermann B, et al. Clin J Pain 23(8):663-8, 2007.
2. Staud R, et al. Rheumatology 45(11):1409-15, 2006.

9 Responses to Heat Tones Down Central Nervous System Pain

  1. Mena says:

    Until I found this I thought I’d have to spend the day inside.

  2. heather Sward says:

    I received an electric blanket for Christmas. It is amazing. I truely think it helps, I’m a night owl so for a couple hrs before bed I lie on it watching Tv or reading and I can’t believe how I can just stand up and go upstairs to bed, with ease. I’m not saying everytime, but more so then not. It used to take everything I had to walk up the 11 stairs to my room.

  3. jackie says:

    Yesterday I was in extreme pain, my head pain was a ten. I used a heated pad, tens on my shoulders and finally took a hot bath for 1 hour. That made the pain bearable enough to sleep. I can not take nsaids. I was on a cough med with codeine that did nothing for the pain at that time. Heat really does work!

  4. Paula says:

    Heat therapy has always been my main source of relief from the pain of FM. I have tried so many medications without success and finally turned to nonmedication therapy. Heat, Rest, gentle Yoga and meditation/prayer. I am on disability as my FM makes it impossible for me to continue working. I am sitting here with a heating wrap on my neck and shoulders now!

  5. Marilynne Rowland says:

    The microwaveable heat wraps (acts like moist heat) have been my life saver for 15+ years! Before I had ever heard of Fibro I was using them. My daughter even gave me a heated seat for my car for Christmas. We only stay at hotels where I can have a microwave to heat them. Cannot go to sleep at night without one one my feet and one on my shoulders, even in summer.

  6. Gloria says:

    I am using an electric mattress pad. It is definitely helping my sleep and pain.

  7. Gloria says:

    I cannot take NSAIDs and couldn’t, turn over in bed without pain. I can get up easier now too.

  8. Misty says:

    I take about a 3-4 hour bath with hot hot water when my legs really act up. I usually refil half way into it if the temp drops but I make that bath almost pure hot water ….strange tolerance for heat I have when I am in pain but my family thinks I’m half nut that I am in a bath so long and check to make sure I haven’t drowned. While I’m in there I have no clue I am there for than many hours.

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