Effects of Biofreeze and chiropractic adjustments on acute low back pain: a pilot study.

Objective
The specific aims of the study were to study the effectiveness of Biofreeze combined with chiropractic adjustments on acute low back pain (LBP) compared with chiropractic care only. The hypothesis was that Biofreeze enhances the effect of chiropractic adjustments on acute LBP.

Methods
The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. For at-home care, subjects were instructed to apply Biofreeze 3 times a day as follows: Using a 5-g sample pack, subjects were instructed to apply Biofreeze to the low back once in the morning and 2 times in the afternoon. For evening application, subjects were instructed to apply once in the late afternoon, once in the evening, and once at bedtime. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity.

Results
A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P < .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P > .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups.

Conclusion
Biofreeze combined with chiropractic adjustment showed significant reduction in LBP. Biofreeze cooling gel gives rise to the cooling sensation without lower skin temperature because of the unique characteristic of menthol, which is one of the main ingredients. It is clear that the cooling effect of Biofreeze is different from the application of cold. It is possible that menthol stimulates the peripheral sensory receptors to inhibit pain through the gate control mechanisms.

Original article by: Zhang J, Enix D, Snyder B, Giggey K, Tepe R. J Chiropr Med. 2008 Jun;7(2):59-65.

Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland