Cold Gel Reduced Pain and Disability in Minor Soft-Tissue Injury.

In patients with sports-related soft-tissue injury, is cold gel more effective than placebo in reducing pain and disability? Randomized (allocation concealed), blinded (clinicians and patients), controlled trial with 28-day follow-up. A university hospital in Kuopio, Finland. 74 patients (mean age, 32 yr; 64% men) who had sustained a sports-related soft-tissue injury of the ankle, leg, knee, or hand within the previous 48 hours. Exclusion criteria were a pain score of <30 mm on the visual analog scale (VAS); pregnancy; the presence of cutaneous lesions or injuries at the site of application, thus precluding the use of gel therapy; or an injury in need of surgery or physiotherapy. Complete follow-up was achieved for 73 patients (99%). Patients were allocated to receive the active cold gel (Ice Power; Fysioline, Tampere, Finland) 4 times per day for 14 days (n = 37) or a placebo gel (n = 37). The gel was applied with the fingers by way of a slight massage. The active cold gel consisted of 3.5% menthol and 8% ethanol and adjuvants. The placebo gel contained no menthol or ethanol. Pain at rest, pain on movement during normal function, and functional disability. Secondary outcome measures were the patients' and investigators' global assessment and satisfaction with the treatment. All outcomes were measured with the 100-mm VAS (0 = no pain or disability and 100 = extreme pain or disability). Analysis was by intention to treat. Pain at rest and pain on movement decreased more in the cold-gel group than in the placebo group (Table). The difference favored the cold-gel group at each week of follow-up. The change in score in terms of functional disability also favored the cold-gel group more than the placebo group (the change in score from the baseline to 7 days was 63 to 31 for the cold-gel group compared with 62 to 48 for the placebo group; p < 0.001). Patients in the cold-gel group expressed more satisfaction with the results of treatment than did patients in the placebo group (VAS score, 71 for the cold-gel group compared with 44 for the placebo group; p < 0.001). The global assessment scores of the patients and the investigators also favored the cold-gel treatment. For patients with sports-related soft-tissue injury, cold gel was more effective than placebo gel in reducing pain and disability. [ABSTRACT FROM AUTHOR]