NEW YORK (Reuters Health) - Local active warming of the abdomen and lower back decreases pain, nausea and anxiety in patients with acute renal colic, researchers at the University of Vienna, Austria, report.

Dr. Alexander Kober and associates enrolled 100 patients with symptoms of urolithiasis and a positive medical history of kidney stones as they were being transported to hospital. Patients were randomly assigned to active warming using a heating pad set to 42 degrees C or to placebo treatment with unactivated heating pads alone. Study findings are reported in the Journal of Urology for September.

All 36 patients subsequently diagnosed with urolithiasis and who underwent active warming reported a decrease in pain of more than 50% on a 100-mm visual analog scale (VAS) between start of treatment and arrival at the emergency room, from 81.8 mm to 36.3 mm. Anxiety scores decreased from 79.0 to 30.7, and nausea declined from 85.7 to 40.6.

In contrast, VAS scores among patients in the placebo group remained comparable between treatment initiation and hospital arrival. Once at the hospital, the active treatment subjects' VAS ratings were significantly lower than those in the placebo group (p < 0.01 for each rating).

Moreover, heart rate decreased significantly after active heating, from 91 to 69 beats per minute. No such decrease was observed after use of unactivated heating pads. "Well performed local warming, even done by a nonphysician, is a rapid and effective treatment for pain caused by kidney stones," Dr. Kober's team concludes.

They caution, however, that vasodilation subsequent to heating could decrease blood pressure or increase the blood loss in patients with intra-abdominal bleeding.

J Urol 2003;170:741-744.

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