The difference appeared later
Warm compression applied to the lower back was linked to lower pain scores at later checks in a randomized trial of 50 women during the first stage of labor. The difference was not statistically significant before treatment or immediately after the first application, but it was significant after the second application and at a check 30 minutes later.
On the study's visual analogue scale, a line-based way of rating pain, mean pain intensity after the second compression was 50.64 millimetres in the warm-compression group, compared with 63.60 millimetres in the routine-care group. At the final check, the means were 46.76 and 76.32 millimetres, respectively. The reported p-values were 0.005 and 0.001, below the study's significance threshold of 0.05.
Pain also fell across the series of measurements within the warm-compression group. The trial's repeated-measures analysis reported a significant decrease over time, with an F statistic of 367 with 3 degrees of freedom and a P-value below 0.001.
What the trial tested
The trial recruited 50 women, with 25 assigned to each group, at a tertiary hospital in central India. Recruitment used convenience sampling and took place from October to November 2023. Participants were allocated using sequentially numbered opaque sealed envelopes, while the control group received routine obstetrical care.
The intervention was a folded cloth made from 100% cotton and dipped in water heated to 50 to 60 degrees Celsius; its temperature was checked before each application. It was placed at L5-S1, the lumbosacral region, twice for 20 minutes, with a 30-minute interval between applications during active labor.
Pain was measured before the intervention, immediately after the first and second compressions, and 30 minutes after the second. The researchers also compared the groups at the start of the trial and found them comparable in demographic and clinical characteristics.
To analyze the pattern over time, the researchers used two-way repeated-measures analysis of variance, or ANOVA, with Bonferroni comparisons for follow-up tests. They treated p-values below 0.05 as statistically significant, and used chi-square or Fisher's exact tests for associations.
A useful result with a narrow reach
The distribution of pain categories pointed in the same direction at later assessments. Mild pain made up 40.0% of the warm-compression group after the first application and 36.0% at each of the next two assessments. In the routine-care group, severe pain accounted for 24.0% at the second post-test and 60.0% at the third.
No adverse events or skin injuries were observed during the intervention period. That is a narrow evidence base: the trial involved 50 women at one tertiary hospital, recruited through convenience sampling, so the findings may not transfer directly to every maternity setting.
Pain was followed only through the check 30 minutes after the second compression, so the trial did not establish longer-term effects. The authors concluded that warm compression may reduce first-stage labor pain and may be a promising adjunct to routine nursing and midwifery care.
Paper data and sources
Original title: Effectiveness of Warm Compression at the Lumbosacral Region on Labor Pain Intensity During the First Stage of Labor Among Parturient Women: A Randomized Controlled Trial
Authors: Patel S, Podder L, Bhardwaj G, Halder A
Journal/Repository: Cureus
Status: Peer-reviewed
First online: 2026-10-07
DOI: Not available
Original paper · Full text