I have tried various heat pads (both direct-to-skin and over-the-clothes varieties) and the Thermacare Wrap comes top on all counts.
*It goes straight to the skin, so the heat is applied directly and exactly where you want it.
*The belt is very comfortable and enables you to move the activated charcoal section around or remove it to shower and then replace it.
*The belt eliminates the need for adhesive on the pad which can introduce an 'ouch!' factor when it is removed (as if you weren't in enough pain already!)
*The pad is significantly warm and comforting, unlike some pads which appear to radiate virtually no warmth at all.
*The small price premium you pay is, in my opinion, well worth it, (and shop around, as prices differ). When your back is playing up any relief is welcome and this product has helped me when others have made little or no difference; clearly a case of getting what you pay for.