Lecture #11 (Thermotherapy, Hot & Cold Combinations, and Counterirritants) Flashcards
What are some indications for heat?
subacute/chronic inflammatory conditions and pain, subacute edema removal, decreased ROM, resolution of swelling, trigger points, muscle guarding, muscle spasm, muscle strain, ligament sprain, contusion
What type of injuries do we usually use heat for?
Subacute and chronic
What are the effects of thermotherapy?
Increased circulation, increased cell permeability, increased skin nutrition, vasodilation, analgesia, relaxation of muscle spasm, lessens threshold for muscle spindle, connective tissue elasticity increases, increased medabolism, and hyperemia (redness-pooling of blood in area).
How does heat produce analgesia?
The temperature variance between the superficial surface and the deeper, cooler injured area.
How does heat increase blood flow?
Sympathetic response causes vasodialtion so heat is dissipated so blood flow is increased.
What defines a subacute injury?
2-3 days up to a week post-injury.
What is the most common reason for the application of heat?
Pain
What should be the water temperature for a hydrocollator?
160-170 degrees
How many layers of toweling should be used with a hot pack for protect the patient?
6 layers
What should the temperature of a whirlpool be for an extremity? Full body? Treatment time?
Extremity= 98-108 degrees
Full body= 98-102 degrees
15-20 minutes
True or false,
A patient can be left unattended while in a warm whirlpool.
False, there is the risk that they could pass out.
What is a paraffin bath used for?
Providing relief from dry skin and heating effects for the hands and feet.
What should the temperature of a paraffin unit be? How many times should the body part be dipped into the wax? Treatment time?
126 degrees
6 times
20-30 minutes
How far away is the patient positioned from a heat lamp?
20 inches
When using an infrared heat lamp, should dry or wet towels be used to help effects?
Both: wet will help create better, more even heating while dry can be used to block heat from unwanted areas.
What are the contraindications of heat?
Acute musculoskeletal injury, impaired circulation, skin anesthesia, malignincies, CAD, hemmorrhagic areas, over abdominal, pelvic, and low back areas of prego ladies, confused patients, open wounds, and if edema is present and you’re unsure of cause.
What has contrast baths shown to be effective in treating?
DOMS
Contrast baths do not produce deep effects, but they produce:
- vasodialation and vasoconstriction
- pain or spasm relief
- desensitization of tissues due to hot/cold sudden change
For a contrast bath, what are the parameters–time, water temps, and ratios?
Time= 16-20 minutes
Temps (cold = 50-60 degrees; hot= 104-106 degrees)
Ratio: 3:1 or 4:1 (minutes of warm:cold)
*typically end with treatment that is most beneficial
*check for swelling post-treatment
True or false:
Counterirritants are an infrared modality.
False
What do counterirritants do?
Cause sensory receptors in the skin to fire (so there’s only superficial effects- 1mm of penetration)
What are the active ingredients in counterirritants?
Menthol, methyl salicylate, camphor, and capsaicin
True or false:
The massage from counterirritant application is more beneficial to the patient than the counterirritant itself.
True
Counterirritants produce a noxious stimulus (either hot or cold). What do they stimulate?
- A-delta fibers
- C-afferent fibers
- Capsaicin may also slow or stop the production of substance P