Lecture #11 (Thermotherapy, Hot & Cold Combinations, and Counterirritants)

Question 1

What are some indications for heat?

Answer 1

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

Question 2

What type of injuries do we usually use heat for?

Answer 2

Subacute and chronic

Question 3

What are the effects of thermotherapy?

Answer 3

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).

Question 4

How does heat produce analgesia?

Answer 4

The temperature variance between the superficial surface and the deeper, cooler injured area.

Question 5

How does heat increase blood flow?

Answer 5

Sympathetic response causes vasodialtion so heat is dissipated so blood flow is increased.

Question 6

What defines a subacute injury?

Answer 6

2-3 days up to a week post-injury.

Question 7

What is the most common reason for the application of heat?

Answer 7

Pain

Question 8

What should be the water temperature for a hydrocollator?

Answer 8

160-170 degrees

Question 9

How many layers of toweling should be used with a hot pack for protect the patient?

Answer 9

6 layers

Question 10

What should the temperature of a whirlpool be for an extremity? Full body? Treatment time?

Answer 10

Extremity= 98-108 degrees
Full body= 98-102 degrees
15-20 minutes

Question 11

True or false,

A patient can be left unattended while in a warm whirlpool.

Answer 11

False, there is the risk that they could pass out.

Question 12

What is a paraffin bath used for?

Answer 12

Providing relief from dry skin and heating effects for the hands and feet.

Question 13

What should the temperature of a paraffin unit be? How many times should the body part be dipped into the wax? Treatment time?

Answer 13

126 degrees
6 times
20-30 minutes

Question 14

How far away is the patient positioned from a heat lamp?

Answer 14

20 inches

Question 15

When using an infrared heat lamp, should dry or wet towels be used to help effects?

Answer 15

Both: wet will help create better, more even heating while dry can be used to block heat from unwanted areas.

Question 16

What are the contraindications of heat?

Answer 16

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.

Question 17

What has contrast baths shown to be effective in treating?

Answer 17

DOMS

Question 18

Contrast baths do not produce deep effects, but they produce:

Answer 18

• vasodialation and vasoconstriction
• pain or spasm relief
• desensitization of tissues due to hot/cold sudden change

Question 19

For a contrast bath, what are the parameters–time, water temps, and ratios?

Answer 19

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

Question 20

True or false:

Counterirritants are an infrared modality.

Answer 20

False

Question 21

What do counterirritants do?

Answer 21

Cause sensory receptors in the skin to fire (so there’s only superficial effects- 1mm of penetration)

Question 22

What are the active ingredients in counterirritants?

Answer 22

Menthol, methyl salicylate, camphor, and capsaicin

Question 23

True or false:

The massage from counterirritant application is more beneficial to the patient than the counterirritant itself.

Answer 23

True

Question 24

Counterirritants produce a noxious stimulus (either hot or cold). What do they stimulate?

Answer 24

• A-delta fibers
• C-afferent fibers
• Capsaicin may also slow or stop the production of substance P