Thermotherapy Flashcards
What are the different ways to apply thermotherapy?
- Moist hot packs (hydrocollator)
- Warm Whirlpool
- Paraffin
- Fluidotherapy
- Contrast bath
- Heat lamps
- (topical counterirritants)
What are the mechanisms of heat transfer for thermotherapy?
Conduction, Convection, Radiation and Conversion
What is conduction?
• Direct contact
– Heat (or cold) applied directly to the skin
What are examples of conduction?
– Hydrocollator packs
– Paraffin bath
What is convection?
Air or water particles move across the body part causing heating (or cooling)
What are examples of convection?
– Whirlpool
– Fluidotherapy
What is radiation?
• Transfer of heat from a warmer surface to
a cooler though air.
What is an example of radiation thermotherapy?
-Infrared lamps
What is conversion?
Heat generated from another energy form.
What are examples of conversion thermotherapy?
– Ultrasound
– Diathermy
What does recent evidence say about superficial heat?
Recent evidence says not just superficial
• Heating of
– Skin and small joints
– Deeper muscles: quadriceps, hamstring?
– Sub Q fat and skin pain makes deep heating
difficult
• NBCE
– Still “deep heat” for US and diathermy
– Other EPAs by name (hot pack, paraffin, etc)
What does thermotherapy help with?
- Pain relief
- Causes a calming or sedating effect
- Spasm reduction
- Increased mobility
How does thermotherapy reduce spasm?
– Decreasing gamma motor neuron activity
How does thermotherapy increase mobility?
– Decreased joint viscosity
– Decreased viscoelasticity of muscle, tendon, and
ligaments
Thermotherapy may be better than ______ at creating an analgesic effect
Ibuprofen
_____ duration low level heat can be
beneficial in the treatment of low back pain
Long
Shorter duration moist heat may help
reduce ________ pain
Myofacial
What are the indications for thermotherapy?
• Decrease pain – Neck, back, shoulder • Decrease muscle spasm • Osteoarthritis • Rheumatoid arthritis
What are the contraindications for thermotherapy?
• Areas of impaired heat sensation • Malignancy • Thrombophlebitis • Hemorrhage • Abdomen, pelvis, low back in pregnancy • Acute inflammation/inflammatory conditions • Confused and unreliable patients
What are the precautions for thermotherapy?
• Impaired circulation • Over wounds • Severe cardiac insufficiency • Over superficial metal implants • May cause decreased motor skill and reaction time • Can increase fever
What is the temperature of the hydrocollator?
158-169 degrees F or 70-70 degrees C
How many layers of towels do you need between the patient and the hot packs?
6-8
T/F: The patient is allowed to lay on the heat packs.
FALSE
Maximum Whirlpool
Temperature by Body Part: Wrist and Hand
112 F
Maximum Whirlpool
Temperature by Body Part: Foot and Ankle
110 F
Maximum Whirlpool
Temperature by Body Part: Elbow
108 F
Maximum Whirlpool
Temperature by Body Part: Knee
106 F
Maximum Whirlpool
Temperature by Body Part: Thigh
104 F
Temperature of water MUST be _____ if the size of the body area being treated is_______.
Lower, Bigger
Describe the Paraffin-Dipping technique
• Application – Check area for contraindications – Remove all jewelry, watches, etc – Wash extremity with soap and water – Dip extremity into paraffin wait until shiny – Re-dip 6-10 times – Place extremity into a plastic bag – Apply toweling to hold heat in – Tx time: 30 minutes – Remove toweling, plastic, bag, and wax. – Return wax to paraffin bath
Describe the Paraffin-Immersion technique
• Application – Check for contraindications – Remove jewelry, watches, etc. – Wash extremity – Dip extremity until shiny – Redip 6-10 times – On 10th time place extremity back into paraffin bath for duration of treatment – Tx time 30 minutes – Remove from bath and return wax – Watch for burns
Describe the Paraffin-Brushing technique
• Application – Check for contraindications – Remove jewelry, watches, etc. – Use a standard paint brush to apply paraffin – 7-10 layers – Wrap or cover in plastic and layer of towels – Tx time: 30 minutes – Remove towel, plastic, and wax. – Return wax to paraffin bath
How do you use fluidotherapy?
• Application: – Check for contraindications – Position patient comfortably – Place injured area into machine – Use toweling at the interface between machine and body segment – Tx time: 30 minutes – Can do active exercises within machine
Inverse square law
Intensity varies with the inverse square of the
distance between the bulb and the skin
– E.g. Change from 20 cm to 10 cm = ½ distance
– Inverse of ½ = 2
– Square of 2 is 4
– Therefore 4X more heat with half the perpendicular distance
The cosine law
Intensity of heat
decreases with change
from perpendicular
– E.g. Rotate 30 degrees from perpendicular
– Cosine of 30 degrees = 86
– Therefore intensity of heat at 30 degrees is 86% of original intensity
What phase is contrast bath used for?
Subacute phase
T/F: Contrast bath is good for the treatment of swelling?
False; – Does not cause pumping of capillaries unless active
exercise
Is contrast bath a deep or superficial modality?
Superficial; Length of treatment does not allow for deep penetration
What are examples of topical counterirritants?
Biofreeze, Icy Hot, Ben Gay, etc.
How are topical counterirritants thought to inhibit pain?
Thought that A-delta and c-afferent fibers
inhibit pain
