Superficial Heating Agents

Paraffin Wax - Treatment Parameters: 1

Temp of the paraffin mixture should be maintained between 113-126 deg. Fahrenheit (45-52 deg. Celsius). * There are three methods of paraffin application: dip-wrap, dip-reimmersion, or paint application

Paraffin Wax

* Is the most commonly used superficial heating agent of the distal extremities. It has the ability to maintain contact over all contoured areas and due to the low specific heat/slower conduction - it does not feel as hot as water at the same temp. Paraffin is easy to use, inexpensive, and can be used at home, however, it cannot be used over open areas

Infrared Lamp (IR) - Treatment Parameters

* The patient should be positioned approx. 20 inches from the source. A moist towel should be placed over the treatment area and the skin should be monitored intermittently throughout treatment. * The standard formula indicates 20 inches in distance should equal 20 minutes of treatment. As the distances decreases, the intensity will increase, and the time of total treatment should decrease.

* Contraindications

1. Circulatory Impairment 2. Area of malignancy 3. Acute musculoskeletal trauma 4. Bleeding or hemorrhage 5. Sensory impairment 6. Thrombophlebitis (vein inflammation related to a blood clot) 7. Arterial disease

Therapeutic Effects

1. Increases temperature, 2. Increase blood flow to the treated area. 3. Decrease nerve conduction latency, 4. Temporarily decrease muscle strength, 5. Increase pain threshold, 6. Increase edema, 7. Vasodilation, 8. Increase nerve conduction velocity, 9. Increase metabolic rate, 10. Increase muscle elasticity, 11. Increase collagen extensibility, 12. Decrease tone

Indications

1. Pain control 2. Chronic inflammatory conditions 3. Trigger point 4. Tissue healing 5. Muscle spasm 6. Decreased range of motion 7. Desensitization

Paraffin Wax - Treatment Parameters: 3

5. Using the dip-reimmersion method, place the distal extremity back into the paraffin bath after the initial 6-10 dips and allow it to remain for the duration of the treatment: up to 20 minutes 6. The paint method is used for body parts that cannot be immersed into the paraffin bath. A layer of paraffin is painted on the body with a brush. After a few seconds: 6-10 additional layers are applied and a plastic wrap is placed over the paraffin with towel on top to insulate the treatment area. 7. Removal of the paraffin is the same for all forms of application. Paraffin should be peeled off after treatment and placed back into the container to melt or simply be discarded

Hot Pack - Treatment Parameters

A hot pack must be stored in hot water between 158-167 deg. Fahrenheit (70-75 deg. Celsius). * Application requires 6-8 layers of towels around the hot pack. The hot pack should be applied on top of the patient. If the patient lies on top of the hot pack additional towels are required. * Skin checks are required after 5 minutes for excess redness or signs of a burn. A patient must have a call device to notify the therapist of discomfort. * Hot packs require approx 20 min. to achieve the desired effects

Hot Pack

Consists of a canvas or nylon covered pack filled with hydrophilic silicate gel that provides a moist heat. The size and shape of the hot pack varies depending on the size and contour of the treatment area. A hot pack is easy to use, inexpensive, and can cover large area. The main therapeutic effects include soft tissue healing, promoting relaxation, and decreasing pain/stiffness. Disadvantages include the need for close monitoring of the skin, the inability to maintain total contact, and the inability to move during treatment

Fluidotherapy

Consists of a container that circulates warm air and small cellulose particles. The extremity is placed into the container and dry heat is generated through the energy transferred by forced convection. The therapeutic effects include promotion of tissue healing, skin desensitization, and prevention of edema. Fluidotherapy allows for active movement during treatment and constant treatment temperature., however, is expensive and may require the extremity to be placed in a dependent position

Infrared Lamp (IR)

Produces superficial heating of tissue through radiant heat. * This form of heating is usually limited to penetration of less than 1-3 millimeters. Infrared does not require contact with the area to be treated and allows for constant observation, however, it requires skill to localized a treatment sits *The main therapeutic effect is the enhancement of soft tissue healing. The used of infrared is declining due to the limited depth of penetration, dehydrating effects on wounds, and the risk of burns treatment

Fluidotherapy - Treatment Parameters

The body part to be treated should be placed in the fluidotherapy unit prior to turning the machine on. The temp should be set between 111-125 deg. Fahrenheit (44-52 deg. Celsius) and the degree of agitation should be adjusted to patient temperature * Treatment time is usually 20 min. A protective covering is required for any open area

Paraffin Wax - Treatment Parameters: 2

The distal extremities utilize the dip-wrap or dip-reimmersion methods. 1. The patient's skin should be dry and clean prior to treatment. 2. The patient is required to maintain a static position as the distal extremity dips into the paraffin bath and is removed. 3. Wait a few seconds for the paraffin to harden and redip 6-10 times using the dip-wrap method. 4. Next, place a plastic bag over the extremity with a towel around it to insulate and maintain heating for approx. 15-20 minutes