WAX BATH:
It is learnt the benefits of thermal effects on the human body. By this method heat can be applied on the affected part smoothly and safely for perfect contact of the skin. When the affected part is immersed into the wax then that part is surrounded by the melted wax (Mixture of wax and paraffin) then the part is wrapped by a polythene paper for 20 to 30 minutes for absorption of heat in the tissues.
Rectangular mobile wax bath is being used for storing and melting of wax at desired temperature level. The glass wool insulated double wall device is available in two different sizes i.e. 14"x9"x7" and 20"x14"x10". The whole unit is made of glossy Aluminium. The unit is designed with concealed heaters to reduce the recurring cost of wax.
After removal of wax start active movement as soon as possible, in case of restricted movement start passive movement at maximum extent. When a shoulder, neck or back is to be treated the wax can be painted on the part with a brush. The wax coating can be kept in place for several hours, thereby maintaining hyperemia. Patient can prepare at home by collection of pure bees wax and liquid paraffin in a container. The mixture must be 7 : 1 wax and paraffin and the temperature 120°F.This penetrating heat relieves pain and stiffness, optimal for patients suffering from arthritis, bursitis, muscle spasms and chronic joint inflammation.
Uses: It may be used in: Rheumatoid arthritis, Sudeck's atrophy & in case of restricted movement of phalangeal joints (interphalangeal joints of hand, the hinge synovial joints between the phalanges of the fingers).
Contraindications: it should not be used if the area to be treated has Open wounds, Cuts, Burns, Skin rashes.
INFRARED IRRADIATION:
Vant's Hoffs Law: Any chemical change capable of being accelerated by heat is accelerated by rise in temperature. Dilatation of the capillaries and arterioles in the superficial tissues. This is due to the direct effects of heat. Heat irritates the superficial sensory nerve ending which causes reflex vasodilatation.
Mid heating has sedative effect on the sensory nerve ending, but stronger heating irritates the superficial sensory nerve endings and relieves pain by counter-irritation. Pain may be due to the accumulation of waste products in tissues and increased flow of blood through the part removes the waste products and so relieves the pain. When the tissues are warm and relief of pain facilitates relaxation and relief of muscle spasm associated with injury or inflammation.
Indications:
It can be used in rheumatoid arthritis, anterior poliomyelitis colles fracture, Volkmann's ischemic contracture, torticollis (disorders that exhibit flexion, extension, or twisting of muscles of the neck beyond their normal position.), stiff joints (peripheral) due to fracture or any recent trauma, in case of paraplegia and in hemiplegia (paralysis of one half of a patient's body).
It is an object of the present invention to provide improved techniques for evaluating and treating nerves with penetrating infrared irradiation in order to normalize their function thereby alleviating chronic pain.
A randomized controlled trial on the efficacy of exercise for patients with chronic neck pain were given infrared irradiation and neck care advice. In addition to infrared irradiation and advice, patients in the exercise group had undergone an exercise program with activation of the deep neck muscles and dynamic strengthening of the neck muscles for 6 weeks. At week 6, patients with chronic neck pain can benefit from the neck exercise program with significant improvement in disability, pain, and isometric neck muscle strength in different directions.
Contraindications:
Infra-red-irradiation should not be applied to areas with a defective arterial blood supply, or where there is danger of hemorrhage. It is unwise to apply infra-red-irradiation where the skin sensation is defective.
SHORTWAVE DIATHERMY:
The principal effect of the short wave diathermy and ultrasound current in the body is production of heat in the tissue which results in the rise of temperature. Heat is accelerated by rise of temperature, consequently heating of tissue accelerates the chemical changes, i.e. the metabolisms.
As a result of the increased metabolism the output of waste products from the cell is increased. This includes metabolites, which acts on the wall of the capillaries and arterioles, causing DILATATION OF THE VESSELS.
Shortwave diathermy - produces an electromagnetic field which generates heat within tissues. This helps healing, reduces swelling and offers pain relief. It is useful for treating soft tissue injuries, slow healing wounds, sinusitis and conditions affecting the pelvic area. Shortwave (SW) diathermy can be used in patients with knee osteoarthritis can significantly reduce both synovial thickness and knee pain.
The heat has a direct effect on the blood vessels, causing vasodilatation, particularly in superficial tissues. Stimulation of superficial sensory nerve ending can cause a reflex dilatation of arterioles as a result of vasodilatation there is increased flow of blood through the area. So that the necessary oxygen and nutritive materials are supplied and waste products are removed. Rise in temperature causes relaxation of muscles and increases the efficiency of their action. The increased blood supply ensures the optimum conditions for muscles contraction.
Indications:
It may be used in osteoarthritis, cervical spondylosis (spinal arthritis/ osteoarthritis), frozen shoulder, tennis elbow, dupuytren's contracture [abnormal thickening of tough tissue (fibrous layer)], meniscus injury (cartilage tears), low back pain, prolapsed intervertebral disc. (P.I.D.) or herniated nucleus pulposus sciatica (pain down the leg, caused by irritation), ankylosing spondylitis (chronic inflammation of the spine and the sacroiliac joints, which causes spinal pain and stiffness) and sinusitis.
Contra-Indications:
It is unwise to apply short wave diathermy to the abdomen or pelvis during menstruation. Hemorrhage may occur in case of gastric or intestinal diseases associated with ulceration. It should not be applied on defective arterial supply, or to the abdomen during PREGNANCY and the region of MALIGNANT growths, so short wave diathermy must not be applied to areas recently exposed to therapeutic doses of x-rays.
ULTRASONIC THERAPY:
Mode of action: - Same as S. W. D. (Short wave diathermy).
Indications:-
It can be used in ankylosing spondylitis, plantar fascia which connects the area of the foot near the toes with the heel, for softening tissues, osteoarthritis, dupuytren's contracture [abnormal thickening of tough tissue (fibrous layer) underneath the skin of the palm and fingers], sometimes it may be used in inflammatory process such as; lymphangitis ((acute streptococcal or staphylococcal infection of the skin or an abscess in the skin or soft tissues), curbuncle.
Contra Indications:-
Ultrasonic waves should not be applied on specialized tissues(Eye, Ear, ovaries or Testes) there may have harmful effect on the brain and spinal cord and growing ends of bones, and on pregnant uterus. It must not be applied on a NEOPLASM because it may causes metastasis.
ELECTRIC CURRENT (Faradic and Galvanic):
Its low strength may be applied through the skin to the superficial muscles causing them to contract. This may be used to help to train weak muscles and also to test the status of nerves. For the purpose of this explanation the term, low-frequency currents apply to those therapeutic currents having pulse repetition rates of from 50 to 100 cycles per second.
The two varieties, most frequently met with in a Physiotherapy practice are the Sinusoidal current and the Faradic current. Both these currents have a frequency of at least fifty cycles per second and will cause a tetanic contraction of voluntary muscle, so for this purpose, the two currents are interchangeable and therefore referred to as Faradic-type current. Several different electrical stimulation devices exist, each producing different frequencies, waveforms, and effects. Electrical modalities include:
1. Transcutaneous Electrical Nerve Stimulation (TENS) (the most commonly used)
2. Interferential Current (IFC)
3. Galvanic Stimulation (GS)
Mode of action:
In resting state the nerve fibres outer surface bears a positive (+) charge, the inner surface a negative (-) charge. In this state the plasma membrane accumulate on its outer surface and there is an associated arrangement of their ions, following a definite pattern, inside and out side of the membrane. If the P.D. (Potential difference) across the membrane falls below a sodium ion; a nerve impulse is initiated if any factor causes the P. D. across the plasma membrane of the nerve cell or fibre to fall below this level.
When this occurs then sodium ions begin to enter the axon and causing further fall in the P. D. and increase the permeability of the membrane of the ions. There is also an arrangement of the other ions and the process builds up until there is a reversal of the P.D. the outer surface of the membrane becomes negative & the inner one positive.
Currents are now set up between this activated part of the nerve and the adjacent area which is still in its resting P. D. in the activated part of the nerve fibre and a fall in that across the plasma membrane of the adjacent area. Thus the reversal P. D. is transmitted along the nerve and is an essential feature of a nerve impulse.
Indications:
It can be used on innervated and denervated muscles. After tendon transplantation or other reconstructive operations and in case of edema (It is better to use faradic current under pressure) to loosen adhesion (use Faradic current Under Tension).
Contra indications:
The current must not be applied to anesthetic area of skin, or where is metal embedded in tissue.
Danger:
Electric shock, electric burn, giddiness, they occur if the current is passed through the region of the semicircular canals, particularly when the intensity is being varied e.g. in treatment of the ear or mandibular joints (joint where your lower jaw bone is connected to the temporal bone of your skull).
Hydrotherapy:
It is extremely valuable for heat application and in addition, because of the buoyant (Upward thrust) effect of water the patient can actively exercise the extremity. In the wounds and ulcer antiseptic lotion should be slowly dripped into or added directly to the continually changing water for both CLEANSING and BACTERIOSTATIC effects.
The recuperative and healing properties of hydrotherapy are based on its mechanical and/or thermal effects. It exploits the body's reaction to hot and cold stimuli, to the protracted application of heat, to pressure exerted by the water and to the sensation it gives. The nerves carry impulses felt at the skin deeper into the body, where they are instrumental in stimulating the immune system, influencing the production of stress hormones, invigorating the circulation and digestion, encouraging blood flow, and lessening pain sensitivity.
The physiological effects of hydrotherapy may be classified as thermal, mechanical, and chemical. Thermal effects are produced by the application of water at temperatures above or below that of the body. The greater the variation from body temperature, the greater the effect produced, other factors being equal. The mechanical effects are produced by the impact of water upon the surface of the body in the form of sprays, douches, frictions, whirlpools, etc. The chemical effects are produced when it is taken by mouth or used to irrigate a body cavity, such as the large colon. The most commonly utilized effect, therapeutically, is the thermal one.
After hydrotherapy the area should be carefully dried. This is followed by the local ultraviolet radiation to the wounds or ulcer. Hydrotherapy is used for early healing of burn and large superficial wounds and to prevent contracture. A Whirl pool tank, Water with antiseptic agent, Propeller is used.
In a study of 40 persons at the University of Minnesota, 85% of the participants chose a whirlpool bath over a still bath. Both were effective in reducing anxiety, but only the whirlpool bath was effective at reducing the participant's reactivity to stress.
Hydro therapy use in the back is useful for diseases of the lungs, bronchial asthma, multiple sclerosis, spinal disease, back pain and weakened back muscles. it should not be used on debilitated patients or those with neurasthenia.
Check below link for more other types:
Note:
Different types of Physiotherapy for fracture, dislocation and others (Part1) includes:THERAPEUTIC EXERCISE AND ITS TYPES, GRADING OF MUSCLE POWER, CERVICAL TRACTION, HEAT THERAPY (THERMOTHERAPY), CONTRAST BATH
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