Thermal Modalities

Circulation

• Heat relaxes muscles

• Heat causes vascular dilation which increases blood flow

• Heat relaxes tense muscles which increases ROM

• Heat relieves pain

Contraindications

• Cognitive issues

• Vascular issues

• Sensory issues (low sensation or tolerance)

• Acute inflammatory phase of healing

• Lymphedema

• Ex. Cancer, pregnancy, metal implants, hemorrhages

Hot Packs

• Larger areas of the body

• Sustained stretch during tx

• Tx time: 20 mins

• Put 6-8 layers of towels btwn the pack & the skin

Paraffin

Helpful for:

• Pain (arthritis, sprain, etc): wax

• ROM: stretched position - wrap - wax

• The therapeutic effects last approx 20 mins

• Diff methods: dip, brush, pour, etc.

Fluidotherapy

• Typically used for desensitization, pain, range of motion, wounds, acute injuries, swelling, and increasing blood flow

• Disadvantage is that the extremity is maintained in a dependent position

• Pts are encouraged to move during tx

• The length of tx is typically 20 mins

Contrast Bath

• Alternating hot and cold water baths

• Creates a pumping type action by alternating vasoconstriction and vasodilation in order to: decrease edema, improve peripheral blood flow

Ultrasound

• Most heat is superficial, but ultrasound penetrates the body to affect deeper structures (tendons, bones, etc)

• We can use it for heat (ROM) or mechanical benefits (healing)

• Continuous wave - deep heat (ROM)

• Pulsed - promotes healing

Phonophoresis

• Using the ultrasound head to apply topical drugs

• Prescription from a physician is required

• Varies state by state