Thermal Agents & Compression

Cryotherapy Purpose

Initially decrease blood flow

Decrease nerve conduction velocity

Increase pain threshold

Alter muscle strength

Decrease spasticity

Facilitate muscle contraction

Decrease metabolic rate

What are indications for cryotherapy use?

Inflammation control

Edema control

Pain control

Modification of spasticity

Cryotherapy Precautions/Contraindications

Circulatory compromise

Cardiac dysfunction

Impaired sensation

Open wound

Nerve damage

Hypersensitive to cold

Cryoglobulinemia (cold impairs circulation more severely than typical)

Raynaud's disease or phenomenon

Hypertension

Very young or very old

When to stop cryotherapy?

When affected area becomes numb

Important cryotherapy set-up points

Apply towels as appropriate for patient comfort

Set a timer for duration of treatment

Provide a way for patient to reach clinician during treatment (e.g. be close by or provide a bell)

Thermotherapy Purpose

Vasodilation

Changes in nerve conduction velocity and firing rate

Increase pain threshold

Changes in muscle strength

Increase metabolic rate

Increase tissue extensibility

Hot Pack Indications

Pain control

Increase range of motion

Decrease joint stiffness

Accelerated healing

Trigger point sensitivity

Osteoarthritis

Rheumatoid arthritis

Prior to electrical stimulation

Thermotherapy Precautions/Contraindications

Recent/potential hemorrage

Fever

Blood clots

Acute inflammation

Devitalized tissue

Impaired sensation

Surgical history (in affected area)

Pregnancy

Edema

Impaired circulation

Cardiac problems

Metal in the area

Open wound

Ointments/creams used in the affected area

Demyelinated nerves

Very old or very young

Important hot pack set-up points

6-8 towels/layers

2-4 hot back covers

Set a timer for the duration of the treatment

Provide a way for patient to reach clinician during treatment (e.g. be close by or provide a bell)

Paraffin Wax and Fluidotherapy Indications

Pain control

Increased range of motion

Decreased joint stiffness

Accelerated healing

Important paraffin wax set-up points

Remove all jewelry

Wash and dry area being treated before and after

Ratio and temperature

Important fluidotherapy set-up points

Remove jewelry and clothing fro treatment area

Cover open wounds with plastic barrier

Temperature

Secure sleeve

Provide a way for the patient to reach the clinician during treatment as needed

Two types of compression wrapping

Spiral

Basketweave

Where to begin compression wrapping

Start at most distal end of limb and move proximally to create a funnel back to the heart

Compression Risks

Skin irritation or breakdown

Pressure injuries

Discomfort or pain

Allergic reactions to compression materials

Circulatory compromise

Inadequate or uneven compression

Compression Indications

Edema of the lower extremities

Venous or lymphatic disease symptoms

Renal insufficiency

Obesity

Inflammation

Compression Uses

Management of venous insufficiency

Promotion of wound healing

Prevention of recurrence

Edeme management

Supportive therapy

Enhanced patient comfort