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Heat therapy, also called thermotherapy, is the application of heat to
the body for pain relief and health. It can take the form of a hot cloth,
hot water, ultrasound, heating pad, hydrocollator packs, whirlpool baths,
cordless FIR heat therapy wrap, and many others. It can be beneficial to
those with arthritis and stiff muscles and injuries to the deep tissue of
the skin. Heat may be an effective self-care treatment for conditions like
Purpose of heat therapy
The general purpose of a heat treatment is to increase the extensibility of soft
tissues, remove toxins from cells, enhance blood flow, increase function of the tissue
cells, encourage muscle relaxation, and help relieve pain. There are two types of heat
treatments: superficial and deep. Superficial heat therapy apply heat to the outside of
the body. Deep heat therapy direct heat toward specific inner tissues through ultrasound
or by electric current. heat therapy are beneficial prior to exercise, providing a warm-up
effect to the soft tissues involved.
Precautions for heat therapy
heat therapy should not be used on individuals with circulation problems, heat
intolerance, or lack of sensation in the affected area. Low blood circulation may
contribute to heat-related injuries. heat therapy also should not be used on individuals
afflicted with heart, lung, or kidney diseases. Deep heat therapy should not be used on
areas above the eye, heart, or on a pregnant patient. Deep heat therapy over areas with
metal surgical implants should be avoided in case of rapid temperature increase and
Description of heat therapy
Hot packs, water bottles, and heating pads
Hot packs are a very common form of heat treatment utilizing conduction as a form of
heat transfer. Moist heat packs are readily available in most hospitals, physical therapy
centers, and athletic training rooms. Treatment temperature should not exceed 131°F
(55°C). The pack is used over multiple layers of toweling to achieve a comfortable
warming effect for approximately 30 minutes. More recently, several manufacturers have
developed packs that may be warmed in a microwave over a specified amount of time prior to
Hot-water bottles are another form of superficial heat treatment. The bottles are
filled half way with hot water between 115-125°F (46.1-52°C). Covered by a protective
toweling, the hot-water bottle is placed on the treatment area and left until the water
has cooled off.
Electrical heating pads continue to be used, however because of the need for an
electrical outlet, safety and convenience become an issue.
Paraffin, a conductive form of superficial heat, is often used for heating uneven
surface of the body such as the hands. It consists of melted paraffin wax and mineral oil.
Paraffin placed in a small bath unit, becomes solid at room temperature and is used as a
liquid heat treatment when heated at 126-127.4°F (52-53°C). The most common form of
paraffin application is called the dip and wax method. In this technique, the patient will
dip 8-12 times and then the extremity will be covered with a plastic bag and a towel for
insulation. Most treatment sessions are about 20 minutes.
Hydrotherapy is used in a form of heat treatment for many musculoskeletal disorders.
The hydrotherapy tanks and pools are all generally set at warm temperatures, never
exceeding 150°F (65.6°C). Because the patient often performs resistance exercises while
in the water, higher water temperatures become a concern as the treatment becomes more
physically draining. Because of this, many hydrotherapy baths are now being set at
95-110°F (35-43.3°C). There are also units available with moveable turbine jets, which
provide a light massage effect. Hydrotherapy is helpful as a warm-up prior to exercise.
Fluidotherapy is a form of heat treatment developed in the 1970s. It is a dry heat
modality consisting of cellulose particles suspended in air. Units come in different sizes
and some are restricted to only treating a hand or foot. The turbulence of the gas-solid
mixture provides thermal contact with objects that are immersed in the medium.
Temperatures of this treatment range from 110-123°F (43.3-50.5°C). Fluidotherapy allows
the patient to exercise the limb during the treatment, and also massages the limb,
increasing blood flow.
Ultrasound heat therapy penetrate the body to provide relief to inner tissue.
Ultrasound energy comes from the acoustic or sound spectrum and is undetectable to the
human ear. By using conducting agents such as gel or mineral oil, the ultrasound
transducer warms areas of the musculoskeletal system Some areas of the musculoskeletal
system absorb ultrasound better that others. Muscle tissue and other connective tissue
such as ligaments and tendons absorb this form of energy very well, however fat absorbs to
a much lesser degree. Ultrasound has a relatively long-lasting effect, continuing up to
Diathermy is another deep heat treatment. An electrode drum is used to apply heat to an
affected area. It consists of a wire coil surrounded by dead space and other insulators
such as a plastic housing. Plenty of toweling must be layered between the unit and the
patient. This device is unique in that it utilizes the basis of a magnetic field on
connective tissues. One advantage of diathermy over various other heat therapy is that fat
does resist an electrical field, which is not the case with a magnetic field. It is found
to be helpful with those experiencing chronic low back pain and muscle spasms. Prior to
ultrasound technology, diathermy was a popular heat therapy of the 1940s-1960s.
Preparation for heat therapy
Before administering any form of heat treatment, heat sensitivity is accessed and the
skin over the affected area is cleansed. When a patient is undergoing any form of heat
treatment, supervision should always be present especially in the treatment of
Aftercare of heat therapy
Once the heat treatment has been completed, any symptoms of dizziness and nausea should
be noted and documented along with any skin irritations or discoloring not present prior
to the heat treatment. A one hour interval between treatments should be adhered to in
order to avoid restriction of blood flow.
Risks of heat therapy
All heat therapy have the potential of tissue damage resulting from excessive
temperatures. Proper insulation and treatment duration should be carefully administered
for each method. Overexposure during a superficial heat treatment may result in redness,
blisters, burns, or reduced blood circulation. During ultrasound therapy, excessive
treatment over bony areas with little soft tissue (such as hand, feet, and elbow) can
cause excessive heat resulting in pain and possible tissue damage. Exposure to the
electrode drum during diathermy may produce hot spots.