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PRESENTED BY:
• SARA IBRAHIM
WAX THERAPY:
COMPOSITION:
• It is a combined immersion technique with
Paraffin wax + mineral oil for conductive heat gains.
• For therapeutic use:
– 7 units of wax ---------1unit mineral oil.
• The most important effect of wax its marked sedative effect on the
tissue.
• The moist heat is remarkable soothing to the patient.
• It is this effect that is used prior to the exercise, in the treatment of
superficially placed joints.
• It is very comfortable to the patient.
• 4. Stretching effect:
14
Cont…
6. Cancer, tumors or tuberculosis ( TB) in the area to be
treated as it ↑ the metabolic activity & rate of growth.
Position of the patient should be such that the part to be treated comes
closer to the wax bath container.
Instruct the patient to avoid touching the sides and bottom of the heating
unit because burns may result.
Instruct the patient who is receiving an immersion method not to move the
joints that are in the liquid. The cracking of the wax will allow fresh paraffin
to touch the skin, increasing the risk of burns.
Treatment:
• Dip the client’s hand into the paraffin up to the wrist,
making sure the hand is -relaxed, for a few seconds,
then remove. Repeat this dip 4 or 5 times until hand is
fully coated.
i. When the dipping process is done, put hands in a plastic
liner, or wrap in warm towels.
ii. Place a mitt over the plastic liner, or just leave the hands
sitting in the towels.
iii. Allow the wax to stiffen for five to 10 minutes, then remove
the mitts, liner, or towels.
iv. Remove the paraffin and throw away the used wax.
Techniques/Methods of application:
2. Brushing / Painting method:
3. Dip & Immerse / Dip &
Leave in method:
4. Dip & Wrap / Glove method:
5. Towelling/Bandaging method:
• A lint cloth / towel is immersed in molten paraffin wax
and then wrapped around the body part.
•Methods:
A systematic database search using the MeSH heading
‘rheumatoid arthritis' combined with the terms: ‘therapeutic use of heat'
and ‘therapeutic use of cold' was implemented. All relevant basic
studies, clinical trials examining the effect paraffin wax has on hand
tissue temperature, and randomised controlled clinical trials specifically
examining the use of paraffin wax for treating rheumatoid arthritis, and
their methodological quality were rigorously assessed according to
standardised criteria.
• Results:
Of the four randomised trials identified concerning the outcome of
paraffin wax applications to rheumatoid arthritic hands, one yielded
equivocal results, while three reported that after three to four weeks,
paraffin wax applications were accompanied by significant
improvements in rheumatoid arthritic hand function when followed
by exercise. The modality also relieves pain and stiffness
immediately after its application with no documented detrimental
effects on the disease process, even though paraffin wax
temporarily raises joint temperature
• Conclusions:
As a whole our data suggest there may be some benefit with few side-
effects in the application of paraffin wax to the hands of people with
non-acute rheumatoid arthritis prior to exercise. However, the data
are insufficient and preclude any definitive conclusions concerning
the efficacy of paraffin wax for treating painful hand arthritis.
Topical analgesic added to paraffin enhances
paraffin bath treatment of individuals with hand
osteoarthritis.
ABSTRACT:
•PURPOSE:
To compare treating patients with symptomatic hand osteoarthritis
(OA) with paraffin baths only (PO) (100% wax) or paraffin baths 80%
wax with 20% topical analgesic (PTA).
•METHODS:
Subjects met criteria of the American College of Rheumatology for
classifying symptomatic hand OA and had a Dreiser's index score >5
points. Current and average pain at rest and with movement was
assessed with visual analogue scales. Hand function was assessed by
the functional index for hand OA (FIHOA).
• RESULTS:
Both groups had a significant reduction in their 'current' pain 15
min after the first and twelfth treatments compared to pre-
treatment but there was no difference between groups (t =
0.10, p > 0.05). The PTA group had greater improvement over
the 12 treatment sessions for their pain at rest (t = 2.92, p <
0.05) and with movement (t = 4.73, p < 0.05) than the PO
group. The PTA group also showed greater improvement in
their FIHOA following 12 treatments than the PO group (t =
3.52, p < 0.05).
• CONCLUSION:
Our results indicate that the addition of a topical analgesic to
paraffin produced significantly greater pain relief at rest and
during movement than paraffin baths alone after 12
treatments. Additionally, the PTA group experienced greater
improved hand function.
• Evaluation of paraffin bath treatment in patients with
systemic sclerosis.
ABSTRACT:
OBJECTIVE:
To investigate the effects of treatment with paraffin bath
in patients with systemic sclerosis (scleroderma).
METHODS:
In 17 patients with scleroderma one hand was treated
daily with paraffin bath in combination with hand
exercise. The other hand was treated with exercise only
and was considered a control. Hand function was
estimated before treatment and after 1 month of
treatment, concerning hand mobility and grip force, and
perceived pain, stiffness and skin elasticity.
• RESULTS:
At the follow-up, finger flexion and extension, thumb abduction,
volar flexion in the wrist, and perceived stiffness and skin elasticity
had improved significantly in the paraffin-treated hand compared
with the baseline values. The improved hand function was
independent of skin score and disease duration. Improvements in
function were significantly greater in the hand which was treated
with paraffin bath and exercise than in the hand treated with
exercise only concerning extension deficit, perceived stiffness and
skin elasticity.
• CONCLUSIONS:
In this pilot study hand exercise in combination with paraffin bath
seemed to improve mobility, perceived stiffness and skin elasticity.
However, further studies with larger sample size are needed to
attain more reliable results of the effect of paraffin bath treatment in
patients with scleroderma.
Efficacy of Paraffin Wax Bath with and without
Joint Mobilization Techniques in Rehabilitation of
post-Traumatic stiff hand.
Abstract
•Objective:
Post-traumatic stiff hand is common a condition which causes pain and
disability, the paraffin wax bath and joint mobilizations have the key role
in its rehabilitation. We conducted the present study to determine the
efficacy of paraffin wax bath with mobilization techniques compared
with joint mobilization alone.
Methodology:
This single blind randomized control trial was conducted on 71
patients in department of physical therapy and rehabilitation, Riphah
International University Islamabad, and patients with post-traumatic stiff
hand after distal upper extremity fractures, were included.
The patients were randomized into two groups: the joint mobilization
techniques with paraffin wax bath were included in group A, and joint
mobilization techniques without paraffin wax bath in group B. The study
variables were pain score on visual analogue scale (VAS) 0/10, thumb
function score (TFS) and passive range of motion (PROM) of wrist
flexion, extension, radial and ulnar deviation, and were compared at
baseline and at completion on plan-of-care after six weeks.
•Results:
Seventy one patients with post-traumatic stiff hand were enrolled
and placed randomly into two groups. The baseline characteristics
were similar in both groups. Six week after intervention, patients in
group A had more improvement in pain score (p=0.001), TFS
(p=0.003), and PROM of wrist flexion (p=0.002), extension (p=0.003),
radial deviation (p=0.013), and ulnar deviation (p=.004), as compared
to group B. However, in group B the improvement was less in pain
score (p=0.104), TFS (p=0.520), and PROM of wrist flexion (p=0.193),
extension (p=0.1081), radial deviation (p=0.051), and ulnar deviation
(p=.168), as compared to group A.
• Conclusion:
Paraffin wax bath with joint mobilization
techniques are more effective than mobilization
techniques without paraffin wax bath in the
rehabilitation of post traumatic stiff hand.
Th a n k yo u :