ELECTROTHERAPY

INFRARED
RADIATION

Pamantasan ng Lungsod ng Maynila College of Physical Therapy

TOPICS FOR DISCUSSION
Definition Therapeutic uses
Different types of infrared
Indications, Contraindications,

lamps & Precautions

Laws related to application of
Parameters
IRR Dangers
Variables affecting
Advantages & disadvantages
penetration & absorption Procedures
Factors affecting increase in
Documentation
tissue temperature
Physiological effects
WHAT IS INFRARED RADIATION?
Infrared radiation is a form of superficial heat

A non-ionizing radiation
Can be used therapeutically for:
Relief of pain and stiffness
Increase joint motion
Enhance the healing of tissue lesions and skin

conditions
Current use:
Decline significantly in contrast to the popular and routine

use of hot packs and paraffin baths (Belanger, 2010)

The fall in popularity appears to be the result of changes in

practice style preferences and concern about overheating

patients if they are placed or move too close to the lamp

rather than evidence of excessive adverse effects or lack of

therapeutic efficacy (Cameron, 2009)

Monochromatic infrared energy (MIRE) - used to restore

sensation of limbs of patients with diabetes to prevent foot

ulcers.
890 nm wavelength transmitted directly to the skin via

pads containing 60 diodes each

Proposed mechanism: stimulation of nitric oxide (a

vasodilator) release from hemoglobin into the circulation

when hemoglobin absorbs the infrared energy

FREQUENCY & WAVELENGTH
Frequency: 7 –400 x 10^14 Hz

Wavelength: 770 nm - 1 mm
 WAVELENGTH
IR-A: 760-1400 nm (Low and Reed);

770-1400 nm (Cameron)
IR-B: 1400-3000 nm
IR-C: 3000 nm - 1mm (not used in

therapy)
 WAVELENGTH
Former classifications of IRR:
Near IR: 760 - 1500 nm (low and reed);

770-1500 nm (Hecox)
Far IR: 1500 - 15 000 nm
 WAVELENGTH
The lamps available at this time generally

emit IR radiation with wavelengths of

between780 and 1500 nmwith peak intensity

at 1000 nm.
WHAT PRODUCES INFRARED?
Any material that is at a temperature above

absolute zero emits infrared.

Wien’s law –states that the wavelength of

the maximum production of radiations is

inversely proportional to the absolute

temperature of the source

 IR SOURCES IN REHABILITATION
Sunlight
IR lamps

Different from IR therapy:

IR light-emitting diodes (LEDs)
Supraluminous diodes (SLDs)
Low-intensity lasers
THERAPEUTIC INFRARED LAMPS

Non-luminous Generator
Luminous Generator
LUMINOUS INFRARED GENERATORS

Emit visible as well as

infrared radiations.
"Radiant heat"

generators.
LUMINOUS GENERATOR: SOURCE
Incandescent lamps consist of a tungsten

filament and/or carbon filament in large

glass envelope which contains inert gas at

low pressure.
LUMINOUS GENERATOR: RAYS
The peak emission occurs at near 1000 nm but

radiation extends from the far infrared

throughout the visible to the ultraviolet

Luminous lamps emit about
70% short infrared
24% far infrared
5% visible light
1% ultraviolet which is absorbed by the glass

of the bulb.
LUMINOUS GENERATOR: RAYS
Produce mainly near infrared rays that

penetrate to subcutaneous tissue.

More efficient-heating source since it

penetrates further and therefore the energy

is distributed in a larger volume of tissue.

 NON-LUMINOUS INFRARED GENERATORS
IR rays often produced by a

metal spiral coil around a

nonconducting/insulating

material such as ceramic,

porcelain or fireclay. As

electricity flows through the

coil, it encounters resistance,

thus producing heat.

NON-LUMINOUS INFRARED GENERATORS
The heater wire can

also be mounted

behind a metal plate

or inside a metal

tube which does not

become red-hot but

emits infrared.
NON-LUMINOUS GENERATOR: RAYS
Emit most energy in the long infrared region

(mainly around 3000-4000 nm)

90% long infrared
10% short infrared
Some give off a little red visible radiation

(Robertson, Low and Reed, 2006)

Produce mainly far infrared rays which are

absorbed primarily by the superficial epidermis

PREHEATING
LUMINOUS GENERATOR
Can be applied immediately without

preheating.

NON-LUMINOUS GENERATOR
Requires preheating; warm up - up to 15

minutes/at least 5 minutes

DISTANCE FROM THE SKIN

LUMINOUS GENERATOR
18-24 inches

NON-LUMINOUS GENERATOR
29-36 inches
EFFECTS
LUMINOUS GENERATOR
Preferred if heating is the desired effect

NON-LUMINOUS GENERATOR
Preferred if sensory stimulation is

considered
 PHYSICAL BEHAVIOURS OF IRR
IR can be reflected, absorbed, transmitted,

refracted and diffracted by matter.

Skin is not a single homogenous tissue, what

happens to any radiation entering the skin is

highly complex.
In general, water and proteins are strong

absorbers of infrared.
 PENETRATION
The penetration depth is the depth at which
approximately 63% of the radiation energy has

been absorbed and 37% remains.

Very long wavelength Infrared (15 000 - 40 000

nm) penetrates several cm.

Long infrared used therapeutically is absorbed at

the surface, at around 3000 nm, penetration

depth is about 0.1 mm.

 PENETRATION

Short infrared region has a maximum penetration

depth of about 3 mm at around the 1000 nm

wavelength region.
PENETRATION
Very short infrared – 1-2 mm
Short infrared – 3 mm
Long infrared – 0.1 mm
Very long infrared - >1 cm
Infrared radiation is characterized by

being strongly absorbed near the skin

surface and the effect will therefore be

marked heating of the skin.

 VARIABLES AFFECTING ABSORPTION

& PENETRATION
Frequency or wavelength
Angle of incidence of the

of rays rays
Thermal conductivity of
Distance from the source

the tissues of infrared

Density of each tissue Patency of the circulation
Specific heat of each
Source of the infrared
tissue
The temperature increase produced by

radiation is directly proportional to the

amount of radiation that penetrates the

tissue.
TISSUE TEMPERATURE INCREASE IS

RELATED TO:
Power & wavelength
Distance
Angle of incidence
Absorption coefficient
 POWER OF RADIATION
Most lamps deliver IR radiation with power in the

range of 50-1500 watts

The smaller lamps, both luminous and non-

luminous, are usually 250-500 W

Large non-luminous ones are often either 750 or

1000 W
Larger luminous lamps are from 600 to 1500 W
 WAVELENGTH OF RADIATION
The lamps deliver IR radiation used clinically,

which is between 780 and 1500 nm, is absorbed

within the first 1 to 3 mm of human tissue.

Short infrared rays have sufficient energy to

cause thermal agitation (heat) by molecular and

atomic motion.
 DISTANCE OF RADIATION SOURCE

Inverse Square Law - as the distance increases,

intensity decreases and v.v.

The intensity reaching the skin is greatest when

the radiation source is close to the patient's skin.

 ANGLE OF INCIDENCE OF RADIATION

TO TISSUE
Cosine Law/Lambert's Cosine Law - as the angle

of incident ray decreases, intensity of radiation

increases and v.v.

The intensity reaching the skin is greatest when

the radiation beam is perpendicular to the

patient's skin surface.

 ABSORPTION COEFFICIENT

Infrared radiation is absorbed most by tissues

with high IR absorption coefficients.

Dark > Fair skin color
PHYSIOLOGICAL EFFECTS
Local cutaneous vasodilation
Nerve stimulation
Increased sweating
Increased metabolism
Phagocytosis
Reflex heating
PHYSIOLOGICAL EFFECTS
Excessive and prolonged infrared

application can cause destruction of

erythrocytes, releasing pigments and

causing brown discoloration of the skin

(pigmentation and erythema).

THERAPEUTIC USES
Pain relief
Reduction of muscle spasm
Acceleration of healing and repair of

wounds and chronic suppurative areas

Increase conduction velocity of normal

nerves
THERAPEUTIC USES
Prophylaxis of pressure sores
Hasten reabsorption of edema
Often the chosen form of heat given prior
to stretching, mobilization, traction,

massage and exercise therapy

Used prior to electrical stimulation,

testing or biofeedback
CONTRAINDICATIONS
Impaired cutaneous thermal sensation
Defective arterial cutaneous circulation,

vascular disease, hemorrhage

Patients whose level of consciousness is

markedly lowered by drugs or disease.

Acute skin disease – dermatitis or

eczema
CONTRAINDICATIONS
Acute infections
Acute inflammation
Skin damage due to deep x-ray therapy or

other ionizing radiation

Patients whose blood pressure regulation

is defective.
Severe cardiac conditions.
Acute febrile illness
CONTRAINDICATIONS
Tumors of the skin/areas with malignancy
Superficially placed metals or metal

implants
Patients who had strong analgesic or

narcotic drugs
Topical creams and oils/liniments
DANGERS
Burns
Skin irritation
Lowered blood pressure
Areas of defective arterial blood flow
Eye damage
Dehydration
Elderly patients, unreliable situations
Testicles
 PARAMETERS
Distance:
Luminous unit: 18-24 inches
Non-luminous unit: 29-36 inches

Intensity:
In clinical practice, the sensory report of

the patient is usually used to gauge the

skin temperature.
 PARAMETERS

Duration:
15-30 minutes; usually 20 minutes for

maximum heating
 ADVANTAGES
Superficial temperature can be increased.
Does not require contact of the medium with the
patient.
The area being treated can be observed

throughout the treatment.

May be used to treat a larger body part.
Soothing and gentle.
 ADVANTAGES
Patients may be taught to apply infrared for

home use.
Ease of application
Local heat without heating the whole body
Very inexpensive
 DISADVANTAGES
Heating is only very superficial
Infrared radiation is not easily localized to a

specific treatment area

It is difficult to ensure consistent heating in all

treatment areas
Dries the skin more than other modalities
 DISADVANTAGES
Burns may occur when an irregular or bony

body part such as the shoulder is treated if the

machine is too close or if the treatment time is

not closely monitored.

Some patients may find that dry heat is

agitating and irritating.

Equipment is often rather unstable.
 DOCUMENTATION
IR on (R) forearm, IR-A 1000 nm, 100 W at 50 cm

for 20 minutes

vs.

Infrared on (R) forearm x 20 minutes

QUESTIONS OR COMMENTS?
THANK YOU FOR LISTENING!