Electrotherapy

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Electromagnetic Spectrum
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Infra-Red Radiation (IRR)
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Objectives:
At the end of this lecture the student should be able to:

1. Define Electromagnetic spectrum.

2. Describe the characteristics of electromagnetic spectrum.
3. Explain the laws governing electromagnetic waves.
4. Describe interactions of electromagnetic waves with material in nature.
5. Define absorption, penetration, refraction and scattering of electromagnetic spectrum.
6. Identify Infra-red Radiations (IRR) and its production.
7. Classify IRR according to its wavelength.
8. Describe luminous and non-luminous sources of infra-red radiations (IRR).
9. List factors affecting the absorption and penetration of IRR in the tissue.
10. Discuss the physiological effects of infra-red radiation.
11. List indications, contra-indications and dangers of IRR.

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 Electromagnetic spectrum

Definition:
1. The electromagnetic spectrum (EM) is an array of all possible frequencies of electromagnetic
radiation arranged according to frequency and/or wavelength (Figure: 5.01).
2. The electromagnetic radiations consist of regular sinusoidal waves of electric and magnetic
fields at right angles to each other (Figure: 5.02).
3. Electromagnetic spectrum includes; visible light, ultraviolet, infrared, microwave, shortwave,
radio waves, x-rays and gamma waves.

Fig. 5.01: Electromagnetic spectrum.

Fig. 5.02: Components of Electromagnetic waves.

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 4. The visible part of the electromagnetic
spectrum includes different wavelengths
which gives the following colors; red,
orange, yellow, green, blue, indigo and
violet. (Figure: 5.03)

Fig. 5.03: Colors of the visible light.

Characteristics of the EM waves:

a. The electromagnetic (EM) waves are transverse waves travelling in straight line with
variation in the strength of both electric and magnetic fields (Figure: 5.02).
a. "Transverse waves" means that, the waves are perpendicular to the direction of travel.
b. Electromagnetic waves have a constant velocity in space (3 × 108 m/sec).
c. Their speed decreases when they pass in biological tissues.
d. They are expressed in terms of frequency or wavelength;
a. Frequency: is the number of complete waves per one second. It is measured in: Hertz
(Hz), up to gigahertz (GHz).
b. Wavelength: is the distance from any point on a wave to the same point on the next
wave (peak of one wave to the next peak). It is measured in: kilometers (Km) down to
nanometers (nm).
e. They are independent from the atoms they pass through, which means that EM waves can
travel in space with no atoms at all.
f. They may give energy to the material they pass through;
a. Their interactions with the material they pass through depend on their frequency or
wavelength.
b. Different frequencies produce different physiological effects depending on amount of
energy they give the tissue.
g. There are no definite division between one type of radiation and the other, except for the
visible light.

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Laws governing electromagnetic waves and their interactions:

1. Arndt-Schultz principle:
a. Arndt-Schultz principle states that "NO physiological reactions can occur if the amount
of energy absorbed is insufficient to simulate biological functions".
b. Implementation;
i. Insufficient energy will produce no physiological effects.
ii. Sufficient energy delivered to the tissue will stimulate biological functions, e.g.,
proper time and distance of infrared radiation (IRR) produce the desired
physiological effects.
iii. Excessive energy delivered to the tissue may stop physiological functions.
iv. Extremely high energy delivered may cause tissue damage, i.e.,
 Longer application time of IRR may cause burn.
 Decreasing distance from the skin may cause burn.

2. Grotthuss-Draper law:
a. Grotthuss–Draper law describes the inverse relationship between energy absorption by
the tissue and its penetration to deeper tissues.
b. It states that; “For electromagnetic energy to produce an effect on tissue it must be
absorbed by this tissue”.
c. Implementations;
i. Electromagnetic waves falling on skin surface may have one of the following
interactions;
 Reflection from the surface: it produces NO effect on tissue.
 Passing through tissue without absorption: it produces NO effect on tissue.
 Absorption by the tissue: it produces physiological effect if the amount of
energy is sufficient.

3. Inverse square law:

a. Electromagnetic waves spread out in all directions as they travel in space which
decreases the intensity as the distance increases. (Figure: 5.04)
b. The inverse square law states that “The intensity of the radiation at any point is
inversely proportional to the square of the distance from the source".
c. When I = intensity, and d = distance, the inverse square law is expressed as;
I α

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 d. Implementation;
i. Intensity of infrared radiation applied at 50 cm. distance from the skin is 4 times
stronger than infrared radiation applied at 100 cm. distance from the skin. (Figure:
5.05)

Fig. 5.04: Inverse square law. Fig. 5.05: Explanation of the inverse square law.

4. Cosine law:
a. Cosine law relates the penetration of radiation falling on the skin to the cosine of the
angle of incidence.
b. The angle of incidence is the angle between the incident light and the perpendicular line
to the skin surface.
c. For any radiation falling on any surface; (Figure: 5.06)
i. The angle of incidence is equal to the angle of reflection.
ii. The incident and the reflected radiation are in the same plane, which is
perpendicular to the surface.
iii. The smaller is the angle of incidence, the less the reflected radiation, and the
greater the absorbed radiation.
iv. Radiations falling on surface at right angles have the highest level of penetration
and least reflection.
d. Implementations;
i. If we apply IRR perpendicular on the skin surface, all infrared waves will
penetrate into skin, i.e., the angle of incidence is zero (cosine 0°=1), which gives
maximum penetration.
ii. If we apply IRR with an angle of 45°, only 70% of infrared waves will penetrate
into skin, i.e., (cosine 45° = 0.7) which makes penetration of waves falls to 70% of
the maximum. (Figure: 5.07)

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Fig. 5.06: Reflection of electromagnetic Fig. 5.07: A) maximum absorption with perpendicular incident waves,
waves. B) reflection of some waves falling with some angle to the surface.

Interactions of electromagnetic waves with biological tissues: (Figure: 5.08)

Electromagnetic waves applied on biological tissues will undergo reflection, refraction,
absorption and penetration, and scattering.

Fig. 5.08: Interaction of electromagnetic waves with matter.

1. Absorption and penetration:

a. There is an inverse relationship between the amount of electromagnetic waves absorbed
in the tissue and the distance it penetrates through this tissue, i.e., greater absorption
means less penetration and vice versa.
b. Penetration depth depends mainly on wavelength, so that radiations that have longer
wavelength will have deeper tissue penetration;
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 i. For example:
 Microwave Diathermy (122.5 mm) has penetration depth of 3 cm in the tissue.
 Infrared radiation (760 nm – 1mm) has penetration depth of 3 mm in the
tissue.
ii. In non-homogenous tissue (biological tissues), absorption and penetration are
irregular.

c. To describe absorption pattern we have to identify two things;

i. Penetration depth: is the depth at which 63% of the original radiation is
absorbed.
ii. Half-value depth: is the depth at which 50% of the original radiation is absorbed.

2. Refraction:
a. Refraction is changing the direction of electromagnetic
waves when they pass to a different medium in which it
travels with different velocity.
b. So, electromagnetic waves change their direction at the
tissue interface (the border between two tissues) with
change in their velocity.
c. If the electromagnetic waves fall perpendicular to the
surface of the medium, it is not refracted.
d. Angle of refraction depends on:
i. The wavelength of the wave. Fig. 5.09: Refraction of visible
ii. Its relative velocity in the two media. light through glass prism.
iii. The angle of incidence, e.g., visible light passing
through glass prism is refracted into seven
different colors depending on the wavelength of
each color forming the rainbow of colors.
(Figure: 5.09)

3. Scattering:
a. Scattering is the net result of both reflection and refraction.
b. Electromagnetic waves passing through biological (non-homogenous) tissues are
refracted at every tissue interface.
c. This results in distribution of the absorbed energy on larger area of the tissue, i.e., larger
than the original area of application, with great reduction in penetration.
d. Shorter wavelengths (e.g., IRR) are more affected with scattering than longer
wavelengths (e.g., M.W.D. and S.W.D).
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 Infra-red radiation
Introduction:
1. Infra-red radiations (IRR) are one type of electromagnetic waves that are converted into heat
when they are absorbed by the tissue.
2. IRR have wavelengths longer than red visible light and shorter than microwave (760 nm - 1
mm).
3. IRR is subdivided into three regions or bands A, B and C differentiated by their wavelength
range and absorption characteristics;
a. Band A (760 – 1400 nm).
b. Band B (1400-3000 nm).
c. Band C (3000 nm – 1 mm).

4. The therapeutic range of infra-red radiations falls between 780-1500 nm.

Sources of IRR: (Figure: 5.10)

1. Sun:
a. It is the main source of infrared radiations.
b. IRR is produced by molecular vibration in all materials, and is nearly emitted from any
heated body.
c. The higher the temperature of the emitting body the higher the frequency of the emitted
infra-red and the shorter the wavelength.

Fig. 5.10: Infra-red lamps.

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2. Infra-red lamps (generators):
a. IRR lamps are available in different sizes, shapes and powers;
i. Small lamps (luminous or non-luminous) producing 250-500 W,
ii. Large non-luminous lamps producing 750-1000 W.
iii. Large luminous lamps producing 600-1500 W.

b. Non-luminous (invisible) generators:

i. These lamps are made of;
 Resistance heater wire coiled around ceramic insulator. (Figure: 5.11)
 Hemispherical reflecting mirror. (Figure: 5.12)
 Protective mesh.
 Metal plates.

ii. Non-luminous Infrared production:

 They act by passing electric current through the resistance wire which
glows red and emits infra-red radiations in addition to some visible light.
 The heater wire might be embedded in a metal tube that emits IRR but does
not become shinning red.
 The heater coil is placed in the center of the reflecting mirror to produce
uniform beam on patient's skin.

iii. The emitted rays are;

 Mainly in the C band (3000-4000 nm).
 10% in the A band (760-1500 nm).

Fig. 5.11: Resistance wire heater of Fig. 5.12: Hemi-spherical mirror and mesh
non-luminous IRR sources. of non-luminous IRR sources.

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c. Luminous (visible) generators: (Figure: 5.13)
i. Luminous generators are made of;
 Tungsten filament embedded in large glass bulb.
 The glass bulb is filled with inert gas under low pressure.
 Part of the inside of the bulb is silvered to act as a reflector.

ii. Luminous infrared production:

 When electric current is passed through the tungsten filament, it becomes
heated to high temperatures.
 It emits IRR, visible light and some ultraviolet radiations.
 The tungsten filament does not oxidize because there is no oxygen inside
the bulb.
 The ultraviolet radiations are absorbed by the glass of the bulb and DO
NOT pass to the patient.

iii. The emitted infrared are;

 70% in the A band (less than 1500 nm) which produce maximum
absorption.
 24% in the C band (3000-4000 nm).
 5% visible light.
 1% ultraviolet.

Fig. 5.13: Luminous IRR sources.

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Absorption and penetration of IRR:
1. When the IRR is applied perpendicular to the skin surface, the reflection of radiations is
negligible and 95% of radiations are absorbed in the skin.
2. The skin is non-homogenous multilayered structure, so, the pattern of IRR absorption and
penetration is variable according to:
a. Skin structure.
b. Vascularity.
c. Skin pigmentation OR skin color; dark skin absorbs more radiations than light skin.
d. Wavelength of the radiation:
i. Wavelength is the most important factor.
ii. With wavelength in the C band (3000-4000 nm) the penetration is about 0.1 mm
in the skin which can only affect the epidermis.
iii. Wavelength in the A band (780-1500 nm), the penetration is around 3 mm in
the skin and can affect skin receptors and subcutaneous capillaries.
iv. The A band is the therapeutic range of IRR.

Physiological effect of IRR:

The main effect of IRR depends on the thermal effect of the radiations which produce
the following effects:

1. Local cutaneous vasodilatation: occur due to;

a. Release of chemical vasodilators, e.g., histamine-like substance.
b. The direct effect of heat on cutaneous blood vessels.
c. Vasodilatation starts after about 1-2 minutes of application and produces patchy
erythema and remains for 30 minutes after stopping the application.
2. Increase metabolism.
3. Relief pain.
4. Reduce muscle spasm.
5. Promote healing.
6. Increase nerve conduction velocity.
7. Sweating: it occurs with prolonged heating, to absorb some of the radiations and cools the
skin with its evaporation. Cooling the skin may increase the radiation penetration.

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Dangers:
1. Burns: occur in cases of loss of sensation, reduced consciousness and poor circulation.
2. Skin irritation: is avoided by proper skin cleaning before the application.
3. Decreased blood pressure: occur due to excess sweating and marked vasodilatation
especially in elderly patients.
4. Dehydration: occur due to excess sweating which is caused by prolonged application over
large area of the body.
5. Eye damage: occurs when the patient looks directly into the lamp.

Indications of IRR:
1. Chronic cases, e.g., chronic pain, inflammations and edema.
2. Sports injuries,
3. Musculoskeletal disorders,
4. Muscle spam,
5. Joint stiffness, joint adhesions and before stretching.
6. Before electric stimulation and biofeedback.

Contra-indications of IRR:
1. Unreliable patients,
2. Loss of sensation and analgesic drugs,
3. Patient receiving deep X-ray therapy,
4. Ischemia and poor circulation,
5. Neoplasm,
6. Acute inflammations and injuries.
7. Open wound and burns (absolute contra-indicated),
8. Some dermatological conditions, such as dermatitis.
9. Some neurological conditions.
10. Superficial metal wear.

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References:
1. Cameron MH.: Physical Agent in Rehabilitation from Research to Practice, 2nd Ed. Saunders,
1999; Pp: 220-227.
2. Prentice WE, Quillen WS, Underwood F.: Therapeutic Modalities in Rehabilitation, 3rd Ed.
New York, The McGraw-Hill Companies, 2005; part two.
3. Robertson V, Ward A, Low J and Reed A.: Electrotherapy Explained, 4th Ed. Edinburgh,
Butterworth-Heinmann Companies, 2006; Pp: 313-335, 344-349.

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