Programme:

Doctor Of Physical Therapy

Course:
PHYSICAL AGENTS &
ELECTROTHERAPY II

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 PARAFFIN WAX THERAPY

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 1.Paraffin Wax / Paraffin Bath

Paraffin wax is a simple, convenient, reasonably

efficient method of applying conducted heat to the
extremities.
It is a combined immersion technique with
Paraffin wax & mineral oil
For therapeutic use:
7 units of wax to 1unit mineral oil.
The paraffin wax is then kept at low temperature and
remains warm for a longer time.

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Heat exchange takes place by conduction
In the case of paraffin, it provides superficial heat with
a depth of 1 cm.

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 Characteristics of Paraffin Wax

1. Paraffin has a low thermal conductivity

2. Paraffin wax has high melting point (55°C).
3. When the oil is added, the paraffin will come to a
temperature of 40° to 44°C.
4. This low specific heat will enhance the patient to
tolerate heat from the paraffin better than from water
of the same temperature.
5. Better tolerance to heat for the patient.

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 Characteristics of Paraffin Wax
1.Self insulator:
It gives moist heat .There is a layer between the skin and
the wax producing heat and sweating which does not
evaporate.
After removal the heated part cools quickly ( by
evaporation).

2. It is analgesic: This insulating layer keeps the heat and

is effective in relief of pain.

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Equipment used for paraffin wax applications
 Wax is placed in a parrafin bath:
 Small sizes are used for home.
 Larger sizes are designed for clinical use .
 2 stainless steel containers + wooden or bakelite insulator + heating
wire.

Paraffin +
mineral oil

Water at 72°C

Thermostat
at 44° C
Maximum
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The water melts the wax. Thermometer reading should also
be taken. The wax has to be melted in advance and it takes
3 to 4 hours or heated constantly.

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 Operation of the Apparatus

 Normally, parrafin wax has a melting point of 55°C.

 Large bath have a capacity of 25 kg of paraffin.
 You will then add 5 litres of light mineral oïl to lower the melting
point and prevent burns.
 To melt the paraffin turn the switch on to heat the coil, the water
for 1 hour prior to treatment.
 Always check the temperature with thermometer before treatment.
 For busy clinics, the bath can be plugged in day & night to be
ready for use.

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 Care of the Paraffin Bath Apparatus
 The patient’s body part should be cleaned before treatment.

 Bath is to be cleaned regularly (every 6 months) while the paraffin

is liquid. Disconnect the unit from electrical outlet & dip the
parraffin out of the bath with a small pan in another container.

 Remove & clean the slots , remaining paraffin and sediments

removed with paper towels.

 Replace then the parrafin back in the bath and add new paraffin as
needed.

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 Physiological Responses to Paraffin Wax
1. Circulatory effects:
 Stimulation of superficial capillaries & arterioles causes
local hyperemia and thus results in vasodilatation of
capillaries in the skin
 causes reflex heating of the joints.
 skin temperature drops quickly after 15-20 min.
 Exercises after wax is important to increase ROM and
muscle strength.

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 Physiological Responses to Paraffin Wax
 Analgesic effects:
Most important effect is sedative effect
on tissue.
Moist heat gives a soothing effect.
Very good prior to the exercise for
superficial joints.

 Stretching effects: wax leaves the skin

moist, soft and pliable. It is useful for
stretching scars and adhesions.

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 Indications
1. Pain and muscle spasm especially in the distal extremities
( toes and fingers).

2. Oedema and inflammation: gentle heat reduces:

 Post-traumatic swelling of the hands and feet

 Swelling of the hands in rheumatoid arthritis.
 Swelling of the hands in degenerative joints disease.
 Especially in sub-acute and early chronic stages of
inflammation.
 ! Caution is needed in acute phase of arthritic pain and
swelling.

3. Adhesions and scars : wax softens and facilitates the

14 mobilization and stretching procedures.
 Contraindications

1. Impaired skin sensation (hot/cold sensation test): anaesthesia,

hyposthesia, hyperesthesia, parasthesia.

2. Some dermatological conditions: eczema,dermatits. (report any

reactions after treatment).

3. Circulatory dysfunction ( varicose veins, DVT, arterial disease)

4. Analgesic drugs as pain tolerance to heat is impaired.

5. Infections and open wounds ( as it increases the infective

activity) such as in blood born infections.

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 Contraindications
6. Cancer, tumors or tuberculosis ( TB) in the area to be treated as
it increases the metabolic activity & rate of growth.

7. Lack of comprehension ( children, senile , head injuries,

confused, agitated)

8. External or internal metal fixators, implants (metal plates in

orthopedics)

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 Advantages

1. 2 or 3 patients can be treated in the same time.

2. Useful for patient with poor heat tolerance, dry scaly skins,
after Plaster of Paris removal.
3. Can be followed by therapeutic exercises.
4. Can be carried out at home.
5. Wax can mold around the bony contours of feet & hands.
6. Heat is applied evenly by conduction.

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 Disadvantages
1. Not sterile or not very desinfected
procedure.
2. Messy technique, floor should be
protected.
3. Sedimentation occurs in bottom of the
bath so requires regular cleaning (daily
or every 2 days).
4. Contamination by air unless covered by
lid.
5. Water collects at bottom of bath.

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 Techniques of Application
1.Dip –Wrap Method
With fingers in abduction dip the hand into the
parrafin
Wait for the layer of parrafin to harden and
become opaque.
Redip the hand and create paraffin glove by
10 repeated dippings.
Wrap the hand in a plastic bag and then in a
Towel.
Leave it for 15 -20 minutes or until it cools.
After completion of treatment peel the parrafin
off the hand in the container to melt.

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Techniques of Application
2.Dip-Immersion Method
Dip once for having a glove then wait for
5 to 15 seconds for the layer to harden

Redip the hand and allow it to immerse

for 15 to 20 min and then remove it.

The temperature should be at the lower

end of the range and the thermostat
should be turned off during the treatment
 Techniques of Application
3.Paint method
Paint a layer of parrafin on the treatment area with
a brush.
Wait for the layer of parrafin to become opaque.
Paint on another layer of parrafin of the same size.
Make six to ten layers of parrafin
Cover the area with plastic bag or paper and then with a
Towel.
Leave it for 15 -20 minutes or until it cools.
After completion of treatment peel the parrafin
off in the container to melt.
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When the treatment is complete inspect the treatment
area for any signs of adverse effects

Parrafin may be sterilized by heating it to 80 degree C

and then allow it to cool overnight .
Its temperature should be allowed to return between
45-50 degree C before using it for treatment.
 Thank you

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