Bio-physics of superficial

heat
(only basic principles)
Subject: biomedical physics

Book: Electrotherapy explained by Low & Reed

Book: Electrotherapy simplified by Basanta Kumar Nanda

Modes of heat transfer
• Conduction (heat transfer by solid state)

• Convection (heat transfer by fluid or air)

• Radiation (heat transfer by rays)

Physiological effects of heat on body
• Increases metabolism
• Reduces viscocity of blood
• Increases extensibility of collagen tissues
• Reduces pain (pain gate mechanism)
• Vasodilatation of blood vessels
How to check skin thermal sensation?
• Check skin thermal sensation by hot and cold test tubes
• Hot test tube 40-45 º C and cold test tube 15-20 º C
How to check skin thermal sensation?
• Do not use test tube temperature less than 15 º C and more
than 45 º C otherwise it will stimuate pain receptors
(nociceptors)
Paraffin wax bath
(PWB)
Introduction
• Melting point of wax is 54° C.

• If molten wax at 51° to 55° C is applied on body part, it may cause

burn.

• Some impurity like liquid paraffin or mineral oil is added to lower the
melting point for safer application

• Thus the temperature of paraffin wax is maintained at 42° to 52° C.

Characteristics of PWB
• Specific heat of wax is lower than water, so it allows patient
to tolerate heat better than water

• Latent heat of fusion of wax is lower than water, so it

solidifies quicker

• Wax has slower heat diffusion

• Wax is insulator, so it prevents heat loss during application

Mode of action of paraffin wax
• Wax transmits heat energy to the tissues by giving up energy as it
solidifies- the latent heat of fusion

• Although, the temperature of the thin layer of wax on the tissue falls
quickly on its outside surface, the low thermal conductivity prevents
much heat loss from the skin surface

• Preventing any evaporation of water from skin, further improving the

insulation

• Thus, leave the skin with more moisture, hence feeling soft and pliable
Paraffin wax bath: indications
• Joint pain of hands and feet due to arthritis
• Strain and sprain of small joints
• Post fracture joint stiffness
• Chronic inflammation of ankle
• Scar adhesion
hydrocollator
pack
Hydrocollater pack (moist heat pack)
• Silicate gel or Bentonite is covered with canvas
Hydrocollater pack (moist heat pack)
• Silicate gel and Bentonite holds large quantity of water for
efficient heat delivery
• Several pockets in febric filled with gel, so whole pack
becomes flexible
Hydrocollater pack (moist heat pack)
• Packs are stored in water
kept at 75-80 º C in tank
with electric heater
controlled by thermostat
Hydrocollater pack (moist heat pack)
• Put pack inside tank and set heat level 75 º C
Hydrocollater pack (moist heat pack)
• Plastic sheet is used to wrapp the pack and towel is wrapped around
it to prevent towel from getting wet and enhances insulating
effects
Hydrocollater pack (moist heat pack)
• Due to layering, skin temperature does not rise above 42 º C
Contrast bath
Contrast bath
• Contrast baths involve alternate immersion in hot and cold
water producing marked hyperaemia of the skin

• There is considerable sensory stimulation due to activation

of cutaneous hot and cold receptors

• This stimulation is quite strong because each time neural

accommodation starts to occure, the temperature
stimulation is reversed
Contrast bath
• This strong sensory stimulation may suppress the pain by
pain gate mechanism

• So there will be subjective relief of pain

Contrast bath
• Two suitably sized baths are filled, the hot at 40-45 º C and
cold at 15-20 º C
Contrast bath
• Place the limb in hot water for 3 minutes followed by
immediate immersion in cold water for 1 minute
Contrast bath: indications
• Post traumatic swelling

• Pain due to swelling

• Chronic inflammation
Whirlpool bath
Whirlpool bath
• It is a stainless steel tank that contains water with a
turbine in it to produce movement of water through
agitation and aeration
Whirlpool bath
• It assist or resist movments of distal parts of extremities
or the whole extremities and the lower trunk
Whirlpool bath
• The motor is secured to
side of whirlpool and pipes
for water and air circulation
are suspended in the water
Whirlpool bath

• For pain relief and wound

debridement (wound
cleaning), the turbine is
directed towareds the
involved area
Whirlpool bath

• For hypersensitive skin and

when wound has lots of
granulation (newly formed
capillaries), the turbine is
directed away from involved
area
Whirlpool bath
• The agitation of water, the whirlpool effect, stimulates the skin
surface mechanically

• This stimulation of large-diameter mechanoreceptors together with

thermoreceptores create analgesic effects

• Mechanical effect can be used to clean open wound by providing gentle

debridement of dirt and necrotic tissue

• Vigorous action can destroy delicate granulations (newly formed

capillaries)
whirlpool bath: indications
• Open wounds

• To mobilize stiff joints of the extremities

• Pain relief
Home remedies
 Home remedies
• Microwavable gel packs
 Home remedies
• Microwavable wheat packs
 Home remedies
• Heating pad Heating blanket
 Home remedies
• Electical heating pads are produced commercially

• Made up of series of resistors to control temperature

produced by heating wire surrounded by asbestos, cotton or
plastic covering
 Home remedies
• Heating pad size is 30 X 30 cm2 and heating blanket is also
available

• The resistance wire when heated by flow of current warms

the fabric covering, and it gives heat to skin by conduction

• Heating pads produce muscle relaxation and reduce pain by

providing superficial heat
Home remedies: indications

• Muscle relaxation

• Pain relief
the end