Thermotherapy

The thermotherapy is the application of thermal energy for therapeutic purposes. We can use it directly or indirectly, through other energies that are transformed into heat inside the body.

What actions does heat cause in our body?

The ideal temperature range to achieve beneficial effects is 40-45ºC, above it we can cause tissue damage and below it we will not obtain any therapeutic effect.

• Contrary to cold, heat produces vasodilation and thus allows blood to reach the affected area that will bring with it the oxygen and nutrients necessary for that tissue to be repaired. For every 10ºC of temperature that we increase, the activity of the tissue increases 2 or 3 times. This restorative action allows tissue healing. It should never be applied, then, in a hemorrhage. It is very important to keep the temperature of the rest of the body constant (36-37ºC) and that only that of the area to be treated is elevated.
• It has an anti-inflammatory effect once the inflammation has been established but never before, because if we put heat at the time of the injury, the only thing that we will be producing is greater inflammation.
• On the muscle causes relaxation and reduces pain. Thus, in case of muscle spasm, contracture or accumulated muscle tension, the heat gives us a very pleasant feeling of well-being. As it has a sedative effect, it will decrease muscle strength and endurance, which is why high temperatures are not good for physical exercise.
• An increase in heart rate and a drop in blood pressure occur on the heart if a person is exposed for a long time to the sun or highly concentrated environments.
• Increase the rate of breathing and sweating.

Types of thermotherapy

Thermotherapy is divided into superficial and deep depending on the extent of heat in the body. Deep thermotherapy consists of the application of so-called short wave, microwave and ultrasound devices, and is described in the electrotherapy chapter . Therefore here we are going to focus on superficial thermotherapy.

Methodology used in thermotherapy

First we highlight solid, liquid, semi-liquid and gaseous media and then we will talk about solar radiation.

Solid media

• Electric blanket
• Dry wraps such as sheets or towels that have been previously heated.
• Hot-pack: bag that is heated and keeps heat very well. They must be wrapped in a cover so as not to cause burns. They are reusable. If this same bag is frozen instead of being heated, it is going to produce cold.
• Bags containing chemicals that become very hot when in contact with each other and harden. There are several sizes but they have the disadvantages that they are not reusable and their price is high.
• Beach sand heated to 40-45ºC, with it the area to be treated is wrapped with a layer of about 20 cm.

Semi-liquid media

They are a mixture of a liquid and another substance.

• Peloids: mixture of organic or inorganic substances with mineral-medicinal water. They are: sludge or sludge, silt, peat, biogleas.
  It is applied on the area to be treated. Its use is more widespread in spas. The application temperature is 38-40ºC for 15-30 minutes.
• Paraffin: substance that is melted in a melter that maintains it at a melting temperature, which for paraffin is 52-54ºC. It is a fast and cheap agent and can be reused many times. It is applied very frequently on the hands and feet but also on the back using a brush to spread it.
• Parafangos: mixture of paraffin and mud. It is already marketed and is what is most used in the physiotherapy service of hospitals.

Gaseous media

They are the least used in treatments. They are distinguished:

• Wet bath: Turkish bath or sauna.
• Dry air: device that emits a jet of dry air that will heat a segment of the body. It is used primarily for burns, scars, edema and pain in the extremities.

Liquid media

It is hydrotherapy, with water over 37ºC.

Solar radiation:

• Ultraviolet radiation: it has no calorific effect, so it is not used for treatments. They are the rays of the sun that give us a reddish coloration and later tan when we expose ourselves to it. It is also used to sterilize surgical equipment.
• Infrared radiation: it constitutes 50-60% of the radiation that the sun sends us.

It is responsible for the calorific effect when we are exposed to the sun. It can be artificially reproduced with lamps, the range of which depends on the wavelength, but does not exceed 10mm. The lamp is usually placed 50-60cm from the person. As we get closer, more intensity. The dose is regulated by the exposure time and by the distance, the machine does not have a power regulator. If we place the lamp too close we can cause a burn. The eye area should never be radiated, if the face is radiated it is better to wear sunglasses.

How deep does each technique go?

Hot pack -> 2-5mm
Hydrotherapy -> 2-5mm
Paraffin -> 2-5mm
Dry air -> 2-5mm
Luminous infrared -> 5mm-1cm

Indications and contraindications

Indications for thermotherapy

• On the musculoskeletal system when it occurs with inflammation (muscles, bones, joints, ligaments and tendons) it will never be applied in the acute phase. It will be indicated in cases of sequelae of trauma, osteoarthritis , arthritis , contractures, muscle spasms, tendinitis, myositis …
• In the irritation of a nerve: neuritis or neuralgia.
• It is also used in diseases of the digestive system , such as colic and respiratory system, such as bronchiectasis and laryngitis.

Contraindications for thermotherapy

Due to the consequences derived from it, there are situations in which it is forbidden to use heat:

• Areas that have little sensitivity, because the person could be burning and not realize it.
• Recent trauma, with inflammation, effusions.
• Bleeding
• Tumors, because we can cause the tumor to spread to other parts of the body.
• Arthritis in the acute phase.
• People with decompensated heart disease or severe respiratory failure.
• Infections: for example, fever .
• When the level of consciousness is low.
• In depressed people, a prolonged treatment with thermotherapy can make them fall into depressive states.

Heat is a source of energy that provides us with very beneficial effects, but we have to know the situations in which it cannot be used because we would aggravate the process.