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Short Wave Diathermy

Short Wave Diathermy current is a high frequency alternating current. The heat energy obtained from the wave is used for giving relief to the patient. Its frequency is 27,120,000 cycles per second and the wavelength is 11 metre.

Types of applications

The condenser field method
(commonly used)
Cable method

Where useful?

  • Inflammation of shoulder joint
  • Inflammation of elbow Joint (Tennis Elbow)
  • Degeneration of joints of neck (Cervical Spondylosis)
  • Degeneration of joints like knee and hip (Osteoarthritis)
  • Ligament sprains in knee joint
  • Low back ache
  • Plantar fascitis (Heel Pain)
  • Sinusitis

Where it should not be used?

General
  • High fever
  • Fluctuating blood pressure
  • Very sensitive skin
  • Persons with untreated fits
  • Persons using cardiac pace maker
  • Severe kidney and heart problems
  • Pregnant women
  • Mentally retarded individuals
  • Tuberculosis of bone
  • Malignant cancer
Local
If the treatment area has:
  • Open wounds
  • Skin disease
  • Unhealed scars
  • Recent burns
Advantages
Relaxation of the muscles
Effective in bacterial infections
Relief of pain
Treatment time
Initial Stage : 5-10 minutes
Moderate Stage : 10-20 minutes
Severe Stage : 20-30 minutes
Disadvantages
Burns
Scalds (Boils)
Overdose
Shock
Electric sparking
Faintness

LASER (Light Amplification Stimulated Emission of Radiation) therapy

LASER is used in combination with infra red. Usually helium neon LASER is used.

Treatment is done in two ways:

Direct contact (Directly over the skin)
Distance contact (5cm away from the skin)

Where useful?

  • Open wounds
  • Pressure ulcers
  • Diabetic ulcers
  • Surgical wounds
  • Pain

Where it should not be used?

  • Epileptic persons / Persons with recurrent fits
  • Persons with cardiac problems
  • Persons using artificial pacemakers
Advantages of mild type laser treatment
Pain is relived
Healing is faster
Precautions necessary when using laser
Use goggles to protect eye

Ultra-Violet Rays (UV Rays)

Ultra-violet Rays are electromagnetic waves. Rays with wavelengths ranging between 3,900 and 1,849 A° are used for treatment purpose.

Sources of UV-rays

Sunlight
Mercury vapour lamp
Fluorescent tubes

Where useful?

Individuals with
  • General weakness
  • Vitamin-D deficiency
  • Weight loss
  • Psoriasis (Skin Disease)
  • Alopecia (Hair Fall)

Where it should not be used?

  • Sensitive skin
  • Dermatitis (Skin Disease)
  • High fever
  • Tuberculosis of lungs
  • Cancer
Advantages
Formation of vitamin-D
Proved resistance to infection
General tonic effect
Disadvantages
Conjunctivitis (Eye Infection)
Reddening of skin
Electric shock
Burns
UV rays should not be used in combination with certain other treatment

Inter Ferential Therapy (IFT)

Inter Ferential Therapy (IFT) uses a mid frequency - current for treatment.

Where useful?

Individuals with
  • Pain
  • Muscles spasm (Pain & Tightness)
  • Swelling
  • Muscles strain

Where it should not be used?

If the treatment area has:
  • Localised wounds
  • Unhealed scar
  • Recent cuts
  • Skin infection

Ultra Sonic Therapy

It's an electromagnetic wave different from sound waves.

Where useful?

  • Inflammation of elbow joint (Tennis Elbow)
  • Plantar fascitis(Heel Pain)
  • Shortening of muscle or ligament
  • Inflammation of tendons(For e.g. Supraspinatus Tendnitis)
  • Ligament sprain(For e.g. Lateral Ligament Sprain of Ankle)
  • Unhealed scars

Where should it not be used?

  • Avoidance to specialised structures such as eyes, ears,ovaries or testes
  • Growing ends of bones
  • Uterus of pregnant women
  • Areas with poor blood supply (In case of Diabetes)
  • Cancer

The frequencies of waves employed for medical purposes are between 5,00,000 and 3,000,000 cycles/sec.

Generation of Ultrasonic Waves

Ultrasonic waves are generated by vibration of a crystal mounted on a special head.

Advantages
Relief of pain
Healing of soft tissues (Ligament)
Healing of unhealed scars
Disadvantages
Burns
Cavitation (Damage to Bones)
Overdose
Treatment Time
Initial Stage : 3-4 minutes
Severe Stage : 6-8 minutes

Modalities used in Physiotherapy Wax Bath

Paraffin wax is used for the treatment. The temperature of the wax is in the range between 40°C to 44°C. The heat energy obtained from the hot wax is used to relieve pain and stiffness of the joints.

When to apply?

  • Joint pain
  • Joint stiffness
  • Conditions like osteoarthritis and rheumatoid arthritis

Where it should not be used?

If the area to be treated has:
  • Open wounds
  • Cuts
  • Burns
  • Skin rashes
Where useful?

This is applied over joints of legs and hands.

Advantages
Joint pain and stiffness is relived
Skin becomes smooth and moist
Causes relaxing effect
Treatment Time

The time duration for the treatment is about 30-45 minutes

COMBINATION THERAPY

Introduction

In general terms, combination therapy involves the simultaneous application of ultrasound (US) with an electrical stimulation therapy. In Europe, Diadynamic Currents are frequently utilised, but in the UK, US is most often combined with bipolar Interferential Therapy (IF).

There is a significant lack of published material in this area. And much of the information herein is anecdotal or based on the experience of those who use the modality frequently. Broadly, the effects of the combined treatment are those of the individual modalities. There is no evidence at present for any additional effects which can only be achieved when the modalities are used in this particular way.

Advantages

It is suggested that:
  • By combining US with IF, the advantages/effects of each treatment modality can be realised, but lower intensities are used to achieve the effect.
  • The accommodation effects that accompany IF treatment are reduced (or even eliminated)
The main advantages on such a combination are said to be:
  • In localising lesions (especially chronic) i.e. diagnostic use
  • In ensuring accurate localisation of US treatment - to provide increased accuracy/effectiveness in treating deeper lesions
  • In treating trigger points

Possible Explanation

Exposure of a peripheral nerve to US reduces the membrane resting potential by increasing its permeability to various ions (especially Sodium (Na+) and Calcium (Ca++). By virtue of this adjusted permeability, the nerve membrane is taken closer to its threshold (the point where it depolarises, though doesn’t usually make the nerve fire. The simultaneous application of the Interferential current through the nerve induces the depolarisation potential, though it will take a smaller current than usual to achieve this due to the potentiation effect of the ultrasound.

This can easily be demonstrated. If both the US and IF are applied, and during the application, the US is turned down to zero, the sensation produced by the IF will diminish even though the IF intensity has not been changed. The intensity of the IF sensation returns when the US is turned up again.

The combination of US with IF appears to give rise to less adverse treatment effects than are associated with the combination of US with Diadynamic Currents, or other electrical stimulations. It has also been suggested that a greater effective treatment depth can be achieved with the US - IF combination though there is no direct evidence for such a claim.

In summary, it would appear that by combining the two treatment modalities, none of the individual effects of the treatments are lost, but the benefit is that lower treatment intensities can be used to achieve the same results, & there are additional benefits in terms of diagnosis & treatment times.