Thermotherapy

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Original Editors - Kirianne Vander Velden

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Definition/Description

This kind of therapy consists of application of heat or cold for the purpose of changing the cutaneous, intra-articular and core temperature.
Using ice or heat as a therapeutic intervention is mostly to decrease pain in soft tissues.

What happens if we use:

Heat
By increasing the temperature of the skin/soft tissue the blood flow becomes higher due to vasodilatation. Also the metabolic rate and the tissue extensibility will increase.

Cold
By decreasing the temperature of the skin/soft tissue the blood flow will become lower due to vasoconstriction. But it will be followed afterwards by a vasodilatation which will prevent against hypoxic damage (hunting reflex). The tissue metabolism will decrease just like the neuronal excitability , inflammation, conduction rate and tissue extensibility.

Both applications will reduce the pain but when we need to use which application is still the question.

Sorts of applications:
Heat: Hot packs, wax baths, sunlight, sauna, steam baths, radiation
We could also get the heat in the deeper tissues when we use electrotherapy (shockwave and infrared radiation)
Cold: Ice packs, ice baths, cooling gel packs and sprays

A very important note that needs to be made is that this sort of therapy is safe for people with a normal skin sensibility. When a patient has problems with thermal sensitivity it could be dangerous. They couldn’t feel if they got burned due to the application.

In the literature they describe cryotherapy (ice application) as the better if they can choose between heat or cold [²,³]. It reduce the swelling and hemorrhage[4], it will improve the range of motion, but there are still some doubts if it actually is effective to relieve pain. To improve range of motion, cryotherapy combined with certain stretching techniques is a very good intervention.

The simple form of thermotherapy can be used on short-terms. If it is effective we can use it for a longer period.
The more complex form of thermotherapy is very expensive and it contains more risks [1].

Duration and frequency of application:
15-20 min, 4 times or more/day

There are still a lot of contradictions if the use of thermotherapy is effective but worldwide it is used to reduce the pain[1].

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