when to use heat and when not

[Doc.Sust]

Heating Modalities (infrared modalities)

From almost the beginning of mankind, heat has been used in the treatment of aches and pains. The use of warm fires, hot coals, warm compresses, hot baths and similar modalities has been passed down through the ages as helpful he A L I Ng tools.

Heating moda1ities fall within two sections of the electromagnetic spectrum (inftared and diathermy), as well as in the acoustic spectrum (ultrasound). The major difference between these types of heating modalities is the depths of penetration. Remembering back to the lecture on wavelengths and frequencies, we note that the infrared modalities have extremely short wavelengths and thus have only superficial penetration and their effects limited to the superficial blood vessels and cutaneous nerve receptors. The diathermies have much longer wavelengths, which are capable of penetrating further into the tissues, and are thus considered to be deep penetrating heat. Ultrasound is also considered to be deep penetrating and, as discussed earlier, is the deepest penetrating modality.

Superficial Heat
The inftared modalities, which transfer heat through convection, conduction and radiation.

Deep Heat
Modalities, which penetrate deeper into the tissues where there energy is converted to heat through the resistance of the tissues.

Heat is defined as the type of energy stored in matter as kinetic energy or the energy of movement of the particles. Temperature is defined as the heat energy possessed by matter.

Three Sources of Heat
Chemical exothermic reactions such as instant hot packs, or the burning of coal, wood or gas. Mechanical sources such as fiiction, or ultrasound (soundwaves)
Electrical currents moving against resistance (Joules Law). Electrical energy is converted to heat as it moves through a conductor.

Four Forms of Heat Transmission
Conduction. Conduction occurs when two or more adjacent objects (media) of unlike temperatures are placed in contact and a state of energy exchange occurs. Heat is transferred (conducted) from the warmer to the cooler object by the process of conduction. Examples: hot packs (hydrocollator type, chemical gel packs, instant chemical hot packs, hot water bottles, heating pads, Kenny Packs and paraffin baths.

Convection. Convection involves the exchange of heat between a surface and a fluid (liquid or gas) moving over the surface. In general, a fluid medium is used and the body part is immersed. Examples: whirlpool baths, fluidotherapy, Hubbard tank, sitz bath, and contrast baths.


Radiation. Radiation is the transmission of heat without the intervening medium being warmed. Examples: longwave (non-luminous) IR and shortwave (luminous) IR.

Conversion. Heat energy can be generated by the conversion of one form of energy into heat such as an electric heater where electrical energy is passed through a wire with high resistance, through fiiction where mechanical energy is converted to heat, vibration where mechanical energy converted to heat (ultrasound), and in electrical current modalities where high tTequency currents are used to convert electrical energy into heat (diathermy- shortwave, longwave and microwave).


Physiologic Effects of Heat
The primary effect of the use of heat is considered thermal. This increase in local temperature further increases the heating effects, which in turn precipitates three basic reactions: an analgesic or calming effect, an increase in local metabolism, and some sedation of sensory nerves. As local metabolism increases this further increases local temperature and gives rise to the release of histamine and histamine-like substances, which results in arteriolar vasodilation. The overall effects of heat application vary according to the intensity (temperature), concentration of application, duration, wavelength and the vascularity of the area. Short periods of heat, where there is little or no build up of heat, seem to have little, if any, therapeutic effect.

Effects of local Heat Application
Increased superficial local temperature
Increased local metabolism
Vasodilation of arterioles and capillaries
Increased local blood flow and hyperemia (increased blood in part of the body)
Increased leukocytosis and phagocytosis
Increased capillary permeability
Increased lymphatic and venous drainage
Increased metabolic wastes
Increased axon reflex activity
Increased elasticity of soft tissue (muscle, ligaments, joint capsules)
Analgesia through increased threshold of pain receptors, the pain gate, and local Enkeph**** production
Increased formation of edema
Decreased muscle tone
Decreased muscle spasm through decreased muscle spindle
Perspiration

Systemic Effects of Heat Application
Increased oxidation
the rate of oxidation
Increased circulation
Increased heart rate- for every 1°F of temperature increase there is a corresponding increase in pulse rate of 10 beats.
Hypotension- as more blood flows to the area of heat application, overall blood pressure levels drop.


Increased perspiration Increased urine production

Indications for Heat
Heat is indicated in subacute and chronic conditions where the following are desired:
-Thermal effects
-Pain relief or sedation
-Decrease myospasm as the heat increases the stimulus threshold of the muscle spindle -Lengthen muscle tissue
-Increase joint motion
-Assist in resolution of the inflanunatory stage through increased blood flow, fi leukocytes, fi phagocytes, and fi lymphatic and venous drainage, however, care must be taken not to heat for so long as to increase edema formation, or increase metabolic wastes, as this would be counterproductive.
-Or where increased phagocytosis is indicated, as in skin abscess or boil. Inflanunation is the normal response of the tissues to the presence of bacteria. The' principle features are vasodilation, exudation of fluids into the tissues, and increase in the concentration ofWBC's and antibodies in the area. Heating the tissues augments these changes and reinforces the body's normal mechanism for de****g with the infected organisms. (Clayton's Electrotherapy)Consensual heat vasodilation (increased blood flow in areas remote to application site) such as the use of deep heat over the low back to increase circulation in the lower extremities of a patient with peripheral vascular disease. Note: This increased circulation is transient.

Specific Conditions: Heat may be used on the following conditions: subacute or chronic; sprain/strain, contusion, fractures; subacute or chronic inflanunatory conditions such as: arthritis, capsulitis, bursitis, tendonitis, tenosynovitis, neuralgia, neuritis, radiculitis, myalgia, myositis, or myofascitis; Catarrhal (head/throat mucus membrane inflanunation) sinusitis, bronchitis; urogenital/gynecological: prostatitis, epididimitis, pelvic inflammatory disease, menstrual cramping; and in skin conditions such as foIliculitis, boils, and abscesses. Bells Palsy, Raynaud's.

Whether or not a patient has responded positively to heat application cannot always be determined immediately. Most patients like the feel of heat. However, how the patient feels several hours after heat application gives us a better indication of the overall benefit of heat application. Common usage of heat in the chiropractic setting is prior to the adjustment, pre*stretching, or pre ROM exercise, where we desire to reduce pain, soften soft tissues, and relax the patient.

Contraindications for Heat Modalities
-Deficient vascular system either peripheral vascular diseases due to organic disease or advanceC cardiovascular disease
-Areas of diminished sensation (over scars, diabetic neuropathies)
-Malignancy in the area (increased metabolism may increase tumor activity)
-Patients with bleeding tendencies (hemophilia, peptic ulcers, heavy bleeding of menstruation) -Active tuberculosis
-Over the low back or pelvis during pregnancy

*-Over deep inflammatory processes especially when suppuration exists -Acute stage of injury, or edema
-The very old, young or debilitated individuals

[guest589745]

Good ****in post! I cant believe I missed this one! I was always wondering that

[Doc.Sust]

i wish more people would read these posts, would save all of us alot of time glad you liked it skull

[guest589745]

i wish more people would read these posts, would save all of us alot of time glad you liked it skull

I know but, I was thinkin....ya know, if you did use the search like youre supposed to and read all the educational type-posts, noone would have a question to ask and there would be almost no new threads lol. But yea, yer right.

[Doc.Sust]

I know but, I was thinkin....ya know, if you did use the search like youre supposed to and read all the educational type-posts, noone would have a question to ask and there would be almost no new threads lol. But yea, yer right.

i see your point too,

[tcw]

So in plain English what is this article saying?

What's the "readers digest" version of this lengthy article.

When do we use Ice?

When do we use Heat?

Is moist Heat better than dry Heat?

[Doc.Sust]

when in doubt always use ice. bottom line

[440Charger]

How long is to long to heat? Is it similar to Icing? 30 mins tops more like 20mins for every 2 waking hours?

[Doc.Sust]

i use the same rules as ice application for heat.

[ScottyDoc]

Doc. Sust, What kind of Doc are you? I'm a Chiro, Love your post, very good!. "When in doubt use Ice!" I love that line, that is what I preach to my Chiro patients on a daily basis. I like the acronym RICE R = rest, I = ice, C = compression, E = elevation. That is a good rule of thumb to stand behind for any new/acute(48-72hrs) injury.

[ScottyDoc]

HEAT vs. ICE

Ice packs and heat pads are among the most commonly used treatments in orthopedics. So which one is the right one to use for your injury, ice or heat? And how long should the ice or heat treatments last?

HEAT: Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Use heat treatments for chronic conditions, such as over-use injuries, before participating in activities. Do not use heat treatments after activity, and do not use heat after an acute injury. Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns (20 minutes). Never leave heating pads or towels on for extended periods of time, or while sleeping.
ICE:
Ice treatment is most commonly used for acute injuries. If you have a recent injury (within the last 48-72 hours) where swelling is a problem, you should be using ice treatment. Ice packs can help minimize swelling around the injury. Ice packs are often used after injuries, such as when a sprain/strain has occurred. Applying ice early and often (20 minutes per treatment) for the first 48-72 hours will help minimize swelling which will, in turn, help to control the pain. Ice treatments may also be used for chronic conditions, such as over-use injuries. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity (heat is protocol for that).

Application of HEAT & ICE: Application of either ice or heat should never be longer than 20 minutes to reduce risk of burning skin, as the skin can be burned/damaged from both ice and heat therapies if used improperly. Also, direct heat or cold should never be applied directly to the skin, there should always be some form of buffer between the two (towel or cloth). Also, my personal preference (what I recommend to my patients) is once an injury has gone past 72 hours and is considered a chronic injury heat and ice should be applied alternately, always ending in ice. For example, 20 minutes of heat then 20 minutes of ice, one right after the other, always ending with ice. So without getting technical, the way I look at it is the heat speeds things up and allows more blood and lymph flow to the injury, which speeds up the healing process. Ice, however, slows everything down and decreases the amount of blood and lymph in the injured area, but also decreases swelling & inflammation (responsible for pain). So think of it as a pump, heat pumps the good stuff in and ice pumps the bad stuff out before it pools and starts to swell and become inflamed. Also, as mentioned above if it is an over-use injury, heat before activity to loosen/warm muscles up and ice after activity to reduce inflammation/swelling, therefore reducing pain.

[oldschoolfitness]

HEAT vs. ICE

Ice packs and heat pads are among the most commonly used treatments in orthopedics. So which one is the right one to use for your injury, ice or heat? And how long should the ice or heat treatments last?

HEAT: Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Use heat treatments for chronic conditions, such as over-use injuries, before participating in activities. Do not use heat treatments after activity, and do not use heat after an acute injury. Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns (20 minutes). Never leave heating pads or towels on for extended periods of time, or while sleeping.
ICE:
Ice treatment is most commonly used for acute injuries. If you have a recent injury (within the last 48-72 hours) where swelling is a problem, you should be using ice treatment. Ice packs can help minimize swelling around the injury. Ice packs are often used after injuries, such as when a sprain/strain has occurred. Applying ice early and often (20 minutes per treatment) for the first 48-72 hours will help minimize swelling which will, in turn, help to control the pain. Ice treatments may also be used for chronic conditions, such as over-use injuries. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity (heat is protocol for that).

Application of HEAT & ICE: Application of either ice or heat should never be longer than 20 minutes to reduce risk of burning skin, as the skin can be burned/damaged from both ice and heat therapies if used improperly. Also, direct heat or cold should never be applied directly to the skin, there should always be some form of buffer between the two (towel or cloth). Also, my personal preference (what I recommend to my patients) is once an injury has gone past 72 hours and is considered a chronic injury heat and ice should be applied alternately, always ending in ice. For example, 20 minutes of heat then 20 minutes of ice, one right after the other, always ending with ice. So without getting technical, the way I look at it is the heat speeds things up and allows more blood and lymph flow to the injury, which speeds up the healing process. Ice, however, slows everything down and decreases the amount of blood and lymph in the injured area, but also decreases swelling & inflammation (responsible for pain). So think of it as a pump, heat pumps the good stuff in and ice pumps the bad stuff out before it pools and starts to swell and become inflamed. Also, as mentioned above if it is an over-use injury, heat before activity to loosen/warm muscles up and ice after activity to reduce inflammation/swelling, therefore reducing pain.

good clear info been here for a while just stopping by this section and whow!!

[D.Pump]

Electrical currents moving against resistance (Joules Law).

This is basically friction...

[aussie_bodybuilda]

HEAT vs. ICE

Ice packs and heat pads are among the most commonly used treatments in orthopedics. So which one is the right one to use for your injury, ice or heat? And how long should the ice or heat treatments last?

HEAT: Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Use heat treatments for chronic conditions, such as over-use injuries, before participating in activities. Do not use heat treatments after activity, and do not use heat after an acute injury. Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns (20 minutes). Never leave heating pads or towels on for extended periods of time, or while sleeping.
ICE:
Ice treatment is most commonly used for acute injuries. If you have a recent injury (within the last 48-72 hours) where swelling is a problem, you should be using ice treatment. Ice packs can help minimize swelling around the injury. Ice packs are often used after injuries, such as when a sprain/strain has occurred. Applying ice early and often (20 minutes per treatment) for the first 48-72 hours will help minimize swelling which will, in turn, help to control the pain. Ice treatments may also be used for chronic conditions, such as over-use injuries. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity (heat is protocol for that).

Application of HEAT & ICE: Application of either ice or heat should never be longer than 20 minutes to reduce risk of burning skin, as the skin can be burned/damaged from both ice and heat therapies if used improperly. Also, direct heat or cold should never be applied directly to the skin, there should always be some form of buffer between the two (towel or cloth). Also, my personal preference (what I recommend to my patients) is once an injury has gone past 72 hours and is considered a chronic injury heat and ice should be applied alternately, always ending in ice. For example, 20 minutes of heat then 20 minutes of ice, one right after the other, always ending with ice. So without getting technical, the way I look at it is the heat speeds things up and allows more blood and lymph flow to the injury, which speeds up the healing process. Ice, however, slows everything down and decreases the amount of blood and lymph in the injured area, but also decreases swelling & inflammation (responsible for pain). So think of it as a pump, heat pumps the good stuff in and ice pumps the bad stuff out before it pools and starts to swell and become inflamed. Also, as mentioned above if it is an over-use injury, heat before activity to loosen/warm muscles up and ice after activity to reduce inflammation/swelling, therefore reducing pain.

what do u mean by an acute injury?

[ScottyDoc]

what do u mean by an acute injury?

If it is not an ugly injury then it is acute injury!

Just joking, acute means new, freshly injured, the opposite of a chronic = long-term injury!

[lovbyts]

If it is not an ugly injury then it is acute injury!

Just joking, acute means new, freshly injured, the opposite of a chronic = long-term injury!

I'm sure he appreciates someone clearing that up and has been waiting patiently for 9 months for the answer. LOL

[Penwrath]

So many things in here that I didn't know! Thanks so much!

[image613]

thank you! learning with every click of the mouse!

[Kinglondon]

Great info!

[Nackel]

Great read. I'm assuming all these effects are experienced at a rather severe degree while on DNP ?