Physical Therapy FAQs

What is cold therapy?

Cold is a physical therapy treatment most often done with cold packs or ice massage. When a cold pack or ice massage is used, you will feel the following changes in stages:

  • Cold
  • Burning
  • Aching
  • Numbness

How does cold therapy work?

Cold decreases blood flow and fluid in the area it is applied to.

How does cold therapy help you?

Cold should decrease pain and swelling in the area that is treated.

What are the common reasons for using cold therapy?

  • Cold is used to decrease swelling in a joint or muscle.
  • Cold can also prevent swelling in a joint or muscle if used right after an injury or exercise.

What is heat therapy?

Heat Therapy is used to increase your skin temperature with very little increase in the temperature of deeper areas of your body.

How does heat therapy work?

  • Heat causes your blood vessels to get bigger allowing more blood to go to the area.
  • Blood brings nutrients to the area and carries away wastes enhancing healing.

How does superficial heat help you?

The warmth created by superficial heat helps by:

  • Relaxing your muscles when you are tense
  • Increase blood flow to your body parts
  • Helps in healing your body tissues
  • Preparing your muscles and joints for exercise and stretching

What are the different forms of heat therapy?

Moist Hot Packs:

  • Moist hot packs are kept in water at a temperature of 140 to 160 degrees Fahrenheit.
  • Moist hot packs are usually wrapped in 6 to 8 layers of towels in order to prevent burning. They are applied for 15 to 20 minutes. Your skin may look red after you have been given a hot pack. This redness should go away in 4-6 hours.

Heating Pads:

  • Heating pads produce a dry heat. Heating pads are not used by your Physical Therapist because moist heat is more comfortable and goes deeper into the body.
  • Heating pads may be bought at a drug store. Make sure that you do not use the pad on more than the medium setting or you may get burned. Some pads can be used with water. If the pad you purchase is approved for use with water, use it in this way. Put a moist towel over the area to be treated and put the heating pad on top of the moist towel. Make sure that it is set no higher than at the medium setting. Never use a heating pad at home for more than ½ hour at a time.

Paraffin:

  • Paraffin is made up of wax mixed with mineral oil. It has a temperature between 118 to 130 degrees Fahrenheit. It is often used to heat the hands and feet. A person dips a hand or foot into the paraffin ten times to form a thick coating of paraffin around the area being treated. The hand or foot is then wrapped in a towel for up to 20 minutes. This allows all the hand or foot joints to warm up. Paraffin is often used to treat arthritis of the hands and feet. Home paraffin units are available at most drug stores.

Whirlpools:

  • Whirlpools are special bath tubs that are kept at a temperature between 98 and 104 degrees Fahrenheit. The area of the body to be treated is placed in the water for about 20 minutes. Agitation is often used to help move the heat of the water around the body part. The agitation also helps improve circulation throughout the skin.

What is iontophoresis?

Iontophoresis is a way to get a drug deep into your body by the use of electricity. The two drugs most commonly used are lidocaine and dexamethasone. The treatment takes 10 to 20 minutes. During the treatment you may feel a slight tingling sensation. The treated area may look red after treatment. This redness should disappear within 8 to 12 hours.

How does iontophoresis work?

Electrodes from a machine produce a small electric current which is placed over the drug. When the small electric current is on, the drugs are pushed away from the electrodes and into your body.

How does iontophoresis help you?

  • Iontophoresis is commonly used when tendons, bursae, or muscles are swollen or irritated. The drug which is pushed into your body helps to remove any extra fluid in the area. This extra fluid may have collected as a result of your injury.
  • If your treatment causes pain, a lot of discomfort, or if your redness lasts longer than 12 hours, call your therapist. If you think that you may be allergic to either lidocaine or dexamethasone, tell your therapist.
  • Please feel free to ask your therapist questions you have about this treatment.

What is phonophoresis?

  • Phonophoresis uses an ultrasound machine to push medicine deep into your joints or muscles. An ultrasound machine makes sound waves that are too high for the human ear to hear. These sound waves travel through your skin and into your body. A gel is used between the head of the ultrasound machine and the skin to help the sound waves enter your body. Ultrasound waves create the effect of deep heat in your muscles and joints.
  • In phonophoresis, medicine is added to the gel. The sound waves from the ultrasound machine push this medicine deep into your body. The most common medicine that is used in phonophoresis is hydrocortisone. With phonophoresis, you get the effects of the ultrasound as well as the medicine.

How does phonophoresis help you?

The deep heat from ultrasound waves causes your blood vessels to get bigger. This allows more blood to go to the area. Blood brings nutrients to the area and carries away wastes. This helps decrease inflammation in the area and helps in healing. Hydrocortisone decreases the swelling and soreness in body tissues.

What are the common uses of phonophoresis?

  • Muscle soreness
  • Tendonitis
  • Bursitis

When should you not have phonophoresis?

Please tell your therapist if you are pregnant or have any other medical conditions.

What can I expect during treatment?

  • Ultrasound feels warm, but should not feel hot or uncomfortable. Let your therapist know if you are feeling a sensation of heat, pinpricking or burning. If you think that you are allergic to Hydrocortisone, tell your therapist.
  • Please feel free to ask your therapist questions you have about this treatment.

What is ultrasound?

Ultrasound machines make sound waves that are too high for the human ear to hear. These sound waves travel through the skin and into the body. Gel is used between the sound head of the ultrasound machine and the skin to help the sound waves enter your body.

How does ultrasound work?

Ultrasound waves create the effect of deep heat in your muscles and joints. The deep heat of ultrasound increases the blood flow to the area being treated. This blood brings nutrients and carries away waste. This helps to promote healing and decreases swelling.

How does ultrasound help you?

Ultrasound helps to:

  • Decrease swelling
  • Relieve pain and/or muscle spasms
  • Promote healing
  • Relieve tightness in the body tissues
  • Prepare the muscle or joint for stretching or exercise

What are the common uses of ultrasound?

Ultrasound is commonly used for the following conditions:

  • Tendinitis, bursitis
  • Pain in the muscles or joints
  • Tightness in muscles or joints
  • Wound healing

When should ultrasound not be used?

  • If you have certain types of cancer
  • If you have a plastic joint implant

What can I expect during treatment?

  • Ultrasound feels warm, but should not feel hot or uncomfortable.
  • Let your therapist know if you are feeling a sensation of heat, pinpricking, or burning.
  • Please tell your therapist if you have a demand type pacemaker.
  • Please feel free to ask your therapist questions you have about this treatment.

What is NMES and how does it work?

Electrical stimulation is safe. A small electric current is used to make your muscles contract. In a healthy person, the nerve carries an electrical message to the muscle telling it to contract. When your nerves are not working normally, the electrical stimulation machine sends the same type of message as your nerve, thus making your muscles contract.

When is NMES used?

Electrical stimulation should be used when your nerves are not working normally.

Electrical stimulation can help in the following ways:

  • Help control pain
  • Prevent your muscles from getting tight
  • Prevent your muscles from getting weak
  • Decrease swelling
  • Increase blood flow to the area
  • Help your wounds heal
  • Increase your muscle strength

When should NMES not be used?

Electrical stimulation should not be used if you have:

  • A cardiac pacemaker, unless your doctor or therapist approved its use
  • Uncontrolled high or low blood pressure
  • Cancer in the area that is being treated

The electrical stimulations pads should not be:

  • Put over your stomach if you are pregnant
  • Put across your chest and back or with one pad in front and one in back

What can I expect after the treatment?

  • You may have a red area on your skin after the electrical stimulation treatment. The red area would be under the electrode where the electric current went into your body or where you had tape on your skin. This red area should disappear after 6 hours.
  • If this treatment causes pain, notify your therapist.
  • Please feel free to ask your therapist questions you have about this treatment.

What is TENS and when is it used?

  • TENS is a battery powered device used for pain relief. It sends painless electrical signals through patches on the skin. The electrical signal travels to the nerves in the skin that transmit pain and replaces the pain with a tingling sensation. There is also some heat produced that helps ease stiffness and increases movement. The TENS also helps your body make more natural pain killers called endorphins. It is a safe, drug free way to manage pain.
  • A TENS can be used to treat different types of pain. It helps to reduce pain after an injury or after surgery. It can also help with muscle, back or arthritis pain.

When should TENS not be used?

TENS should not be given to you if you have:

  • A pacemaker for your heart, unless your doctor has approved its use.
  • Blood pressure that is not controlled, either too high or too low.

Other Precautions:

  • Use caution in your daily activities. TENS may suppress the sensation of pain that your body uses to tell you when something is wrong.
  • Use TENS only for the condition for which the device is ordered. Talk to your doctor if you have any change in your condition or if a new condition develops.
  • Do not leave the electrodes in place for long periods of time without checking or cleaning the skin underneath. You should not have skin irritation, rash and burns beneath the electrodes that last more than 6 hours. If you do, stop your use of TENS and call your therapist.
  • Do not place the electrodes on irritated skin or on skin that has poor sensation.
  • Do not drive or operate hazardous equipment when using the TENS.
  • Do not use the device in the bath or shower.
  • Do not use heat or cold producing devices such as heating pads or cold packs. These could change the way the electrodes work or change your sensitivity and increase your chance of injury.
  • Do not use the device while asleep. The electrodes could come off as you move.

Electrodes should never be placed:

  • Across a pregnant uterus
  • On your head or neck if you have a history of seizures
  • Over broken, numb or infected skin
  • Over active cancer areas unless your doctor has approved its use
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