Heat therapy. Physiological and therapeutic effect

Hydrotherapy and thermotherapy methods, by their nature and characteristics, are closely related to the natural healing factors of the environment. These factors are very diverse in their modifications (solid, liquid, gaseous) and methodological techniques. All these methods act on the body through thermal, mechanical and chemical stimulation.

The physical media used for hydrotherapy and heat therapy are: water, mud, paraffin, ozokerite, naphthalan, clay.

The determining factors in the effect of these media on the body are their physical and chemical properties. Of the physical properties, heat capacity, thermal conductivity and heat-holding capacity are of primary importance.

The chemical characteristics of these media are determined by the mineral salts, organic and gaseous substances they contain.

Heat capacity- the amount of heat required to warm the body by 1 °C; thermal conductivity - the ability to transfer heat from one part of the body to another; heat-retaining capacity - the ability to retain heat. These physical features are different for different thermotherapeutic agents (Table 2.3).

The degree of irritation of the human body and its response depend on heat capacity and thermal conductivity. Water has a high heat capacity. To heat 1 liter of water by 1°C, it is necessary to expend as much heat as is needed to heat 8 kg of iron by 1°C.

Table 2.3

Thermal conductivity water is 28-30 times higher than the thermal conductivity of air. Such high thermal conductivity and heat capacity of water determine the height of its average indifferent temperature for humans - 34-36 ° C (indifferent air temperature is much lower - 22-23 ° C).

When using thermotherapeutic environments The mechanical factor (pressure, friction, etc.) plays a significant role. In a fresh bath, a water column height of 0.5 m exerts a pressure of 1/5 atm, which can affect a person’s breathing and blood circulation.

The pressure exerted by environments such as dirt, paraffin, ozokerite, promote deeper heating of tissues through contact, because the blood in the compressed capillaries of the skin carries away less heat.

The combined action of therapeutic factors is widely used: pressure and temperature (Charcot's shower), mechanical action and temperature (jet shower), etc.

Thermotherapy environments They are also used for the purpose of chemical irritation, which is caused by the mineral salts and gaseous substances contained in them (silt mud, mineral baths, etc.).

The main place of application of temperature stimuli is leather, which is supplied with many blood vessels. Changes in blood circulation in it under the influence of temperature influences are manifested by various reactions in various organs and systems of the body. Temperature perception of the skin includes two different systems - thermal and cold.

Temperature irritations perceived by skin receptors through complex and diverse reflexes cause a reaction that is manifested by changes in physiological processes both in the body as a whole and in its individual organs and systems. This reaction depends on the nature and intensity of the stimulus, the place of its application, the area of influence, as well as on the state of reactivity of the body.

At high intensity, thermal effects can cause destruction of a large number of skin elements. An example of such a condition is various degrees of frostbite and burns.

Also I.P. Pavlov found that when the skin is exposed to weak heat, it is easy to cause inhibition in the cerebral cortex (drowsiness appears after a heat bath). The influence of temperature stimulation is not limited to the place where the stimulus is applied, but extends to the entire body (generalized reflex).

Temperature irritants help reduce and even stop pain. For example, when the skin is strongly cooled with chlorethyl, local anesthesia occurs, which allows minor surgical operations to be performed painlessly (temperature effects, “blocking” the corresponding skin receptors, prevent the transfer of pathological impulses to the central nervous system).

Temperature stimulation reflexively affects the width of the lumen of blood vessels and, consequently, on distribution of blood in the body. Thus, when using hot or cold foot baths, a reflex reaction from the blood vessels of the brain is observed.

Reaction of blood vessels of the abdominal organs to temperature stimuli is diametrically opposite to the reaction of the skin vessels: when the skin vessels dilate, the vessels of the abdominal organs narrow compensatoryly, and, conversely, the narrowing of the skin vessels leads to the dilation of the vessels of the abdominal organs. The exception is the vessels of the kidneys, which react in the same way as the vessels of the skin (Nikitin-Dastr-Mohr-Kirichinsky law).

When using temperature stimuli, it is necessary to take into account the temperature and color of the skin, which is different in different parts of the body in the same person and can vary significantly from external influences (Fig. 2.28).

Rice. 2.28. Skin temperature of different parts of the body (°C)

The temperature of the internal organs, in contrast to the temperature of the skin, is relatively constant - within 37°C. In the process of evolution, humans have developed a number of complex adaptive mechanisms of thermoregulation to maintain a constant body temperature. There are physical and chemical thermoregulation.

The basis of physical thermoregulation is the blood supply to the blood vessels of the skin. Under the influence of high temperature, the blood vessels of the skin dilate, the flow of blood to the skin increases, resulting in an increase in heat transfer.

When exposed to low temperatures, the skin cools, its vessels narrow, blood supply decreases, which leads to a decrease in heat transfer.

Chemical thermoregulation associated with changes in metabolic rate under the influence of ambient temperature. Cold increases metabolism , an increase in temperature reduces it.

The reaction of blood vessels to heat is noted not only at the site of its direct application (although here it is most intense), but also on the entire surface of the body.

The application of heat to the heart area causes an increase in heart rate, which is not due to the direct effect of heat on the heart muscle, but to irritation of the rut receptors. During thermal procedures (especially when affecting the entire body), increased breathing and an increase in the number of heart contractions are observed; at the same time, blood pressure decreases.

With intense heat, the process of sweating increases noticeably. The diaphoretic effect of the thermal procedure can contribute to some depletion of blood in water, which can affect the resorption of exudate.

The effect of heat on the sensitivity of the body is noted: with short-term exposure to heat, sensitivity increases, with longer exposure it decreases.

Thermal procedures also have an antispastic and analgesic effect. With prolonged exposure to heat on muscles, relaxation of their tone and increased fatigue are observed.

The body's response to cold treatments consists of three phases.

For first phase Characterized by constriction of skin blood vessels when exposed to cold. The skin turns pale and becomes cold, as blood moves to the internal organs, which leads to a decrease in heat transfer.

Second phase the reaction occurs in less than a minute: a reflex dilation of the skin's blood vessels occurs, it acquires a pink-red color and becomes warm to the touch.

If the cold continues, third phase reactions: capillaries and small veins remain dilated, and arterioles are narrowed, the speed of blood flow slows down, the skin becomes purplish-red, even bluish, and cold to the touch.

The narrowing of skin blood vessels and increased blood pressure during cold procedures is subsequently replaced by their expansion and lowering blood pressure.

Breathing during cold procedures is initially rare and deep, but later it becomes more frequent, metabolism and heat production increase.

Short-term exposure to cold increases nerve excitability, and a longer one lowers it. Cold also causes an increase in muscle excitability. The use of cold delays the development of acute inflammatory processes.

Changes in the body that occur under the influence of hydrotherapy procedures (from the nervous, cardiovascular and other systems, as well as thermoregulation and metabolism) manifest themselves differently in different patients. The combination of these changes is called the physiological response of the body. The direction in which these changes occur is judged by the vascular reaction of the skin.

When the hydrotherapy procedure is performed correctly, the skin turns red and becomes warm; At the same time, patients indicate good health, cheerfulness, and a feeling of pleasant warmth.

If the procedure is performed incorrectly, then the opposite picture is observed: the skin becomes pale, cold, trembling appears, and often “goose bumps” appear: in this case, the procedure should be stopped.

The nurse should observe the patient's physiological response, as well as monitor the state of pulse and respiration.

Bykovskaya T.Yu. Types of rehabilitation: physiotherapy, physical therapy, massage: textbook. allowance / T.Yu. Bykovskaya, A.B. Kabarukhin, L.A. Semenenko, L.V. Kozlova, S.A. Kozlov, T.V. Besarab; under general ed. B.V. Kabarukhina. - Rostov n/d: Phoenix, 2010. – 557 p. (Medicine). pp. 92-97.

– one of the most common physiotherapeutic methods, which has been used since ancient times. The main effect of heat treatment is on the skin, which allows you to achieve the desired physiological effects. Currently, there are several methods of heat treatment using mud, clay, sand, ozokerite and paraffin.

Therapeutic effect of heat therapy

The effectiveness of therapeutic procedures during heat therapy is due to the fact that under the influence of thermal factors certain changes occur in the body, namely:

blood redistribution;

increase in local temperature;

improvement of capillary blood flow and local metabolism;

improvement of regional blood flow;

resorption of inflammatory processes.

Mud for heat therapy

Healing mud is one of the oldest coolants used in medicine. Depending on the mineral composition of mud, they have different heat capacity and heat-holding capacity. Therefore, depending on the specific disease, the patient may be shown different muds.

As a rule, mud therapy takes from 10 to 20 sessions. It is effective for subacute and chronic inflammatory processes in the joints, diseases of the spine, diseases of the central nervous, genitourinary, digestive and respiratory systems.

Reader Questions

18 October 2013, 17:25 Hello. I am diagnosed with dermatitis with elements of eczema. I'm going to go to Saki. Are Saki muds useful/contraindicated for my diagnosis? Thank you

Ask a Question

Healing clay

Another excellent coolant is clay. Most often it is used to treat skin diseases.

Initially, the clay is heated in a water bath, and then applied to the place that is subject to heat exposure and covered with film. The course of treatment is usually 15-20 sessions.

In addition to skin diseases, clay is also used for diseases of the muscles, joints, spine, peripheral nerves, injuries and other diseases.

Using paraffin

Paraffin began to be used in physiotherapy due to its unique physical properties: it expands when heated and decreases when cooled. Thus, it exerts a slight compressive effect on the skin, causing heat to be distributed into deeper tissues.

Treatment with paraffin helps relieve pain, improves blood circulation, lymph flow and metabolic processes in the skin. Paraffin therapy perfectly relieves swelling and softens scars.

As a rule, the treatment procedure lasts 40-60 minutes. A standard course of paraffin therapy lasts 15-20 sessions (every day or every other day). After each session, the patient is allowed to rest for 30-40 minutes.

Heat treatment with ozokerite

Ozokerite is a petroleum product consisting of solid and gaseous hydrocarbons, mineral oils and resins. When ozokerite is applied to the skin, a spasm of small vessels occurs in the first few seconds, after which they expand. In this case, the hyperemia caused by the expansion of capillaries persists for almost an hour.

Ozokerite has a pronounced anti-inflammatory, analgesic, antiallergic and regenerating effect. Ozocerite therapy is especially popular in the treatment of injuries, chronic diseases of the joints, nervous and genitourinary systems.

Arkady Galanin

Gorlovka branch

Open International Development University

person "Ukraine"

Department: physical rehabilitation

Essay

discipline: Physiotherapy

"Thermal therapy"

1. Paraffin therapy

Paraffin therapy - medicinal use of medical paraffin.

Physical characteristics. Paraffin - mixture of high molecular weight chemicals inactive hydrocarbons methane series obtained during the distillation of oil. This translucent white substance, chemically and electrically neutral, has high heat capacity, heat-holding capacity, and low thermal conductivity, its melting point is 48-52 C. There is no convection. Thanks to these properties, even at high temperatures (60 ° C or more), paraffin does not cause burns .

Devices. Paraffin is melted in special paraffin heaters PE, Varitherm, Wax Bath or in a water bath.

When carrying out procedures, liquid paraffin is used, heated to a temperature of 60-90 ° C. Melted paraffin (55-65 C) is applied to an area of the body pre-lubricated with Vaseline with a flat paint brush in a layer 1-2 cm thick (layering technique). More often, after applying 1-2 layers of paraffin 0.5 cm thick, a napkin soaked in paraffin (65-70 ° C) made of 8-10 layers of gauze is applied to the affected area or blocks of frozen paraffin 1-2 cm thick at 42-50 ° C in a cuvette or tray (cuvette-application method). Sometimes hands or feet, previously coated with paraffin, are dipped into a bath of paraffin (bath technique). On top of the paraffin layer, the corresponding area of the body is covered with oilcloth or waxed paper and tightly wrapped with a layer of cotton wool or a blanket.

Mechanism of action of the factor

Physico's them ical effects: In the mechanism of action of paraffin, the main role belongs to the thermal factor. When heated paraffin is applied to the skin, heat (exogenous) is transferred by thermal conduction, which causes an increase in its regional temperature. When paraffin hardens (crystallizes), its volume decreases, which is accompanied by compression of surface tissues (mechanical factor).

Physiological effects: an increase in tissue temperature under paraffin by 1-3 ° C leads to the expansion of capillaries, increased oxygen transport, and the resorption of infiltrates and reparative regeneration in the lesion will accelerate. In the area of paraffin application, muscle spasm is reduced, compression of nociceptive conductors is relieved, which leads to a decrease in pain. The observed tissue compression during paraffin hardening causes excitation of low-threshold mechanoreceptors. As a result of this, local and segmental reflex neuroreflex reactions are formed, which enhance tissue trophism. When paraffin is applied to biologically active zones, changes occur in the organs associated with this skin metamer.

Therapeutic effects: anti-inflammatory (secondary, primary - anti-inflammatory), weak anti-edematous, reparative-regenerative, metabolic, antispastic; secretory.

Indications. Paraffin therapy is indicated general inflammatory changes (beyond exacerbation); intoxication; painful; chronic bronco-obstructive; hypertensive (except for elderly people in the collar area); dyspeptic; stool disorders; exocrine pancreatic insufficiency; hepatic and renal colic; dysuric; nephrotic and urinary (beyond exacerbation); convulsive; muscular-tonic; Raynaud; joint dysfunction; spinal deformities; skin, violation of tissue integrity; allergic; hypothyroid; obesity; menopausal; cephalgic, encephalopathy; hypothalamic; polyneuropathy; dyscirculatory encephalopathy; vestibular; dyskinetic (spastic); atrophic; asthenic; neurotic; radicular; radicular-vascular; reflex (beyond exacerbation).

Diseases: chronic inflammatory (bronchitis, tracheitis, pneumonitis, pleurisy, chronic gastritis, duodenitis, chronic cholecystitis, hepatitis, colitis, adnexitis, prostatitis) and metabolic-dystrophic diseases of internal organs; inflammatory diseases and consequences of injury to the peripheral nervous system (neuritis, radiculitis, neuralgia) and the musculoskeletal system (bone fractures, joint dislocations, ligament ruptures, arthritis, periarthritis); hypertension stage I-II; skin diseases (squamosal lichen, neurodermatitis, dermatoses); wounds, burns, frostbite, Raynaud's disease.

Contraindications. Along with the general for syndromes: general inflammatory changes (exacerbation); hypotensive; thrombophlebitic; phlebothrombosis; nephritic; jaundice; portal hypertension; hyperthyroid; hyperglycemic; liquor hypertension; dyskinetic (atonic); edematous; vegetative-vascular dystonia; liver failure; meningeal

2. Ozocerite therapy

Ozocerite therapy- therapeutic use of medical ozokerite.

Physical characteristics. Ozokerite is a mountain wax mixture of solid hydrocarbons of the paraffin series, a rock from the group of petroleum butums (ceresin up to 80%, paraffin - 3-7%), gaseous hydrocarbons (methane, ethane, propylene, ethylene), high and low boiling mineral oils, asphaltenes, tars, carbon dioxide and hydrogen sulfide (up to 8-10%). Depending on the content of resins and asphaltenes, the color of ozokerite ranges from yellow to black. It also includes a thermotolerant ozokerite rod, which has antibiological properties. Brown ozokerite is more common. Its density is 0.8-0.97. Ozokerite is soluble in gasoline, benzene, chloroform and insoluble in water. It has maximum heat capacity and heat-holding capacity and minimum thermal conductivity. melting point - 60-80° C. Deposits of the rock from which ozokerite is obtained are available in Truskavets, Ukraine. For medicinal purposes, purified ozokerite is used, from which water, alkalis and acids have been removed.

Devices. Ozokerite is melted in a water bath, paraffin heater, and heated in a thermostat.

Methodology and technique of the procedure. Ozokerite is applied at a temperature of 50 C to the surface of the skin, previously lubricated with a thin layer of Vaseline. As with paraffin therapy, layering and application techniques are used. The area of the body with ozokerite is covered with oilcloth or wax paper and tightly wrapped with a layer of cotton wool or a blanket.

Mechanism of action of the factor

Physico-chemical And logical effects: in the action of ozokerite, thermal (heated ozokerite upon application increases the skin temperature by 2-3 C), chemical (the active substances included in its composition, entering the skin, irritate epidermal cells, fibroblasts and fibroclasts, macrophages, which contribute to the destruction of connective tissue in scars) and mechanical factors of action.

Physiological effects: Initially, ozokerite upon application causes a short-term (5-40 s) spasm, followed by dilation of microcirculatory vessels and increased peripheral blood flow, severe hyperemia, increased sweating, activating metabolism in tissues, and reducing muscle tone. During solidification (crystallization), the initial volume of ozokerite decreases by 10-15% (1.5 times more than paraffin), which leads to pronounced compression of surface tissues, excitation of skin mechanoreceptors and reflex-segmental reactions of metamerically associated organs.

Medicinal effects : anti-inflammatory (secondary, primary - pro-inflammatory), reparative-regenerative, metabolic, antispastic, defibrosating, secretory.

Indications. Ozocerite therapy is indicated at the nextmainsyndromes: general inflammatory changes (beyond exacerbation); intoxication; painful; respiratory, vascular, stage I insufficiency; hypertensive; dyspeptic; stool disorders; exocrine pancreatic insufficiency; hepatic and renal colic; dysuric; urinary; convulsive; muscular-tonic; Raynaud; violation of the functions of the statutes; spinal deformations; cutaneous; violation of tissue integrity; allergic; hypothyroid; obesity; menopausal; encephalopathy; encephalomyelopathy; hypothalamic; polyneuropathy; neuropathy; discirculatory encephalopathy; vestibular; dyskinetic; atrophic; asthenic; neurotic.

Diseases: chronic inflammatory diseases of internal organs and skin, injuries of the peripheral nervous system and musculoskeletal system, Raynaud's disease, vibration disease, ankylosing spondylitis, adhesions in the abdominal cavity, trophic ulcers.

Contraindications. Ozokerite therapy, along with general contraindications, is not used for syndromes: general inflammatory changes (exacerbation); painful (acute); heart, liver, kidney failure; hypertensive, hypotensive; thrombophlebitic; phlebothrombosis; jaundice; nephrotic; nephritic (exacerbation); joint degeneration (including syndrome of increased synovial fluid production); hyperglycemic; hyperthyroid; liquor hypertension; dyskinetic (atonic); edematous; vegetative-vascular dystonia; radicular (exacerbation); meningeal

Diseases: acute inflammatory, in elderly people on the collar zone with hypertension, rhythm disturbances and temperature sensitivity of the skin, purulent inflammation, thyrotoxicosis, diabetes mellitus, acute and subacute thrombophlebitis, diseases of the nervous system with a progressive course (amyotrophic lateral sclerosis, tick-borne encephalitis, etc. ), angina pectoris above FC III, liver cirrhosis, chronic glomerulonephritis, nephrosis.

3. Batch heat therapy

Package heat therapy - medicinal the use of artificial coolants of various chemical nature.

Physical characteristics. The heat capacity and heat-holding capacity of packaged coolants is higher than that of paraffin and ozokerite and they transfer heat to tissues for a long time. Sectional blocks of packages of such coolants wrapped in transparent plastic are called thermal pads. They come in various shapes and sizes. Warming pads with binary substances stored in different packages (electrochemical heating pads) and electric heating systems are also used.

Methodology and technique of the procedure. Thermal pads are heated in warm water or a thermostat to 70 ° C and placed on the patient’s body above the pathological focus or on the segmental reflex zone, covered tightly with a towel or blanket. Batch coolants are used according to the application method.

Mechanism of action of the factor, indications, contraindications, dosage similar to paraffin therapy.

4. Peloid therapy

At resorts and medical institutions, natural coolants are used - therapeutic mud or peloids - natural organomineral colloidal formations containing biologically active substances and living microorganisms.

The Slavic and Saki muds produce biological substances such as vitamins A and B, alcoholic fermentation enzymes, volatile organic substances, hormone-like components such as folliculin, acetylcholine and choline, penicillin-like and other products that have a therapeutic effect.

Physical characteristics. Depending on the composition and origin of mud, it is divided into five most commonly used types:

There are dirt:

1. Silt sulfide mud, which is these deposits of salt water bodies.

2) sapropels - silt deposits of fresh water bodies containing more than 10% organic matter;

3) peat mud - peat formations of swamps containing 50% organic matter;

4) hill mud - enriched with organic substances of petroleum origin;

5) clayey silts and hydrothermal muds.

Homogeneity, high plasticity, high heat capacity and low thermal conductivity determine the therapeutic use of mud. The first three types of mud are most often used in the clinic.

Mud consists of three parts - crystalline skeleton, colloidal fraction and mud (saline) solution. Crystalline skeleton, or frame, - the coarse part of the mud, consisting of inorganic particles 0.01-0.001 mm in size, coarse organic residues of plant and animal origin (gypsum, calcite, dolomite, phosphates, silicate and carbonate particles, etc.). Colloidal complex - the finely dispersed part of the dirt, represented by particles less than 0.001 mm in size (organic substances, organomineral compounds, hydrotrollite, sulfur, hydroxides of iron, aluminum, manganese, etc.). I" mud solution -- liquid phase of mud containing its main components(minerals, organic matter and dissolved gases). The mineralization of the mud solution ranges from 0.05-1 to 400-450 g/l. The properties of the mud solution are determined by the mineralization and composition of the mud. Microorganisms, especially hydrogen sulfide bacteria, play an active role in mud formation. The black color and plasticity of the mud are due to iron oxide hydrate.

Silt hydrogen sulfide mud- a black shiny mass of ointment-like consistency, velvety to the touch. It forms at the bottom of sea estuaries and salt lakes containing sulfates. As a result of the decomposition of the remains of aquatic plants and animals, sulfates are reduced to hydrogen sulfide. In silt mud, mineral substances predominate over organic substances, the content of which is low (usually up to 5%). The ash content of mud varies - from several to hundreds of grams per liter. Organic substances are represented by bitumen, humins, lignin, cellulose, compounds of nitrogen, phosphorus, iron, sulfur, remains of algae and living organisms. Silt mud also contains biologically active substances, enzymes, hormone-like compounds, microelements, etc.

Sapropels - formed at the bottom of fresh water bodies, it is a gelatinous mass of greenish color, rich in organic substances. Unlike silt mud, sapropels have a greater heat capacity. Sapropels are fine colloidal deposits, the organic substances of which are represented by the lignin-humus complex, bitunam, liquid and solid carbohydrates, complex humic acids, resins and pigments, from the group of carotenoids. Enzymes, vitamins, hormones, microelements and other biologically active compounds were found in sapropels.

Peat mud- a product of long-term decomposition of plant organisms in swampy conditions. This dark brown mass has a moisture content of 60-65%, and its thermal conductivity is no less than that of silt mud. The composition of peat includes proteins, humic acids, bitumen, fats, enzymes, phenols, colloidal and crystalline substances.

Devices. They use the Potok apparatus for galvanic mud, a Barzhansky syringe or a Zdravomyslov tamponator to introduce mud rectally and vaginally. The procedures are carried out on a mud couch with electric heating, a couch for gastrointestinal irrigation with a dosing barrel (mud and general procedures).

Methodology and technique of the procedure. The most commonly used mud applications are on the panty area of the lower back, hypogastrium and segmental areas. Depending on the localization of the pathological focus, general, diluted mud baths, segmental reflex and local mud applications are used. For general applications, therapeutic mud is applied in an even layer 3-4 cm thick over the entire body of the patient, excluding the neck, head and cardiac region. Segmental reflex and local applications are carried out by applying mud to various areas of the body. The area of the body exposed to therapeutic mud is successively wrapped in a tarpaulin sheet, oilcloth and blanket. After the procedure is completed, the patient is unwrapped and the surface layer of dirt is removed from him. Then the patient washes himself in the shower, dresses and rests for 30-40 minutes. Mud therapy is also used in the form of mud baths, galvanic mud, diadynamic mud, amplipulse mud, fluctuating mud, as well as electrophoresis of mud extraction ("mud squeeze" and mud preparations are used). The mud solution is obtained by centrifugation, squeezing out the mud under a press, and filtration. The method of obtaining the solution does not significantly affect its chemical composition. Sapropel centrifugates in sterilized glass containers can be stored for up to 6 months. Due to the possible precipitation of some components, it is better to use a freshly prepared solution. The composition of mud solutions includes chlorine, sodium, and magnesium ions. iron, zinc, phosphorus compounds, soluble organic substances such as humins, fulvic acids, lysine, amino acids, etc. Organic substances in ionic form are able to penetrate into tissues through intact skin and have a reflex and humoral effect on the body. To prepare mud baths, add 2-3 buckets of mud to a bath of fresh or mineral water. The temperature of the mud baths is 40-42C. In addition to the external method, mud is administered in the form of rectal and vaginal tampons.

Mechanism of action of the factor

Physico-chemical effects: the impact of dirt occurs largely through temperature and, to a lesser extent, through mechanical, chemical and biological factors. The thermal effect is due to the fact that mud has the properties of heat carriers - high heat capacity, low thermal conductivity, lack of convection ability. When applying mud, the volatile substances it contains, ions, peptide and steroid hormonal substances, humic acids and non-polar gas molecules penetrate the skin through the ducts of the sebaceous glands and hair follicles, which causes the chemical action of the mud. Muds are a kind of sorbents and ion exchangers. The mechanical effect is less pronounced and appears mainly when prescribing general mud procedures, mud baths and large-area applications.

F physiological effects: accumulating in the skin, the active components of the mud enhance the metabolism of the underlying tissues, induce differentiation of the germ layers of the epidermis, the release of local vasoactive peptides (histamine, bradykinin, endothelial relaxing factor), and increase the excitability and conductivity of the nerve conductors of the skin. Under the influence of such complex irritation, a series of complex functional changes occur in the body, which are manifested by a general and local (focal) reaction.

Therapeutic effects: anti-inflammatory, metabolic, immunomodulatory, (desensitizing), defibrosing.

Indications. Peloid therapy is indicated with the following main syndromes: general inflammatory changes (beyond exacerbation); intoxication; pain (chronic); respiratory, vascular, insufficiency, stage l; hypertensive; dyspeptic; stool disorders; exocrine pancreatic insufficiency; hepatic and renal colic; dysuric; convulsive; muscular-tonic; Raynaud; dysfunction of joints; spinal deformities, tissue integrity violations; allergic; anemic; obesity; dyscirculatory encephalopathy; dyskinetic (spastic); cerebroischemic; hyperadrenergic; hypersympathicotonic; atrophic; asthenic; neurotic (astheno-neurotic, neurosis-like); radicular; radicular-vascular; reflex (beyond exacerbation).

Diseases: chronic inflammatory and metabolic-dystrophic disorders of the musculoskeletal system, consequences of its injury, diseases of the peripheral nervous system, chronic inflammatory diseases of the genitourinary system, respiratory, digestive, ENT organs, skin diseases without exacerbation, adhesive disease, impotence.

Contraindications. Along with the general npu syndromes: general inflammatory changes (exacerbation); intoxication; painful (acute); broncho-obstructive; presence of liquid in the cavity; heart rhythm disturbances; heart, liver, kidney failure; hypotension; thrombophlebitic; phlebothrombosis; jaundice; nephrotic and nephrotic (exacerbation); joint deformities (including the syndrome of increased production of synovial fluid); hyperglycemic; hyperthyroid; liquor hypertension; dyskinsticheskopkh (atonic); edematous; vegetative-vascular dystonia; radicular; radicular-vascular (exacerbation); hypomenstrual with hypofunction of the ovaries.

Diseases: acute inflammatory or chronic in the acute stage, active tuberculosis, impaired temperature sensitivity of the skin, arrhythmias, pregnancy (on the abdomen), thyrotoxicosis, diabetes mellitus, angina pectoris above FC III, hypertension above stage 1, bronchial asthma, nephrosis, ovarian hypofunction, cirrhosis liver.

Dosages. Dosing of peloid therapy procedures is carried out according to the temperature of the therapeutic mud or mud solution, area and duration of exposure. Currently, silt mud is used at temperatures from 38 to 46 C. Peat mud, whose thermal conductivity is lower than other muds, is used at a slightly higher temperature (38-48 C). Mud therapy has 3option: softened, medium, intense.

Bibliography

1. Bogolyubov V.M. Physical factors in prevention, treatment and medical rehabilitation. - M.: Medicine. - 1987. - 154 p.

2. Bogolyubov V.M., Ponomarenko G.N. General physiotherapy: Textbook. - M., 1999

3. Clinical physiotherapy / Ed. V.V. Orzheshkovsky. - Kyiv, 1984

4. Klyachkin L.M., Vinogradova M.N. Physiotherapy. - M., 1995

5. Ponomarenko G.N. Physical methods of treatment: Handbook. - St. Petersburg, 2002

6. Ulashchik V.S., Lukomsky I.V. General physiotherapy: Textbook, Minsk, “Book House”, 2003.

7. Physiotherapy: Transl. from Polish /Ed. M. Weiss and A. Zembaty. - M.: Medicine, 1985.-496 p.

Biological basis of heat therapy

Thermal energy is a physical factor with high biological activity. Thermal exposure has a significant impact on the body's energy balance, which causes a variety of biological responses that manifest themselves at the clinical level.

The body of warm-blooded (poikilothermic) animals has the ability to maintain a relatively constant temperature of its internal environment. The constancy of the temperature reaction is ensured by two interrelated processes: heat production and heat transfer, which make up the body’s heat exchange. As a rule, different parts of the animal's body surface have different temperatures due to different heat transfer conditions.

The intensity of heat transfer processes depends primarily on the density and thermal conductivity of tissues. Liquid media (blood, lymph, cerebrospinal fluid, etc.) have high thermal conductivity and high sensitivity to thermal influences, while dense tissues (skin, subcutaneous fat, hair) conduct heat much worse and have thermal insulating properties, helping to retain heat.

Heat production by its nature is a chemical process and is associated with redox reactions in tissues and organs; heat transfer is physical in nature and occurs through convection, evaporation and thermal radiation.

Convective heat transfer occurs when liquid or gaseous media move both inside and outside the body (blood, lymph, inhaled air, etc.). During evaporation, heat is lost not only from the surface of the skin and mucous membranes, but also from the surface of the pulmonary alveoli during breathing.

Any excess heat received from the external environment increases heat transfer and, conversely, heat loss increases heat production. This is the biological meaning of the influence of thermal procedures on a living organism.

Characteristics of the main coolants

To carry out thermotherapy procedures, coolant substances or peloids are used. These include paraffin, ozokerite, clay, sand and therapeutic mud.

Peloids- these are substances with high heat capacity and very low thermal conductivity, that is, these are substances capable of retaining heat for a long time and gradually, slowly releasing it to the body. Peloidotherapeutic procedures are intended for topical use only.

Paraffin- this is the most affordable means for carrying out thermotherapy procedures both in clinics and at home. Paraffin is a product of the distillation of oil or brown coal. For medicinal purposes, highly purified varieties of white paraffin with a melting point of 50-55 degrees are used. Paraffin has extremely low thermal conductivity, the ability to retain heat for a long time (60-90 minutes), as well as a pronounced compression ability (when cooled, it decreases in volume by 10-12%).

Ozokerite ormountain wax is a natural hydrocarbon compound of dark brown or black color. It consists of a mixture of paraffin hydrocarbons, mineral oils, asphalt resins, and a number of gaseous hydrocarbons. Ozokerite has a thermal and compression effect, similar to paraffin. However, unlike paraffin, it also has a chemical effect due to the biologically active substances (BAS) it contains, which have an acetylcholine-like and estrogenic effect. Penetrating through intact skin, these substances have a reflex effect on the autonomic nervous system and a stimulating effect on metabolism.

Application of heated sand ( psammotherapy) is one of the simplest and most accessible methods of heat therapy used at home. For this purpose, clean river sand is used, free from foreign impurities and small stones.

Mud therapy- use of natural mud for medicinal purposes. Based on the origin of mud, they are divided into three groups: silt, peat and pseudovolcanic.

Silt mud is formed in salty (sulfide) or fresh water bodies (sapropel) and is a product of slow decomposition under water of animal residues, with their gradual interaction with soil, water and salts. Silt mud is a black ointment-like mass with the smell of hydrogen sulfide or ammonia. Sapropelic mud is an organic peloid formed at the bottom of freshwater bodies of water. It is a gelatinous mass of greenish color.

Peat mud is formed in swamp-type reservoirs from plant residues. Pseudovolcanic mud is ejected from mud hills and consists of softened rock mixed with water. Therapeutic mud consists of two phases - liquid and solid. The liquid phase (mud solution) is an aqueous solution of mineral salts and organic compounds. The solid phase consists of a crystalline skeleton and a colloidal fraction, represented mainly by iron sulfides, organic collides and silicic acid. Therapeutic mud contains a large amount of hormone-like and vitamin-like biologically active substances that have high activity, great penetrating ability and antibacterial effect. The biological effect of mud is manifested in the following:

Pronounced thermal effect for a long time,

Mineral salts and organic substances have an astringent effect on the skin.

Entering through the skin gate, active substances have a beneficial effect on metabolic processes,

The activity of the excretory organs (urinary system, sebaceous and sweat glands) and the endocrine system improves.

Thus, the therapeutic effect is due to the simultaneous influence of the temperature of mechanical and chemical stimulation.

Heat therapy is a type of physical therapy that is used to reduce symptoms of the disease, shorten the period of exacerbation and create a longer period of remission. The discovery of this treatment method goes deep into history. One of the types of heat therapy, peloidotherapy, is mentioned in the works of the Roman scientist of the 1st century AD. e. Ayurveda. In his works, he described the successful treatment of various diseases with mud. Herodotus spoke about the healing properties of salt lakes and Egyptian methods of treatment. During the Crusades, healers used mud to heal wounds, which soon healed without infection.

In modern medicine, other methods are also used for heat treatment. Ozokerite therapy began to be used in medicine in the middle of the 19th century, when the active substance was analyzed and its medicinal properties were confirmed. The use of paraffin therapy as a physiotherapeutic method of treatment was proposed at the beginning of the 20th century by the French doctor B. Sandorf. This method gained its main popularity during the First World War, after which its positive effect was used during the Great Patriotic War in the treatment of wounds. Modern scientific research has proven the effectiveness of heat therapy, and it is recommended by clinical protocols.

Types of heat therapy methods

Practitioners actively use various types of substances for therapeutic, preventive and rehabilitation purposes: mud, ozokerite, paraffin, naphthalene, clay.

The general mechanism of action for all methods is based on the high heat transfer of the substances used; heat affects the patient’s body throughout the entire session.

In addition to thermal properties, each substance has individual physical and chemical properties.

Paraffin therapy is the use of the healing properties of paraffin for healing purposes. The substance, paraffin, is obtained from oil refining and is a complex of carbohydrates. It has a high heat capacity and retains heat well. For therapeutic purposes, a special dehydrated agent is used.

The effect of paraffin therapy is intense heat transfer at the site of application and an increase in regional temperature by 2-3°C. As a result, there is an increase in local blood flow in the microvasculature. Redness of the skin improves metabolism, activates the resorption of infiltrates and regeneration mechanisms at the site of the lesion. In the area of paraffin action, a pronounced antispasmodic effect is observed, skeletal muscles relax and compression of nerve fibers decreases, which leads to the disappearance of pain.

When the substance hardens, compression occurs at the site of application, as its volume is reduced, this excites skin receptors and increases their susceptibility to temperature and mechanical effects. During the procedure, tissue nutrition at the site of paraffin application improves. The effect of heat on biologically active zones leads to a restructuring of the functioning of organs corresponding to the area of influence.

Ozokerite therapy involves performing therapeutic procedures using flavored wax – ozokerite. The mixture is a complex of hydrocarbons and a heat-resistant ozokerite stick. It is characterized by good heat-retaining properties and conducts heat slightly. In physiotherapy, purified and dehydrated ozokerite is used.

The basis of the ozokerite therapy method is thermal, chemical and mechanical effects. Ozokerite initially causes a spasm of the blood capillaries, then their expansion. In the area of application, microcirculation and tissue nutrition are improved, biological processes are activated aimed at destroying bacteria. At the site of application, venous and lymphatic outflow is activated, regeneration in the area of inflammation improves. Activation of nerve receptors leads to local reactions and enhances the activity of organs; innervation corresponds to a specific dermatome.

Ozocerite therapy directly affects the parasympathetic nervous system. The chemical elements included in the structure of ozokerite have a stimulating effect, entering deep into the epidermis, activating cell division, and enhancing the protective functions of the body. As a result, this therapy stimulates the body’s immune system and promotes scar healing.

Another method of thermotherapy is the use of naphthalene oil. It promotes activation of blood circulation, improves the permeability of the vascular wall of capillaries, has antioxidant properties, reduces blood clotting and prevents the formation of blood clots. By reducing the activity of biologically active chemicals, this method reduces inflammation and pain, and activates the work of motor fibers of peripheral nerves. Thermotherapy increases the amount of serotonin and has a desensitizing property.

Methodology for performing thermal procedures

To carry out paraffin therapy, there are several algorithms for performing procedures. Before any of them, it is necessary to melt the paraffin to 55-65°C in a special apparatus - a paraffin bath. Then, gradually, using a brush, layering one layer on top of another, apply paraffin up to 2 cm thick. For paraffin therapy in the extremity area, it is possible to use the immersion technique. An oilcloth and a warm towel are placed on top, and when performing physical treatment of the limbs, warm mittens and socks are put on. The procedure lasts 15 minutes, 10 sessions per course.

The cuvette-application procedure is carried out by pouring paraffin into cuvettes, the layer is more than 2 cm. Cover the selected area of the body with the cooled substance, covering it with oilcloth and a warm cloth. Session duration is 20 minutes. The therapeutic course includes 10 procedures.

The napkin-application procedure is carried out by spreading several layers of paraffin on the required area. The gauze fabric is soaked in paraffin at 60°C, wrung out and laid on top of the applied layer. Cover the top with a warm cloth and leave for 20 minutes. There are 10 sessions per course of treatment. After the session, the patient needs to rest for 30 minutes. Subsequent procedures are prescribed by a specialist.

Physiotherapeutic measures using ozokerite are perceived quite comfortably by patients even at a substance temperature of 70°C. Very often, in practice, mixed types of treatment are used: ozokerite-paraffin therapy, ozokerite-phototherapy. The following types of ozokerite therapy are carried out: application in layers, dipping, cuvette and napkin applications. Ozokerite is prepared, brought into a liquid state over boiling water, in a thermostat, in paraffin melts.

Ozokerite is laid out in a special vessel with a layer of 3 cm. When the substance reaches 50°C, it is laid out on the selected area, previously covered with petroleum jelly. Cover the top with film and insulate it with a towel or cotton wool. The application lasts 20 minutes. The treatment course contains 12 sessions.

When applying with a napkin, gauze fabric, laid in layers, is moistened in ozokerite. The napkin is placed on the desired area of skin, covered with a terry towel or cotton wool, application duration is 20-30 minutes. Perform 15 applications every day.

Naphthalene oil is used for lubrication, application and ultraphonophoresis. The lubrication procedure is performed by applying up to 200 grams of naphthalene to the skin with a brush. The area is then irradiated with infrared lamps. The procedure lasts 20 minutes, after which the naphthalene is washed off in the shower. Sessions are performed once every two days. Treatment course: 15 procedures.

Applications are carried out with a substance consisting of naphthalene and paraffin, heated in a steam bath. The resulting composition is poured into cuvettes, cooled and spread on the desired area. The top is insulated with a terry towel or cotton wool. Session duration is up to 30 minutes. The therapeutic effect occurs after 12 sessions, performed once every 1-2 days.

Ultraphonophoresis is carried out using an ultrasonic device, having previously applied naphthalene to the skin. The procedure is performed not only in a physical therapy room, but also at home, if you have the necessary equipment and skills. The average frequency of ultrasound is 0.6 W, but should be based on the patient's immediate sensations. The session lasts 12 minutes, daily. Heat therapy consists of 20 sessions.

Indications and limitations for the use of heat therapy

Thermal procedures are widely used by various specialists in the treatment of a number of diseases. Heat therapy has indications and contraindications, on the basis of which the doctor individually selects the method of implementation. Heat therapy is carried out for the following pathologies:

Diseases of the musculoskeletal system due to injuries, chronic or subacute inflammatory process: fractures, ligamentous injuries, violation of the integrity of the joint capsule, myositis, osteochondrosis, degenerative changes in the joints.
Consequences of injuries or inflammatory diseases of peripheral nerves in the subacute and chronic stages: neuritis, neuralgia, radiculopathy.
Diseases of the lower respiratory tract in the chronic stage.
Diseases of the cardiovascular system: arterial hypertension stages 1-2, varicose veins, obliterating endarteritis, inflammation of the veins, Raynaud's disease.
Diseases of the gastrointestinal system: peptic ulcer, gastroduodenitis, chronic inflammation of the liver, cholecystitis without stones.
Chronic processes of the genital organs in women: adnexitis, endometritis.
Pathological processes of the skin: lichen, neurodermatitis, dermatitis, poorly healing ulcers and wounds, eczema, psoriasis.
Adhesive process.
Diseases of the genitourinary system in men and women.
Inflammatory processes of the ENT organs are in remission.

Thermal procedures are contraindicated if:

Acute inflammatory diseases or purulent processes.
Blood diseases, including those with a tendency to bleed.
Bleeding.
Oncological diseases or suspicions of their presence.
Acute or viral hepatitis.
Inflammatory kidney diseases: pyelonephritis, nephrosis, glomerulonephritis.
Tuberculosis of the respiratory system and osteoarticular system.
Arterial hypertension stages 2-3.
Myocardial ischemia stages 2-3.
Myocardial infarction, no earlier than six months after the disease.
Angina pectoris with frequent attacks, functional class 3.
Atrial fibrillation.
Pronounced signs of atherosclerotic changes in blood vessels.
Decompensation of blood circulation 2nd degree.
Cirrhotic stage of hepatitis.
Myoma and myomatous nodes of the uterus.
Hyperthyroidism.
Neuropsychiatric disorders.
Any period of pregnancy and breastfeeding.
Infectious diseases.
Intoxication syndrome.
Hyperthermia.
Diseases of any organs and systems in the stage of decompensation.
Hereditary degenerative processes of the nervous system in a child are in the progression stage.
Dysfunction of the autonomic nervous system.
Individual intolerance to heat treatments or chemicals.

Thermotherapy can have a number of unwanted effects during procedures.

They can manifest themselves in the form of an allergic reaction such as urticaria, skin hyperemia, itching. Symptoms of toxic effects may appear: nausea, headache, tachycardia, pain in the heart, changes in blood tests. Heat therapy occupies a fairly important place in physiotherapy, but if it is impossible to use the method, alternative types of physiotherapy can be used: phototherapy, various types of electrotherapy.

Heat therapy. Physiological and therapeutic effect

Therapeutic effect of heat therapy

Mud for heat therapy

Healing clay

Using paraffin

Heat treatment with ozokerite

Similar documents

Biological basis of heat therapy

Characteristics of the main coolants

Types of heat therapy methods

Methodology for performing thermal procedures

Indications and limitations for the use of heat therapy