Sample Case: Superficial Heating Modalities

Hot Moist Pack

A 5 yr old boy comes to your clinic with a fracture of (L) wrist 2months ago. Your initial treatment is to use heating modality prior stretching the wrist, what heating modality are you going to use to address your goal?

A 64 yr old woman was diagnosed to have (B) rheumatoid arthritis of the hand. She complains of pain on (B) hands and you plan to use heating modality. What heating modality are you going to use to alleviate patient’s condition?

Paraffin Wax Bath

A 35 yr old construction worker complains of low back pain two days ago. The physiatrist diagnosed patient’s condition as muscle spasm of the back. What heating modality are you going to use to decrease patient’s symptoms?

Patient comes to you with complain of aching pain on the upper cervical area. You opt to use heating modality to decrease patient’s symptoms, what heating modality to use to best address patient’s complain?

Techniques of Application: Hot Moist Pack

Hot Moist Pack (HMP)

HMP provides superficial moist heat. It is made up of bentonite and silica gel. The gel has a property to absorb more water than its own which give off moist heat for 30 to 40 mins. The HMP is heated in a hydrocollator tank with a temperature of 76 to 80 degree Celsius (165 to 175 degree F)

The packs are in different sizes and shapes. Common sizes are the standard, low back and cervical packs. They are usually covered by Turkish towel, terry cloth or a bathroom towel with 4-6 layers (Wadsworth)6-8 layers (Michlovitz) 6-12 layers (Hecox).

Duration of Treatment : 20 – 30 mins

Techniques of Application:

1. Get the patient’s Vital Signs

2. Position the patient with the part to be treated relaxed and comfortable

3. Inspect the area to be treated for abrasions, cuts, wounds, scars, edema and other circulatory dysfunction.

4. Test patient’s sensation as to hot and cold

5. Do not expose the patient unnecessarily

6. Give the rationale to the patient as to the intensity, duration and the purpose of the treatment

7. Inform the patient to alert you if any pain, discomfort or burning sensation is felt

8. Remove the hot pack from the tank with tongs

9. Place the hot pack in a terry cloth or towel. Ensure that there will be 6-8 layers from the HMP and the patient’s skin.

10. Place the hot pack on the appropriate body area and secure it firmly to prevent slipping.

11. Tell the patient not to fall asleep

12. Check the patient every 5 mins to ensure that no extremely hot red areas or burns have developed.

Post Treatment Procedures:

1. Dry and inspect patient’s skin
2. Put the pack back in the tank
3. Hang the towels and covers to dry
4. Change patient’s towel if wet and if necessary
5. Get the patient’s Vital signs before leaving

References:

Thermal Agens in Rehabilitation by Michlovits

Electrophysical Agents in Physiotherapy by Wadsworth

Physical Agents by Hecox