Paraffin Wax Bath

*Introduction:-

~Paraffin wax bath therapy is an application of the molten  paraffin  wax on the body part.

~Paraffin wax is a white or colorless soft, solid wax. It’s made from saturated hydrocarbons.

~the melting point of wax is 51-55c.

~if the molten wax at 51-55 c is poured on the body part,its may cause burn.

~some impurity like  liquid paraffin or mineral oil is added to lower the melting point of safe application.

~thus the tempreture of the paraffin wax is  maintained at 40-44 c.

~the combination of the wax and mineral oil has low specific heat.

~this enhances the patient “s ability to tolerate heat from the wax better than from the water of the same tempreture.

~the composition of wax : paraffin : mineral oil is 7:3:1 or wax: paraffin or mineral oil is 7:1.

~the mode of the transmission of the heat from praffin to the patients skin is through conduction.

~paraffin has a slow thermal conductivity.

~slow heat diffusion(6 times lower than water)

~paraffin wax has a low melting point (55).

~when the oil is added ,the paraffin will remain at a tempreture of 40 to 44 C.

~This low specific heat  will enhance  the patient to tolerate heat from the paraffin better than from water of the same tempreture.

*self insulator:-

~its give moist heat.

~there is a layer between the skin and the wax producing heat and sweating which does not evaporate.

~after removal the heated part cools quickly by the evaporation.

~it is analgesic;-

~This insulting  layer keeps the heat and is effective in relief of pain.

*PWB Unit:-

~container is made up of enamelled baths or stainless still and fiberglass shell.

~container contains wax and paraffin oil in the prescribed ratio.

~thermostat keeps the tempreture adjusted with knob.

~thermostat pilots lamp indicates wether thermostat is on or off.

~power pilots lamp show wether power is on or off.

~lid cover container and caster allow the paraffin wax bath container to be move from place to place.

*PWB methods off application:-

*Dipping and Wrap:-

~most common method.

~involves  placing  body part to be treated in a paraffin bath, followed by removing it and allowing the paraffin cool and harden.

~approximately 7 to 12 dips are done.

~followed by wrapping in wax paper or plastic which is covered by towel or insulated mitts.

~ application time is 20 to 30 minutes or till wax cools.

*Immersion:-

~dip once for having a glove.

~then immerse for 15 to 20 min.

~never immerse at first for long time without making a glove.

~dry before to have insultions.

*direct pouring method:-

~the molten wax is direct poured by a mug or utensil on the part to be treated and 

~wrapped around by a table.

~the wax is allowed to be solidified for about 10-20 minutes.

~several(4-6) layer can be made over the body tissues.

*Toweling or Bandaging method:-

~a towel or roll of bandage is in molten paraffin wax and 

~wrapped around a body part.

~several layers can be made over the body part.

~this methgod preferably used for treating proximaly part of the body.

*Brushing Method:-

~it is less commonly   used  method of paraffin wax bath application.

~8-10 coats of paraffin wax are applied to the area with a paint brush using even and rapid strokes.

~the area is then wrapped with towel for 10-20minutes and after this time paraffin wax is removed and discarded.

*Physiological effects of heat:-

~hemodynamic effect 

~neuromuscular effect

~metabolic effect

~tissue extensibility

~pain and muscle spasm:especially in the distal extremities.

*Indications:-

~oedema and inflammation:-

~gentle heat reduces

~post traumatic swelling of hands and feet

~swelling of the hands in rheumatoid arthritis

~swelling of the hands in degenerative joint disease.

~especially in sub acute and early chronic stages or inflammation.

~caution is needed in acute arthritic pain and swelling.

*Adehsions and scars:-

~wax soften and facilitets  the mobilization and streching procedures.

*Contraindications:_

~ischemia:-eg; arterial insuffiency

~haemorrhage:-there is an increased arterial and capillary blood flow and heat.

~imaired sensation :-spinel cord injury may predispose to burn.

~inabillity to communicate or respond to pain :-eg;dementia

~malignancy:-may increase tumor growth

~acute trauma or inflammation:-diffusion across membrane is increased

~scar tissue:-elevation of  tempreture  increases the metabolic demand of the tissue ,scar tissue  has inadequate vascular supply , and is not able to provide an adequate vascular response when heated, which can lead to ischemic necrosis.

~poor thermal regulation.

*Advantages:-

~useful for pt. with poor heat tolerance ,dry scaly skins,after plaster of paris removal.

~can be follopwed by therapuetic exercises.

~can be carried out at home.

~wax can mold around the bony contours of heat & hands.

~heat is applied evenly by conduction.

*Disadvantages:-

~effective only for distal extremities in the term of ease of application.

~no method of tempreture controls  once applied.

~heating last only about 20 minutes.

~it is a passive treatment:-exercise may not be performed simultaneously.

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About vastralphysiotherapyclinic

Physiotherapist , Samarpan Physiotherapy Clinic, Vastral, Nirant Cross Road, Ahmedabad

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