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Heat Treatments

Overview :

There are four different ways to convey heat:

  • Conduction is the transfer of heat between two objects in direct contact with each other.
  • Conversion is the transition of one form of energy to heat.
  • Radiation involves the transmission and absorption of electromagnetic waves to produce a heating effect.
  • Convection occurs when a liquid or gas moves past a body part creating heat.

Hot packs, water bottles, and heating pads

Hot packs are a very common form of heat treatment utilizing conduction as a form of heat transfer. Moist heat packs are readily available in most hospitals, physical therapy centers, and athletic training rooms. Treatment temperature should not exceed 131°F (55°C). The pack is used over multiple layers of toweling to achieve a comfortable warming effect for approximately 30 minutes. More recently, several manufacturers have developed packs that may be warmed in a microwave over a specified amount of time prior to use.

Hot-water bottles are another form of superficial heat treatment. The bottles are filled half way with hot water between 115-125°F (46.1-52°C). Covered by a protective toweling, the hot-water bottle is placed on the treatment area and left until the water has cooled off.

Electrical heating pads continue to be used, however because of the need for an electrical outlet, safety and convenience become an issue.


Paraffin, a conductive form of superficial heat, is often used for heating uneven surfaces of the body such as the hands. It consists of melted paraffin wax and mineral oil. Paraffin placed in a small bath unit becomes solid at room temperature and is used as a liquid heat treatment when heated at 126-127.4°F (52-53°C). The most common form of paraffin application is called the dip and wax method. In this technique, the patient will dip eight to 12 times and then the extremity will be covered with a plastic bag and a towel for insulation. Most treatment sessions are about 20 minutes.


Hydrotherapy is used in a form of heat treatment for many musculoskeletal disorders. The hydrotherapy tanks and pools are all generally set at warm temperatures, never exceeding 150°F (65.6°C). Because the patient often performs resistance exercises while in the water, higher water temperatures become a concern as the treatment becomes more physically draining. Because of this, many hydrotherapy baths are now being set at 95-110°F (35-43.3°C). There are also units available with moveable turbine jets, which provide a light massage effect. Hydrotherapy is helpful as a warm-up prior to exercise.


Fluidotherapy is a form of heat treatment developed in the 1970s. It is a dry heat modality consisting of cellulose particles suspended in air. Units come in different sizes and some are restricted to only treating a hand or foot. The turbulence of the gas-solid mixture provides thermal contact with objects that are immersed in the medium. Temperatures of this treatment range from 110-123°F (43.3-50.5°C). Fluidotherapy allows the patient to exercise the limb during the treatment, and also massages the limb, increasing blood flow.


Ultrasound heat treatments penetrate the body to provide relief to inner tissue. Ultrasound energy comes from the acoustic or sound spectrum and is undetectable to the human ear. By using conducting agents such as gel or mineral oil, the ultrasound transducer warms areas of the musculoskeletal system Some areas of the musculoskeletal system absorb ultrasound better that others. Muscle tissue and other connective tissue such as ligaments and tendons absorb this form of energy very well, however fat absorbs to a much lesser degree. Ultrasound has a relatively longlasting effect, continuing up to one hour.


Diathermy is another deep heat treatment. An electrode drum is used to apply heat to an affected area. It consists of a wire coil surrounded by dead space and other insulators such as a plastic housing. Plenty of toweling must be layered between the unit and the patient. This device is unique in that it utilizes the basis of a magnetic field on connective tissues. One advantage of diathermy over various other heat treatments is that fat does resist an electrical field, which is not the case with a magnetic field. It is found to be helpful with those experiencing chronic low back pain and muscle spasms. Prior to ultrasound technology, diathermy was a popular heat therapy of the 1940s–1960s.

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