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Paraffin wax bath
- 1. Dr. Arjun Patel MPT- musculoskeletal and sports science Paraffin Wax-Bath
- 2. CONTENTS • Structure of the bath, • composition of wax and mineral oils, • physiological effects and therapeutic uses of wax bath • Other Heating Modalities: -Heating Pads, -moist heat.
- 3. Paraffin wax baths • Paraffin wax bath therapy is an application of melted paraffin wax on the body parts. • Paraffin wax for therapy is one of the most convenient ,reasonably efficient method of applying conducted heat to the extremities.
- 4. • It is one of the most useful of the superficial thermal modalities . • It is an easy , economical , and efficient way of applying gentle heat to an irregular surface such as the hand or wrist .
- 5. Paraffin bath unit • Parts of the typical paraffin wax bath unit are • container, • mains, • thermostat, • thermostat pilot lamp, • lid and caster.
- 6. • Container contains wax and paraffin oil . • Thermostat keeps the temperature fixed in the range which is adjusted with knob.
- 7. Thermostat pilot’s lamp indicates whether thermostat is on or off. Power pilot’s lamp function is to show whether power is on or off. Lid covers the container and caster allow the container to be moved from one place to another.
- 8. The temperature of the paraffin wax is maintained at 40-440c . The melting point for the paraffin wax is 51-550 c.
- 9. • If the only molten wax ,without the paraffin oil, at 51-550c is poured over the body part, it may cause burn over the body tissue. • So to prevent that some impurity is added to lower down its melting point such as liquid paraffin oil(mineral oil).
- 10. Most wax baths are kept at temperate between 42 to 52ºc ,often at the higher range for hand treatments and lower for the feet. The wax is molten in stainless steel baths which are electrically heated; the temperature is kept constant by the thermostat. some baths are contained within a heated outer water bath. The more modern designs of wax bath can be adjusted for height.
- 11. • They are light ,with a stainless steel bowl and outer fiberglass shell. • Initially heating is quicker with this type because there no water jacket to be heated .
- 12. • The combination of paraffin and mineral oil has low specific heat which enhances the patient’s ability to tolerate heat from paraffin better than from the water of the same temperature. • The mode of transmission of heat from paraffin to the patient skin by means of conduction.
- 13. • The composition of wax: liquid paraffin oil is 7:1 . • Some also use the proportion at the rate of 2:1:1, i.e. 2 parts of wax, 1 part liquid paraffin , 1 part petroleum jelly.
- 14. PHYSICAL CHARACTERISTIC OF WAX • Wax has a low thermal conductivity , and therefore it gives off heat slowly . • When a part is dipped in wax and the wax is allowed to set , there will be no rapid loss of heat from treated part . • The low thermal conductivity of the wax is prevents the patients felling as hot as in water of the same temperature
- 15. • The wax is self insulating . • the first layer creates a thin layer of air next to the skin which acts as an insulator. • Sweat does not evaporate and it also insulates. • After the removal of the wax ,the part cools quickly and feeling soft and pliable .
- 16. Physiological response to paraffin wax therapy • Heat production • Circulatory effects • Analgesic effects • Stretching effect
- 17. Heat production • There is a marked increase in skin temperature in the 1st two minutes, up to 120 130 c . • In the subcutaneous fascia ,there is an increase of 50 c at the end of the treatment. • In the superficial muscles, there is only about 2 to 30c rise in temperature at the end of treatment
- 18. Circulatory effects • Local hyperemia and reflex vasodilatation due to stimulation of superficial capillary and arterioles . • This is marked only in the region of the skin . • The effect of vasodilatation in the muscles are negligible ,but there may be some reflex heating in the joints.
- 19. • Skin and subcutaneous tissue temperature drops rapidly after 15 to 20 min ,reducing vasodilatation . • Exercise after wax is essential to increase muscle circulation , and to use the sedative effect of heat to obtain more range of movement and muscle strength.
- 20. Analgesic effects: • The most important effect of wax is its marked sedative effect on the tissues. • The moist heat is remarkably soothing to the patient . • It is useful for superficial joints.
- 21. Stretching effect: • Wax leaves the skin moist , soft and pliable . • This is useful for stretching scars and adhesions before applying mobilization techniques.
- 22. Indications • Pain and muscle spasm • Oedema and inflammation it reduces post traumatic swelling of the hand and feet and also swelling in hands affected by rheumatoid arthritis or degenerative joint disease, particularly in the sub acute and early chronic stage of the inflammation.
- 23. • Osteoarthritis • Joint stiffness • Adhesions and scars • Post – immobilization stiffness.
- 24. contraindications • Impaired skin sensation • Some dermatological conditions Eczema, Dermatitis • Circulatory dysfunction patient with Deep vein thrombosis , Arterial disease • Infections and Open wounds
- 25. • Skin rashes or open suture • Cancer or tuberculosis • Allergic conditions • Liniments • Lack of comprehension For e.g., children , very old patients ,
- 26. ADVANTAGE OF PWB • Low specific heat allows for application at a higher temperature than water without the risk of a burn • Low thermal conductivity. • Molten state allows for even distribution of heat to areas like fingers and toes • First dip traps air and moisture to create more even distribution
- 27. • Oil used in the wax add moisture to the skin • Wax remains malleable after removable. • Comfortable. • Relatively inexpensive to replace wax
- 28. DISADVANTAGE OF PWB Effective only for distal extremities in terms of ease of application . Most effective method of application is the bath method, which limits accessibility for other body parts to be treaded effectively . No method of temperature control once applied . Heating last only about 20 minutes. It is passive treatment ;exercise may not be performed simultaneously.
- 29. Methods of application Various methods used for application of wax: • 1) Direct Pouring Method • 2) Brushing Method • 3) Direct Immersion Or Dipping Method • 4) Bandage Method
- 30. Direct pouring method- • The molten wax is directly poured by a mug or utensil on the part to be treated and then wrapped around by a towel. wax is allowed to solidify for about 10mnts. several (4-6) layers can be made over the body tissues.
- 31. • Because of making 4-5 layers, the heat will not be lost in the environment. • So ,the tissue will get the proper amount of heat.
- 32. Brushing method • A brush is used to apply wax over the body part. • Several coats (4-6) are applied over the body part • Towel is wrapped over the part. • Wax is allowed to solidify.
- 34. Direct immersion or dipping method • The body part to be treated is directly immersed into the container of wax bath and taken out. • Once the wax solidifies , the part is again immersed to make another layer ,repeated for 3-4 times, and wrapped around by a towel.
- 36. • Once the treatment is given by wax bath, it can be reused for the next session. • Regular cleaning and changing of wax is required to ensure good hygiene.
- 37. Bandage method • In this method ,bandage of a suitable size and mesh is soaked in hot wax and then it is wrapped around the limb. • Additional wax then can be poured or brushed over the bandage.
- 38. 10 STEPS FOR APPLICATION PWB • 1) An area to be treated is inspected for any contraindications Like wound ,skin infection ,rashes etc . • 2) the patient is positioned in such a way that the part be treated comes closer to the container bath , clean the skin using tissue paper/cotton. • 3) tell the patient in brief about nature and temperature of wax and the benefits.
- 39. • 4) drip down few drops of molten wax on the dorsal surface of your hand to check the temperature . • This is done before the patient so that he/she can prepare psychologically and fear of heat is minimized .
- 40. • 5) Using 4 inch broad and thin pointing brush ,paste few inch area on the part of patient .see patients reaction ,tolerance and confidence to bear the heat . then repeat twice or thrice .
- 41. • 6) After the above steps the patient is always found to cooperate and fear of molten wax and heat is removed from the mind of patient. • 7) Now paste the entire area to be treated , and first layers of wax is formed .this layer should not be thin . -Like the same way, second and third layer is coated.
- 42. -When the layers are cooled and patients feels temperature has been reduced ,the wax layers are broken down or the ‘glove’ of the wax is normally left in place for some 10-15 minutes by which time the wax is completely solid, so that can be removed in one piece. • 8) Always use small quantity of wax on the brush especially when making first layer. -Brush movements should be medio-laterally and/or superio-inferiorly.
- 43. • 9) after removing the wax ,area is checked for any adverse conditions developed. • 10) the wax is applied in cycles for 5 to 20 minutes per day , for at least 10 days .
- 44. Purification of wax • The wax is periodically purified by transferring it in to a purifier before it is reused. • The technique of purification can be: the container with a wax is added with water and the mixture is heated to 100* temperature, till the wax is melted.
- 45. • After melting the wax the mixture is left undisturbed and allowed to cool gradually. • After cooling, the dirty materials will be deposited at the bottom whereas the wax has solidified at the top layer. • With proper care the pure wax is removed into the wax tank, leaving the dirty materials in to the purifier.
- 46. Mode of action of PWB • Despite the fact that skin temperature above 45*c can lead to damage, it is possible to dip the part in the molten wax at 50*, because the specific heat of wax is lower than the water.
- 47. • The wax transmits heat energy to the tissue by giving up energy as it solidifies.
- 48. • Although the temperature falls from the outer surface of the wax layer, the low thermal conductivity prevents much heat loss from the skin surface. • It prevents evaporation of water from skin – further improves insulation.
- 49. • Because of preventing the water loss from the skin, the Rx tends to leave the skin with more moisture , hence feeling soft and pliable.
- 50. Therapeutic Effects • Relief of pain • Relief of muscle spasm • Sedation • Increase of the joint range of motion or lengthening of scar tissues
- 51. •Thank you