Thermotherapy methods. The role of physiotherapy in the complex of rehabilitation measures: heat therapy, hydrotherapy, balneological resorts

– 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

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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

Thermotherapy(thermotherapy) - the use of heated bodies, called coolants, for therapeutic purposes. The fabric is heated by direct contact with the coolant.

Heat therapy is one of the oldest and most common methods of physical therapy. A large number of different coolants, proposed by both traditional and official medicine, have been used before and are currently used.

Thermal effects cause changes in metabolism. With an increase in tissue temperature by 1°, the intensity of metabolic processes in it increases by approximately 10%. To achieve a therapeutic effect, it is enough to increase the temperature of the tissue by 4-5°, but the heating must be sufficiently long and the heat flow uniform and stable. In this regard, the coolant must have certain physical properties that ensure such heating.

Preference should be given to coolants with a high heat capacity. Heat capacity is the amount of heat, expressed in calories, that is required to increase the temperature of 1 gram of a substance by 1 C. The greater the heat capacity of the coolant, the more heat will be transferred to the tissues. Another important characteristic of a coolant is thermal conductivity, which determines the ability of a substance to transfer heat. Upon contact with the coolant, a thermal note is sent into the fabric, the intensity of which is measured by the amount of heat passing per unit of time through a unit of surface. The greater the thermal conductivity of the coolant, the more intense the heat flow. Since much heating of the tissue is not required to obtain a therapeutic effect, coolants with low thermal conductivity, which provide a heat flow of low intensity, are preferable. The heat-holding capacity of a heated body is closely related to thermal conductivity. The lower the thermal conductivity, the longer the coolant remains heated, the longer the heat flow. Convection is important in heat transfer processes - mixing of cold and warm layers of a heated substance or environment. Heat transfer from water, for example, is provided mainly by convection. In coolants used in physiotherapy, convection currents are insignificant or practically absent. When such a coolant comes into contact with tissues, its thin layer directly adjacent to the skin quickly cools. The bulk of the coolant gives off its heat through this cooled layer through heat conduction. Since the coolant has low thermal conductivity, the patient can easily tolerate a fairly high temperature of the coolant.

Consequently, substances with high heat capacity and low thermal conductivity, in which convection is minimal or completely absent, are primarily used as coolants.

Basic physiological reactions and therapeutic effects of heat, the main indications and contraindications for its use were discussed in previous sections. We remind you of the following main effects of heat: antispastic, analgesic, intensifying blood and lymph circulation and metabolism in tissues. The latter effect is associated with the resolving and regenerative effect of heat, in particular during inflammatory processes.

Coolants are used mainly in the form of local effects - applications. The procedure is dosed according to the temperature of the coolant and the duration of exposure (30 - 60 minutes). Procedures are carried out daily or every other day, in an amount from 12 to 20 per course of treatment.

Main indications for thermotherapy procedures.

1. Inflammatory processes (without suppuration) in the stage of resolution

2. Degenerative-dystrophic and inflammatory diseases of the musculoskeletal system.

3. Diseases and injuries of the peripheral nervous system.

4. Consequences of injuries for the purpose of pain relief (bruises, sprains).

5. Hypermotor dyskinesia of internal organs.

6. Spastic type muscle contractures (before therapeutic exercises).

Main contraindications to heat therapy.

1. Acute and subacute stages of the inflammatory process, purulent inflammation, exacerbation of chronic diseases.

2. Impaired thermal sensitivity of the skin.

Therapeutic use of paraffin and ozokerite.

Paraffin(parumaffinis - inactive, lat.) - a mixture of solid high-molecular hydrocarbons of the methane series, has a microcrystalline structure. Paraffin is obtained by special processing of certain types of oil. Depending on the degree of paraffin purification and the content of petroleum oils in it, highly purified, purified and unrefined varieties are distinguished. In physiotherapy, highly purified and purified paraffins are used, which are a white mass.

The melting point of different types of paraffin varies widely. In medicine, high-melting paraffins are used, the melting point of which is 52-55o C.

Paraffin has a high heat capacity, very low thermal conductivity and is practically devoid of convection. In its therapeutic effect, its latent heat of fusion is of particular importance - the amount of heat spent on converting paraffin from a solid to a liquid state. During the reverse transition from the liquid to the solid state, the latent heat of solidification is released, which is equal to the latent heat of fusion. During this transition, the temperature of the paraffin mass used for application remains constant, which ensures a stable heat flow for quite a long time

When heating paraffin before a treatment procedure, its temperature is brought to 95o C. For this, a special paraffin heater with electrical heating is used, which operates on the principle of a water bath.

The following paraffin treatment methods are used.

1. Cuvette-application method: an enamel cuvette is used, the size of which corresponds to the area of paraffin application. Melted paraffin is poured into a cuvette lined with medical oilcloth in a layer 1-2 cm thick. The frozen but still soft paraffin is removed from the cuvette along with the oilcloth, applied to the area of the body to be treated, and covered with a quilted pad or blanket. This method is the simplest in technique, implementation, and can be used at home. The cuvette can be moved into the ward and the procedure can be carried out outside the thermotherapy room.

2. Napkin-application method: molten paraffin is applied to the surface of the skin with a brush to a layer thickness of 0.5 cm. A napkin made of 8-10 layers of gauze and soaked in molten paraffin is applied to this layer. The napkin is covered with oilcloth, then with a quilted pad or blanket.

3. Layering method: melted paraffin is applied to the surface of the skin with a brush to a layer thickness of 1-2 cm, covered with oilcloth, then with a quilted pad or blanket.

4. Paraffin bath method: used to treat the hand or foot, which is covered with paraffin using the layering method. Then the hand or foot is immersed in molten paraffin, heated to 60-65°, which is filled with a special bath or oilcloth bag.

When treating with paraffin, you must ensure that the skin being treated with paraffin is completely dry to avoid burns. The hair should be shaved or the corresponding area of skin should be lubricated with Vaseline so that it does not stick to the cooled paraffin.

When melting, the mass of paraffin increases in volume by 10-15%. When hardening, the volume of paraffin decreases accordingly. When using circular paraffin application, tissue compression is significant. During compression, a greater amount of heat is transferred, at the same time, this heat is transferred to a lesser extent by the blood to other organs and tissues. The same paraffin can be used for heat treatment several times. Before reuse, paraffin is sterilized by heating it to 110°. Then heating is stopped.

Reducing the temperature of paraffin to 100° under normal room conditions takes time sufficient to sterilize it. To preserve the elastic properties of reused paraffin, 15-20% of fresh paraffin should be added to it. This procedure can be repeated 3-4 times. After this, paraffin loses its elasticity, crumbles when cooled and cannot be used for further use.

Ozokerite(ozo-smell, heros-wax, Greek), “smelling wax”, mountain wax. This is a product of petroleum origin, consisting mainly of a mixture of solid high-melting hydrocarbons of the paraffin series with an admixture of liquid and gaseous hydrocarbons of the same series. Ozokerite is a natural rock. Its various deposits differ in chemical composition and color: light green, yellow, brown, black. When stored in air for a long time, ozokerite darkens.

Ozokerite is obtained by evaporating the rock in boilers or extracting it with organic compounds. Next, partial distillation of mineral oils is carried out, completely freeing it from water and mechanical impurities. After processing, ozokerite looks like beeswax.

The melting point of ozokerite is from 52 to 68 °. Its heat capacity is higher and its thermal conductivity is lower than that of paraffin. The heat-holding capacity is much greater than that of paraffin; heat convection is practically absent.

The therapeutic effect of ozokerite is associated not only with its properties as a coolant, but also with the presence in its composition of biologically active substances that penetrate intact skin. They have an acetylcholine-like effect, increasing the tone of the parasympathetic division of the autonomic nervous system. There is information about more active regeneration of peripheral nerves during their diseases and injuries when treated with ozokerite compared to paraffin. The presence of folliculin-like substances in ozokerite is mentioned, and therefore its use in the treatment of female infertility associated with ovarian underdevelopment is recommended.

In general, the treatment methods with ozokerite, indications and contraindications for its use are the same as for paraffin treatment.

Thermotherapy– the use of heated bodies, called coolants, for medicinal purposes. The fabric is heated by direct contact with the coolant.

Heat therapy is one of the oldest and most widespread methods of physiotherapy. A large number of different coolants are used, proposed by both folk and traditional medicine.

Basic physiological reactions and therapeutic effects of heat: The achieved effects are antispastic, analgesic, intensifying blood and lymph circulation and metabolism in tissues. The latter effect is associated with the resolving and regenerative effect of heat, in particular during inflammatory processes.

Coolants are used mainly in the form of local influences - applications. The procedure is dosed according to the temperature of the coolant and the duration of exposure (30 - 60 minutes). Procedures are carried out daily or every other day, from 12 to 20 per course of treatment.

Main indications for thermotherapy procedures :

Inflammatory processes (without suppuration) in the stage of resolution
Degenerative-dystrophic and inflammatory diseases of the musculoskeletal system
Diseases and injuries of the peripheral nervous system
Consequences of injuries for the purpose of pain relief (bruises, sprains)
Hypermotor dyskinesia of internal organs
Spastic type muscle contractures (before therapeutic exercises)

Main contraindications to heat therapy

Acute and subacute stages of the inflammatory process, purulent inflammation, exacerbation of chronic diseases
Impaired thermal sensitivity of the skin

At the Day Hospital of the City Clinical Hospital named after. M. P. Konchalovsky (formerly City Clinical Hospital No. 3) provides the following thermal treatment services: paraffin and ozokerite

Terms of service:

For all for those who apply, services are provided on a paid basis .

To order a service you need to come for a consultation with the physical therapy doctor Alekseytseva S.A.

Have your passport with you. After the examination, the physical therapy doctor gives an opinion and recommendations. Here an agreement for the provision of paid services is concluded and a receipt for payment is provided.

Paraffin(parumaffinis - inactive, lat.) - a mixture of solid high-molecular hydrocarbons of the methane series, has a microcrystalline structure. In medicine, high-melting paraffins are used, the melting point of which is 52-55 o C.

When heating paraffin before a treatment procedure, its temperature is brought to 95 o C. For this, a special paraffin heater with electrical heating is used, which operates on the principle of a water bath.

The following paraffin treatment methods are used :

Cuvette-application method: an enamel cuvette is used, the size of which corresponds to the area where paraffin is applied. Melted paraffin is poured into a cuvette lined with medical oilcloth in a layer 1-2 cm thick. The frozen but still soft paraffin is removed from the cuvette along with the oilcloth, applied to the area of the body to be treated, and covered with a quilted pad or blanket. This method is the simplest in terms of technique. It can be used at home. The cuvette can be moved into the ward and the procedure can be carried out outside the thermotherapy room.
Napkin-application method: molten paraffin is applied to the surface of the skin with a brush until a layer thickness of 0.5 cm is achieved. A napkin made of 8-10 layers of gauze and soaked in molten paraffin is applied to this layer. The napkin is covered with oilcloth, then with a quilted pad or blanket.
Layering method: melted paraffin is applied to the surface of the skin with a brush until a layer thickness of 1-2 cm is achieved, covered with oilcloth, then with a quilted pad or blanket.
The paraffin bath method is used to treat the hand or foot. They are coated with paraffin using the layering method. Then the hand or foot is immersed in molten paraffin, heated to 60-65°, which is filled with a special bath or oilcloth bag.

When melting, the mass of paraffin increases in volume by 10-15%. When hardening, the volume of paraffin decreases accordingly. When using circular paraffin application, tissue compression is significant. During compression, a greater amount of heat is transferred to the neck, while at the same time this heat is transferred to a lesser extent by the blood to other organs and tissues. The same paraffin can be used for heat treatment several times. Before reuse, paraffin is sterilized by heating it to 110°. Then heating is stopped.

The melting point of ozokerite is from 52° to 68°. Its heat capacity is higher and its thermal conductivity is lower than that of paraffin. The heat-holding capacity is much greater than that of paraffin; heat convection is practically absent.

The therapeutic effect of ozokerite is associated not only with its properties as a coolant, but also with the presence in its composition of biologically active substances that penetrate through intact skin. They have an acetylcholine-like effect, increasing the tone of the parasympathetic division of the autonomic nervous system. There is information about more active regeneration of peripheral nerves during their diseases and injuries when treated with ozokerite compared to paraffin. The presence of folliculin-like substances in ozokerite is mentioned, and therefore its use in the treatment of female infertility associated with ovarian underdevelopment is recommended.

In general, the treatment methods with ozokerite, indications and contraindications for its use are the same as for paraffin treatment.

Indications for treatment with ozokerite :

Joint diseases (arthrosis, arthritis);
Spinal diseases (treatment of osteochondrosis);
In the treatment of ENT diseases (frontal sinusitis, sinusitis, tonsillitis, otitis media);
Post-traumatic treatment;
Treatment of gynecological diseases, including secondary infertility;
Diseases of the nervous system (treatment of neuritis);
Muscle inflammation (myositis);
Diseases of internal organs (chronic pneumonia, pleurisy, hepatitis, cholecystitis, gastritis, colitis, gastric and duodenal ulcers.

Tasks:

1 Familiarize yourself with the types of coolants and the general physical and chemical properties of these substances.

2. Familiarize yourself with the technique of using peloids, the mechanism of action and indications for their use.

HEAT TREATMENT- thermotherapeutic method of influencing the body using coolants. The term coolant is understood as a natural or artificial substance with high heat capacity, low thermal conductivity and significant heat-holding capacity. The most widespread use in both veterinary and humanitarian medicine is paraffin, ozokerite, sand, clay and mud. The use of mud is called peloidotherapy - from the Greek word pelos (dirt, silt), paraffin - paraffin therapy and, accordingly, the use of ozokerite ozokerite therapy.

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 insulation 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, activity of the 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.

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Introduction

physiological paraffin ozokerite therapy

Heat treatment (thermotherapy) is the use of heated bodies, called coolants, for medicinal purposes. The fabric is heated by direct contact with the coolant.

First of all, substances with high heat capacity and low thermal conductivity, in which convection is minimal or completely absent, are used as coolants.

For heat treatment, heated paraffin and ozokerite are used.

1. Paraffin therapy

Paraffin is a wax-like substance, a mixture of saturated hydrocarbons (alkanes) with a composition from C18H38 to C35H72.

The name comes from Lat. parum - "little" and athnis - "similar" due to its low susceptibility to most reagents, melting point 40-65 ° C; density 0.880-0.915 g/cm³ (15 °C). Obtained mainly from petroleum.

Paraffins are a mixture of solid hydrocarbons of the methane series, predominantly of normal structure, with 18-35 carbon atoms per molecule and a melting point of 45-65°C. Paraffins usually contain some isoparaffin hydrocarbons, as well as hydrocarbons with an aromatic or naphthenic core in the molecule.

The therapeutic effect of paraffin consists of the action of thermal and mechanical factors. Unlike medicinal mud, the effect of which is largely determined by its chemical composition, the effect of paraffin is based mainly on its physical properties.

When applied to the skin, molten paraffin hardens, forming a film whose temperature quickly decreases to body temperature. A thin gas layer forms between the skin and the film. The film and gas layer protect the skin from the high temperature of the overlying paraffin layers. When hardening, paraffin releases heat, as a result of which the temperature under the paraffin layer remains constant throughout the entire procedure.

As paraffin cools, its volume decreases by approximately 10%, which causes its compressive effect on tissue. It is especially evident with circular applications on the limb, and the compression of the tissues increases due to an increase in the volume of the warmed part of the limb. This promotes the spread of heat in the tissues to a greater depth, as well as reducing the lumen of peripheral vessels and accelerating blood flow in them.

Paraffin therapy procedures promote the expansion of capillaries and cause redness of the skin. In this regard, local metabolism in organs and tissues is enhanced, metabolic processes in the body are activated, which accelerates the removal of toxins from organs and tissues, especially those affected by disease. Increased local sweating also helps remove toxic substances from the body. All this determines the anti-inflammatory and stimulating effect of paraffin in chronic diseases of various organs.

It has been established that paraffin in patients with diseases and injuries of peripheral nerves accelerates the restoration of their conductivity. It has also been established that paraffin has a depressing effect on pathogenic microbes.

For medicinal purposes, purified white medical paraffin, free of impurities, with a melting point of 52-55 ° C is used. Melt the paraffin in a water bath, heating it to a temperature of 65-100 °C.

Paraffin therapy is indicated with the following main syndromes: 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

Equipment

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

The following paraffin treatment methods are currently used.

1. Layering technique. Melted paraffin (temperature 55-65 °C) is applied to the corresponding surface of the skin with a flat paint brush in a layer of 1-2 cm. Then the area of the body exposed to paraffin is covered with compressed oilcloth or wax paper and wrapped in a blanket or special padded pads. The temperature of such an application is about 50 °C.

2. Paraffin bath technique. The hand or foot is first coated with paraffin (temperature 50-55 °C), and then immersed in a wooden bath or oilcloth bag filled with molten paraffin at a temperature of 60-65 °C.

3. Napkin-application technique. After applying 1-2 layers of paraffin to the skin (up to a thickness of 0.5 cm), apply a gauze cloth folded in 8-10 layers, soaked in paraffin (temperature 65-70 ° C) and slightly wrung out; the napkin is covered with oilcloth and then with a blanket or quilted pad.

4. Cuvette-application technique. Melted paraffin is poured into a cuvette (5 cm deep), lined with medical oilcloth, protruding 5 cm beyond the edges (the dimensions of the cuvette must correspond to the area where the paraffin is applied). The thickness of the paraffin layer in the cuvette should be at least 1-2 cm. The frozen but still soft paraffin (50-54 ° C) is removed from the cuvette along with the oilcloth and applied to the area of the body to be exposed, and then covered with a blanket or a special padded jacket.

Paraffin therapy procedures lasting from 30 to 60 minutes are carried out every other day or daily. A total of 12-20 procedures per course of treatment. You should rest for at least 30-40 minutes after the procedure.

When applying paraffin to a small area (especially with an uneven body surface), it is best to use the layering technique. The paraffin bath technique is comfortable for the joints of the hands and feet. Napkin and cuvette-application techniques are widely used. They are used in cases where paraffin needs to be applied to relatively flat surfaces, the size of which can be different. The cuvette-application technique is very simple and convenient in terms of technique; the cuvettes can be transferred to the ward.

To avoid burns, the exposed area of the body must be completely dry. To prevent hair from sticking to the cooling paraffin, it is first shaved off or the skin is lubricated with Vaseline.

To treat burns, wounds and ulcers, a paraffin-oil mixture is used. It consists of heat-sterilized paraffin (75%) and fortified fish oil or cottonseed oil (25%). A paraffin-oil mixture heated to a temperature of 100°C is sprayed with a spray bottle and applied to the wound surface, somewhat capturing the surrounding healthy tissue. When spraying, the mixture cools to 70-80 °C. After spraying is completed, a sterile gauze napkin moistened with this mixture, folded in several layers, is placed on top of the resulting thin layer of paraffin, secured with a bandage, and left for several days. The procedure, providing thermal and compression effects, promotes faster healing of the wound.

Paraffin can be reused, but subject to prior sterilization. For this purpose, paraffin is heated to a temperature of 120 ° C and kept at this temperature for 10-15 minutes. To restore the plastic properties of paraffin, it is necessary to add 10-15% fresh paraffin each time.

In children of the first years of life, especially in an excited state, the first paraffin film is more difficult to obtain. Cracks often form on it, into which hot paraffin can then get trapped. To avoid this, the first layer of paraffin is created using 1-2 layers of gauze soaked in semi-cooled paraffin. Then further layers of hot paraffin are applied to a total thickness of 2-3 cm.

The application site is covered with oilcloth, a padded pad, and the patient is wrapped in a blanket. The duration of the first procedure is 20 minutes, subsequent ones for young children up to 30 minutes, preschoolers and schoolchildren - up to 40 minutes. Paraffin baths can be used to treat limbs. Children usually tolerate paraffin baths and baths well. After removing the paraffin, the limbs are wrapped in a warm sheet and blanket and the patient should sleep for 1-1.5 hours. It is better to carry out the procedure an hour before bedtime.

Paraffin therapy is contraindicated in children under one year of age, with a tendency to bleeding, tuberculosis and severe exhaustion, and malignant neoplasms.

2. Ozocerite therapy

Ozokerite literally means “smelling wax.” After appropriate processing, it looks like beeswax, has a petroleum smell and is plastic.

Ozokerite (“black wax”, or “frozen tears of the earth”, as it is popularly called) has been known in the Carpathian region for as long as oil, and it was used mainly for making candles and medicines. The first chemical analysis of ozokerite delivered from Truskavets was made in 1840 in Paris. The color of natural ozokerite depends on the quality and quantity of resins and varies from light green and brown to black. The mineral oil content in it determines its consistency - pasty, waxy, brittle or hard. The product is soluble in gasoline, kerosene, resins, chloroform, and practically insoluble in water, alcohol and alkalis.

Ozokerite consists from high molecular weight paraffins and ceresins with the addition of liquid oils and asphalt-resinous substances. The only deposit of ozokerite in the world is located (at a distance of 4 km from the Truskavets resort) in the city of Borislav.

Physiological therapeutic effect

The main property of ozokerite as a therapeutic agent is to significantly enhance peripheral blood circulation and metabolism, which has a dispersive, anti-inflammatory and antiseptic effect.

Physico-chemicalAndlogicaleffects: 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.

Physiologicaleffects: 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.

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

Indications and contraindications for use

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.

Equipment

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

Most commonly used techniques

Ozokerite compress. To prepare ozokerite compresses, gauze or other hygroscopic fabric is taken, which is folded into six to eight layers and sewn together in the form of a gasket. The gasket is lowered into the vessel and soaked in molten ozokerite, and then pressed out by twisting it around a forceps on a flat hard surface (pan lid, metal plate, etc.). The gasket must be thoroughly squeezed out to completely eliminate the liquid ozokerite, the flowing drops of which can cause a burn on the skin. Then the gasket is spread out on an oilcloth lying on the table to cool to the desired temperature. The temperature is determined by a chemical thermometer in different areas of the gasket.

An ozokerite compress usually consists of two multi-layer gauze pads, placed one above the other, wax paper or oilcloth and a padded pad. The temperature of the first pad adjacent to the skin should not be higher than 45-50°C, the second pad, slightly smaller in size than the first, should have a higher temperature. Depending on the readings, the temperature of the second gasket is gradually increased from 60°C to 70°C, but not higher than 80°C.

The ozokerite compress is applied to the corresponding area of the body in the following order: first pad, second pad, wax wax, padded pad. The compress is fixed with a bandage, after which the patient is carefully covered with a sheet and a warm blanket.

2. Ozokerite cakes. With the cuvette-application method, molten ozokerite is poured into metal cuvettes of appropriate sizes with a side of 4-5 cm, pre-lined with oilcloth, protruding at the edges by 5 cm. The dimensions of the cuvettes for the thigh, lower leg and spine are 50x30cm, for the lower back and abdomen - 40x20cm, For individual joints, the cuvette sizes are slightly smaller.

Molten ozokerite, poured into a cuvette, cools to the desired temperature, thickens and turns into a cake. The duration of heat retention of an ozokerite cake depends (under all other conditions) on its thickness (2-5 cm): the thicker the cake, the longer the heat is retained. An ozokerite cake of the required temperature is removed from the cuvette along with the oilcloth and applied to the area of the body to be treated. A layer of gray cotton wool or a quilted pad is applied on top of the oilcloth, followed by wrapping.

Unlike ozokerite compresses, ozokerite cakes do not allow the use of ozokerite at high temperatures. Thus, in cases where certain indications require the use of more intense heat, ozokerite compresses are preferable.

When applying ozokerite cakes, greater contact of the ozokerite mass with the skin is achieved; in addition, the cuvette-application technique is simpler and does not require the use of dressing material.

Before applying an ozokerite compress or ozokerite cake, the skin of the corresponding area should be thoroughly dried to avoid burns. If there is abundant vegetation, the hair is shaved off. Oilcloth is placed on the bed or couch.

In most cases, treatment with ozokerite is carried out with the patient lying down. An exception is allowed for ozokerite therapy of certain areas of the upper extremities, for example: shoulder, elbow joint.

An ozokerite compress or ozokerite cake is usually placed for 40-60 minutes. After removing the ozokerite compress or cake, subsequent washing, unlike mud therapy, is not required; Ozocerite particles stuck to the skin can be easily removed with a cotton swab and Vaseline.

Treatments are given daily or every other day. After each procedure, a mandatory rest of 30-40 minutes is required. The general course of treatment averages 15-20 procedures.

Ozokerite compresses or ozokerite cakes are applied either directly to the site of the disease, or to the reflexogenic zone or to a symmetrical limb. When acting locally on a painful focus (joint, infiltrate, hemorrhage, etc.), an ozokerite compress or cake should be applied over a larger area than the area of the painful focus.

3. Ozokerite napkin. To create an ozokerite napkin, waffle fabric impregnated with ozokerite is used. Before application, the napkin is warmed up to 36-37°C, applied to the sore spot, and a heating pad (12-volt) is placed on top in such a way as to ensure normal adhesion of the napkin to the patient’s skin.

The procedure lasts 30-60 minutes. You should not sleep while taking the procedure so as not to cause overheating.

Features of use in pediatric practice

In children's practice, preference is given to the napkin-application method (napkins are moistened with ozokerite at 50 0C and a compress is applied). Typically, a course of ozokerite therapy consists of 10-15 procedures.

For children, ozokerite is heated to a lower temperature (not higher than 500C); The duration of the procedure is reduced to 15 minutes. Conclusion

Paraffin treatment and ozokerite treatment in medical practice are classified as heat therapy.

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

In our work, we examined the physiological therapeutic effect, indications and contraindications for use, equipment, and the most commonly used methods of paraffin therapy and ozokerite therapy.

List of used literature

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.

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