Shortwave diathermy

OVERVIEW OF SHORTWAVE DIATHERMY

1. SHORTWAVE DIATHERMY Dr.prashanth kumar 1 st yr pg in orthopaedics

2. Diathermy is a therapeutic treatment commonly prescribed for muscular and joint associated pains. The term ‘diathermy’ means ‘through heating’ or producing deep heating directly in the tissues of the body. ‘ Dia ’ through (also means two) ‘ thermy ’ heat or temperature It simulates the circulation, relieve pain, enhances rate of recovery of healing the tissue. INTRODUCTION

3. PRINCIPLE OF DIATHERMY Before injury, the dipole molecules of the body tissue are arranged on the basis of polarity . When the tissue is damaged the dipoles distribution become irregular and deviates from polarity based arrangement . Under the influence of an electric field , they rotate according to the polarity of their charge in the direction of the field lines and get rearranged and tends to acquire its previous stage of polarity

4. CHALLENGES OF DIATHERMY As the subcutaneous layer is fatty , direct delivery of heat to the deep layers of tissue is not possible. Diathermy involves uneven and uncontrolled delivery of heat therefore sometimes instead of the target tissue , surrounding tissue gets affected Subcutaneous layer

5. Diathermy uses an electric current to produce heat deep inside a targeted tissue. It can reach areas as deep as two inches from the skin’s surface. The diathermy machine does not apply heat directly to the body . Instead, the current from the machine allows the body to generate heat from within the targeted tissue. As the heat increases, it promotes blood flow. It can also help improve flexibility in stiff joints and connective tissue.

6. BENEFITS OF DIATHERMY Intense heat delivered provides pain relief and better flexibility Reduces inflammation Improves circulation Accelerate healing

7. TYPES OF DIATHERMY SHORT WAVE DIATHERMY LONGWAVE DIATHERMY MICROWAVE DIATHERMY ULTRASOUND DIATHERMY LASER DIATHERMY

8. SHORT WAVE DIATHERMY Def .: SWD is a modality that produces deep heating via conversion of electromagnetic energy to thermal energy . The pattern of heat produced depend on: ᴥFreq . used. ᴥ type of SWD unit. ᴥwater content of the tissues.

9. Shortwave diathermy current freq. 10 – 100 M Hz (The shortest radiofrequency wave is used in therapeutic diathermy.) the commonly used in medical work having freq . of 27.12 MHz with wavelength of 11 meters

10. Modalities: ether continuous or pulsed (PSWD). PSWD : application of series of short pulses of SWD so that short periods of SWD interrupted by gaps where there is no SWD. The pt. receives lower dose of SWD energy if compared with continuous SWD applied of the same time. The tissues will receive lower thermal load .

11. SWD : produce both deep and sup. Tissue heating , under certain controlled conditions it’s applied for 20 min at the max tolerable dose

12. T yp e s of Sho r t w a v e D i a th e r m y I ndu c t i o n F i e ld C a p aci t i v e F i e ld

13. I ndu c t i on F i e l d D i a th e r m y P laces t he p a tie n t in t he elect r o m a g n e ti c f ield C ur r e n t f l o w i ng w i t h in t he c o il p r o du ces a r o t a ti ng m a g n e ti c f ield Ma g n e t i c f ield p r o d u ces e ddy c ur r e n ts in t he ti ssu es E ddy c ur r e n ts c a use fr i c ti o n t h a t p r o du c e h e a t Selecti v el y h e a ts mus cl e A l s o r e f e r r ed t o a s: – Ma g n e ti c f ield d i a t h e r m y

14. C a p a c i t i v e F i e l d D i a t h e r m y U s es t he p a tie n t ’ s ti ss u es as a p a r t o f t he ci r c u it T he ti ssu e s’ ele c t r i c al r e s i s t a n c e p r o du ces h e a t Selecti v el y h e a ts sk in – M us c le is h e at e d v ia c o ndu c ti o n f r o m t h e a d i p o s e A l s o r e f e r r ed t o as “ c o nd e ns e r f ield d i a t h e r m y ”

15. TY P E S O F E L E C T R O D E S Fl e xibl e pad s: c o n s i s t o f m e t al e l e c t r o d e e n c a s e d in rubb e r and p r o du ce an e l e c t r o s t a t i c fi e ld.

16. S p ace pl a t e s : c o n s i s t of a r i g i d m e t al e l ec t r o d e e n c a s ed i n a P e r s p e x c o v er € e l ec t r o st a ti c f i e ld .

17. C o i l or c a bl e e l ec t r o d e c o n s i s t s of a w i r e w it h plu gs a t e ith er e n d c r e a t es e l ec t r o m ag n e ti c f i e ld .

18. Th e m o n o d e : f l a t, r i g i d c o i l e n c a s ed i n pl a s ti c c o v er € e l ec t r o m ag n e ti c f i e ld .

19. Th e d i p l o d e : or d r u m e l ec t r o d e , c o n s i s t s of a f l a t c o i l e l ec t r o d e e n c a se d i n a P e r s p e x c o v er w it h t w o w in gs € e l e c t r o m ag n e ti c f i e l d

20. F A C T O R S I N F L UE N C E F I ELD D I S T R IB U T I ON I N S . W . D S p a c in g : a l l o w s t h e li n es o f f o r c e in t he e lec t r o s t a ti c f ield t o d i v e rg e b e f o r e e n t e r i ng t he ti s s u e s . T h is p r e v e n ts c o n ce n t r a ti o n o f h e a t in t he sup e rf icial ti ssu es a n d e nsu r es m o r e h e a t i ng t h r o u g h t he p a r t. S p aci ng p r o v i d ed b y : w r a pp i ng f l e xi b l e p a d s in t o w el. f l a t f elt sp aci ng p a d s b e t w een p ad elect r o de a n d sk in ai r wh en us i ng sp ac e p l at es .

21. N or m al s p ac in g € e v en f i e l d di s t r ibuti o n . In c r ea s ed s p ac in g € d eep f i e l d c o n ce n t r a ti o n . D ec r ea s ed s p ac in g € s up er f i c i al c o n ce n t r a ti o n

22. ◉ E l ect r od e s i z e : i f t h e e le ct r o de s a r e t oo s m a l l t h an t h e di a m e t e r of t r e a t e d p a r t lin e of f o r ce w il l b e c o n c e n t r a t e d s uper f i c i a ll y . ◉ I f t h e el e ct r o de s a r e m a r k e d l y l a r g er t h e lin e o f f o r ce w i l l b e l o s t i n t h e a i r . ◉ I de a ll y , t h e ele ct r o de s s h o ul d b e s li g h t l y l a r g e r t h an t h e a r e a t r e a t ed .

23. T o c o n ce n t r a t e h e a t on o n e a s p ect of th e p art th e e l ec t r o d e s h o ul d b e un e qu al i n s i z e ( s m a ll er o n e pl aced o v er th e a r ea w h e r e c o n ce n t r a ti on of h e a t i s r e qui r e d) . Y ou c an p r o du ce c o n ce n t r a ti on of h e a t b y u s in g e qu al s i z e e l ec t r o d es bu t w it h un e qu al s p ac in g (2 5 m m o v er c o n ce n t r a t ed a r ea a n d m o r e th an 3 m m on o th er e l ec t r o d e ) .

24. T H ER A P EU T I C V A R I A T I ON I N T H E F I ELD D I S T R IB U T I ON C o p la n ar a pp li ca ti o n t o s t r u ct u r e s o n o n e as p e ct o f t h e b o d y . I f t h e s p ac i n g is l e s s t h a n 2 5 mm m o r e c o n c e n t r a ti o n in t h e t r e a t s u p e r f icial tis s u e . If s p a c i n g I n c r eases m o r e d e p th ac h i e v e d .The distance between a d j a c e n t end s m u s t b e g r e a t e r t h an t h e su m of sk i n ele ct r o d e di s t a n ce (A + B ) o t he r w i s e t h e lin e of f o r ce w il l p ass di r e ct l y b e t w e e n Ele ct r o de s r a t he r t ha n t i ss ue s

25. C o n t r a pl a n a r a ppli c a t i o n s T w o f l e x ibl e p a d s , t w o s p a ce pl a t e s o r f l e x i b l e p ad w i t h a s p a ce pl a t e a r e u s ed . It i s e ss e n t i al t o p u t a c o t t on t ow e l b e t w ee n t h e t w o li m b s t o a n y a b so r b pe r s pi r a t i o n .

26. C r o ss -fi r e a pp li c a t io n: F o r t he t r e a t m e n t of s i n u s e s ,s p a c e p l a t e s p o s i t io n e d af t er h alf d ia g o n all y , of t r e at me n t t i me t he p o s i t io n s a r e alternate . this ensures that the all the sinses membranesare heated . Care must be taken to avoid direct placement over the eye , uterinedisorders such as dysmenrrohea .

27. Appli ca ti on u s in g a c o i l e l ec t r o d e : 1 . Th e c o i l w o un d e v e nl y f i r ml y 2 P a n c a k e a ppli ca ti on

28. Appli ca ti on u s in g dipl o d e : A d j u s t w in gs of dipl o d e p a r a ll el t o th e s ki n of th e t r e a t ed a r ea , e l ec t r o m ag n e ti c f i e l d w il l p r o du ce.

29. PHYSIOLOGICAL EFFECTS The principal effect of SWD on the body is the production of heat in the tissues due to the rise of temperature. 1. Increased metabolism: Heating tissues accelerates chemical changes such as metabolism, so oxygen and food stuffs are used up. With increased metabolism, there will be increased output of waste products.

30. Increased blood supply: As a result of increased output of waste products such as metabolites, which act on the walls of the capillaries and arterioles, these tissues dilate. In addition, heat has direct effect on blood vessels, causing vasodilatation. Heat also produces stimulation of superficial nerve endings, causing reflex dilatation of the arterioles.

31. . General rise of temperature: As blood passes through the heated tissues, it also becomes heated and carries the heat to other body parts. Rise of temperature induces muscle relaxation and increases the efficiency of muscle action.

32. . Fall in blood pressure: The generalized vasodilatation reduces the peripheral resistance to blood flow. Heat also reduces blood viscosity , which helps in the reduction of blood pressure.

33. . Increased activity of sweat glands: If a general rise of temperature occurs, there will be increased activation of the sweat glands.

34. Therapeutic Uses Effect on Inflammation Assist in removal of Waste Products All these effects bring about resolution of inflammation

35. . Effect on Bacterial Infection Inflammation is normal response of Body to bacteria Heating the tissue auguments these changes so reinforces body's normal mechanism to of dealing with infecting organisms Ex. Boils, Carbuncles, Abscesses

36. . Reducing Healing time Increased Blood supply More Nutritive Material More O 2 supply

37. . Relief of Pain Sedative Effect Removal of Waste Products Resolution of Inflammation Counter irritation

38. Effect on Muscle Tissue Muscle relaxation Relief of Muscle Spasm

39. Musculoskeletal Disorders Degenerative Joint Disorders Ex. OA and RA Sprain Strain Hematoma Muscle & tendon Tears Capsule Lesions USES

40. Inflammatory Conditions Boils Carbuncles Sinusitis Pelvic Conditions Infected Surgical Incisions

41. DANGERS Burn s Co n c e n t r a t io n o f ele c t ri c f iel d E x c es s c u r r e n t Im pa i r e d b loo d f l o w H y p e r se n si t i v e s k i n Le ads t o u c h i ng s k i n S c al d s Elect r i c sh o c k O v e r d o se P r eci p i ta ti o n o f g a n g r e ne F ai n t n e s s G i dd i n e s s

42. Co n t r a i nd i c a t io ns M e t al im p l a n ts o r m e t al j e w el r y (be a w a r e o f b o dy p ie r c i n g s ) C a r d i ac pa c em a k e r s Is c h emi c a r e as P eri ph e r al v a s c u l ar d ise a s e P e r s p i r a t io n and moi s t d r essi n g s : T he w at e r c olle c ts and c o n c e n t r at e s the h e a t. T e nd e n c y t o h emorr ha g e , i n c l ud i ng me n s t r u a t io n. P r e g nan c y F e v e r S e n so r y los s C an c e r D ee p X ra y T u mo u r s U n r eli ab l e p a t ie n ts A r e as o f pa r t i c u l ar se n si t ivi t y : E p i p h y seal p l a t es i n c h il d r en T h e g en i t a l s S i t es o f i n f e c t i o n T h e abd om en wi t h an i m p l a n t ed i n t r au t e ri n e d e v ic e ( I U D ) T h e e y es and f a c e A pp li c a t i o n t h r o ugh t h e s k u l l