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2. PARAFIN WAX THERAPY BATH

3. Learning Objectives

4. Paraffin Wax Therapy Paraffin wax bath therapy is an application of molten paraffin wax over the body parts. By means of conduction The temperature of the paraffin wax is maintained at 40–44ºC, whereas its melting point is 51–55ºC. If the molten wax at 51–55ºC is poured on the body parts, it may cause burn over the body tissues, that is why some impurity is added to lower down its melting point such as liquid paraffin or mineral oil.

5. Paraffin wax bath therapy provides about six times the amount of heat available in water. The combination of paraffin and mineral oil has low specific heat which enhances the patient’s ability to tolerate heat from paraffin better than that from the water of the same temperature. The composition of solid wax: liquid paraffin: petroleum jelly is 7 : 3 or solid wax : liquid paraffin or mineral oil is 7 : 1.

6. Paraffin is usually used for heating the distal extremities because it can maintain good contact with these irregularly contoured areas. Paraffin may also be applied to more proximal areas such as the elbows and knees, or even the low back , by using the paint method.

7. Paraffin Wax Bath Unit Parts of a typical Paraffin wax bath unit are stainless steel container, mains, thermostat, thermostat pilot lamp, power pilot lamp, lid and caster (Fig. 7.1)

8. Initially, heating is quicker with this type because there is no water jacket to be heated. Container contains wax and paraffin oil. Mains function is to switch on or off the heating element, which is located in the casing of paraffin wax bath unit. Thermostat keeps the temperature fixed or static in the range which is adjusted with knob. Thermostat pilot lamp indicates whether thermostat is on or off. Power pilot lamp function is to show whether power is on or off. Lid covers the container and caster allows the paraffin wax bath container to be moved from one place to another .

9. Physiological Reponses to Paraffin Wax Therapy Circulatory effects Stimulation of superficial capillaries & arterioles causes local hyperemia and thus results in reflex vasodilatation of capillaries in the skin causes reflex heating of the joints. skin temperature drops quickly after 15-20 min. Exercises after wax is important to increase ROM and muscle strength .

10. Analgesic effects : Most important effect is sedative effect on tissue. Moist heat gives a soothing effect . Very good prior to the exercise for superficial joints. Stretching effects wax leaves the skin moist , soft and pliable. It is useful for stretching scars and adhesions .

11. Indication Paraffin wax therapy is used for the treatment of: Rheumatoid arthritis Osteoarthritis Joint stiffness, adhesions Post immobilization stiffness, scars on the skin, etc

12. Contraindication Paraffin wax bath therapy should not be used in the cases of: Open wounds Skin rashes Allergic conditions Impaired skin sensation Defective arterial supply, etc

13. Methods for Paraffin Wax The part to be treated must be cleaned with soap and water. Moisture is to be soaked with towel. Position of the patient should be such that the part to be treated comes closer to the wax bath container. Before application one must ensure that there should be no moisture over the body tissues otherwise burn could occur. The warm wax is placed on body tissues by various techniques and the treatment is given for about 10–20 minutes.

14. Techniques of Application Various techniques used for the application of paraffin wax are as follows: Direct Pouring Method Brushing Method Dip Immersion Method Towel and Bandaging Method

15. 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. The wax is allowed to solidify for about 10–12 minutes. Several (4–6) layers can be made over the body tissues.

16. Brushing method A brush of various sizes (4’’ or 6”) is used for the application of molten wax over the body tissues. Several coats (4–6) are applied over the body tissues and wax is allowed to solidify and wrapped over by a towel.

17. Direct immersion or dipping method In this method, the body part to be treated is directly immersed into the container of paraffin wax and taken out. Once the wax solidifies, the part is again immersed to make another layer of paraffin wax and wrapped around by a towel.

18. Toweling or bandaging method A towel or a roll of bandage is immersed in molten paraffin wax and then wrapped around the body part. Several layers can be made over the body part. This method is preferably used for treating proximal parts of the body.

19. For all methods: When the treatment is complete, inspect the area for any signs of adverse effects Paraffin may be sterilized by heating it to 80 degree C. and then allowing it to cool overnight. Its temperature should be allowed to return between 45 and 50 degree C before it is used again for treatment.

20. Advantages 2 or 3 patients can be treated in the same time. Useful for patient with poor heat tolerance , dry scaly skins, after Plaster of Paris removal . Can be followed by therapeutic exercises . Can be carried out at home. Wax can mold around the bony contours of feet & hands. Heat is applied evenly by conduction.

21. Disadvantages Not sterile or not very desinfected procedure . Messy technique, floor should be protected . Sedimentation occurs in bottom of the bath so requires regular cleaning ( daily or every 2 days ). Contamination by air unless covered by lid . Water collects at bottom of bath.

22. Maintenance of Paraffin Wax Bath Unit Sterile the paraffin wax bath by heating it to 212° Fahrenheit. For reuse, sterilization should be done frequently. Drain the melted paraffin wax, filter it out and replace it back for reuse. Change the wax at least once in 6 months.

23. References 1.Text Book of Electrotherapy by jagmohan

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