INFRARED INFRARED Therapy Therapy

Dr. Navjyot TrivediDr. Navjyot TrivediM.P.T (Musculo)M.P.T (Musculo)SSIP, BhavnagarSSIP, Bhavnagar

ObjectivesObjectivesAt the end of this lecture the student must At the end of this lecture the student must be able to;be able to;•Understand how the infrared radiation is classified in the Understand how the infrared radiation is classified in the electromagnetic spectrum.electromagnetic spectrum.• •Describe the physiological effect of infrared radiation.Describe the physiological effect of infrared radiation.

•Describe the indications and contraindications of infrared Describe the indications and contraindications of infrared radiation.radiation.

•Explain how the therapist can use the infrared radiation.Explain how the therapist can use the infrared radiation.

OutlinesOutlines Definition and classification (types).Definition and classification (types). Sources and production.Sources and production. Physiological and therapeutic effects.Physiological and therapeutic effects. Indications and contraindications.Indications and contraindications. Dangers/PrecautionsDangers/Precautions Practical and clinical applicationPractical and clinical application

IntroductionIntroduction

• Infrared- Below redInfrared- Below red• Discovered by William Herschel in early 19Discovered by William Herschel in early 19thth Century. Century.• Two types: Near(Short) and Far (Long).Two types: Near(Short) and Far (Long).• Near: not hot buy Far: HeatNear: not hot buy Far: Heat• IR wavelength: 710nm to 1mm.IR wavelength: 710nm to 1mm.• Use: Remote control, radiant heater, grills, optical Use: Remote control, radiant heater, grills, optical

fibers, night vision.fibers, night vision.• Dangers: Skin burn.Dangers: Skin burn.

Infrared Definition and Infrared Definition and Classification Classification

Infrared radiations are part of an Infrared radiations are part of an electromagnetic spectrum, with wavelength electromagnetic spectrum, with wavelength of of 750nm-1mm, 750nm-1mm, and frequency of and frequency of 4x104x101414 and 7.4x 10and 7.4x 101111, and located between , and located between microwave and visible light.microwave and visible light.

Infrared is superficial Heating Infrared is superficial Heating modality (penetration depth 1- modality (penetration depth 1-

10mm).10mm).Infrared is radiant heat transmits Infrared is radiant heat transmits

energy by radiation.energy by radiation.

Source of InfraredSource of Infrared

Classification IRClassification IRNear (short)=750-1500nmNear (short)=750-1500nm Far (long)=1500-15000nmFar (long)=1500-15000nm

TypesTypes IRA=750-1400nmIRA=750-1400nm IRB=1500-3000, IRB=1500-3000, IRC=3000nm-1mmIRC=3000nm-1mm

SourceSource Luminous heated bodyLuminous heated body-Incandescent bodies -Incandescent bodies -Sun-Sun -Tungsten-Tungsten

Non-luminous Heated bodies Non-luminous Heated bodies -Hot pack-Hot pack-Electrical heating pads-Electrical heating pads

PenetrationPenetration Deeper; Deeper; penetrates to penetrates to epidermis , dermis & epidermis , dermis & subcutaneous (5-10mm) subcutaneous (5-10mm)

Superficial;Superficial; penetrates to the penetrates to the epidermis ≤5mm epidermis ≤5mm

AbsorptionAbsorption Deep Deep Superficial Superficial

IR- GeneratorIR- GeneratorNon-Luminous and LuminousNon-Luminous: •A coil of wire wound on a cylinder of some insulating material.•Electric current passes through wire and produces Heat.•IRR emitted by hot wire.•It produces IRR and Some visible rays.•This kind of lamps required sometime to warmup, the lamp may take up to 15 mins to reach maximum emission.

Luminous(Visible) generatorLuminous(Visible) generator•Luminous generator are produced by INCANDESCENT LAMPS.•This lamps consists of a TUNGSTEN FILAMENT which contain INERT GAS AT LOW PRESSURE.•Inside of glass is silvered to provide reflection.•When you pun on lamp it produces visible light, IR and few UVR.•The radiation extends from FAR IR to UVR.•Out side of glass is reddened, to absorb green and blue rays.•Human skin absorbs 95% of energy if it is perpendicular to surface.

Luminous versus non-luminous Luminous versus non-luminous IRRIRR

LuminousLuminous Non-luminousNon-luminous Sources &typesSources &types Electrically heated filament

e.g. Quartz lamp, Tungsten lamp, Carbon filament lamp

Electrically heated resistance wire coiled. It takes about 5-15 minutes to be heated and emit their maximum intensity, e.g. Hot pack

wavelengthwavelength 350-4000nm (maximum 1000nm) 1500-12000nm (maximum 4000nm)

EmissionEmission 70% near IRR, 24% far IRR, 5% visible light, & 1% UV

90 % far IRR, and 10% near IRR.

PenetrationPenetration Epidermis, dermis & subcutaneous tissue (5-10mm)

Epidermis & superficial dermis (2mm)

UsesUses Chronic inflammation Acute conditions.

Physiological Physiological effecteffect

Pain reduction via counter-irritant effect

Pain reduction via sedative effect

Treatment timeTreatment time 15-20minutes 20-30minutes (Why)

DistanceDistance 40-60cm from treated area 75-90cm from treated area

Factors Regulating Absorption & Factors Regulating Absorption & PenetrationPenetration

of IRRof IRR Infrared radiations striking the surface of the skin will be

reflected, scattered, refracted, penetrate and absorbed in the tissues. The depth of penetration and absorption of IR depends on;

1-Wavelength/ frequency of radiation 2-Thermal conductivity of the tissue 3-Thickness of tissue. 4-Cosine law. 5-Inverse square law. 6-Arndt-Schultsz principle 7-Grotthous Draper law 8-Intensity of IR source. 9-Vascularity of tissues 10-Types of the skin

Physiological Effects of IRRPhysiological Effects of IRRINCREASE

Local temperature superficially Local metabolism Capillary permeability and blood flow Lymphatic and venous drainage Vasodilatation of arterioles and

capillaries Leukocytes& phagocytes activity Axon reflex activity Stimulation of sensory nerve

Vasodilatation starts after 1–2 minutes and lasts for 30 minutes. Erythema: is of irregular patchy red appearance of skin due to vasodilatation and lasts for about 30 minutes after IR application.

Therapeutic Effects and UsesTherapeutic Effects and Uses1. Relief of pain & muscle spasm.

1. Mild heating has a 'sedatory' effect on sensory nerves endings used for the relief of acute pain.

2. Strong heating has a ‘counter irritant' effect on sensory nerves endings and used for the relief of chronic pain.

2. Joint stiffness: viscosity decrease, increase collagen extensibility

3. Skin lesion: psoriasis4. Prior to other Treatments: (e.g. stretching, mobilization,

traction, massage, exercise therapy, electrical stimulation, and biofeedback).

5. Increased blood flow and circulation (e.g. reduce chronic edema)

6. Muscles relaxation 7. Increase healing of tissue (no more recommended)

Indications Indications • Pain and Muscle spasm• Chronic inflammatory stage – oedema• Pressure sore, Healing of wounds• Joint stiffness- acute and chronic stage

Contraindications and Precautions of IRContraindications and Precautions of IR

• Acute inflammatory conditions

• Impaired cutaneous thermal sensation and circulation

• Peripheral vascular disease• Markedly loss of

consciousness.• Acute skin disease, e.g.,

dermatitis or eczema• Deep X-ray therapy• Defective blood pressure

regulation • Acute febrile illness (Fever)• Tumors of the skin • Hemophilia.

Unreliable and elderly patients.

Never apply heat directly to eyes or the genitals.

Never heat the abdomen during pregnancy (first and last trimester )

Dangers side effects of IRDangers side effects of IR Burn Intensity of radiation is so high

Loss of sensation, Reduce consciousness

Unreliable patients Accidentally touch of hot element Metal & Inflammable materials in

treated area,

Electrical Shock: Due to exposed part or heated wires in the circuit

These dangers can be avoided by:

Flaw application principle

Adequate warnings to the patient

Checking the skin several times

DehydrationLowering blood pressure and fainting Damage to the eyes

Infrared radiationInfrared radiation

Advantages • Can be used to treat large area, with local effect• Easy of application (Patients can apply at home) • Inexpensive

Disadvantages• Heating only superficial tissue, therefore

limited in use.• Not effective as hot packs and paraffin wax• Equipment is often unstable.

Practical and clinical Practical and clinical applicationapplication

Selection of equipment: •Sedative effects- non-luminous IRR•Counter irritant(Chronic condition) – Luminous IRRSetting up the lamp:•Never position the lamp over patient•Lamp must be placed perpendicular to area to be treated•Distance should be 50cm to 75 cm•Protect the eyes•Check the knobs and screw of the lamp•Switch on the heating element

•)

Clean the treated area from any sweat, dirt, or oils, and remove any jewelry.

Position the patient in a comfortable manner. Drape the body part so that only the area to be treated is

exposed. If a moist heat treatment is desired, place a damp terry cloth

towel over the area.To prevent burns, instruct the patient not to move/sleep and

check the patients comfort periodically. The intensity may be adjusted by moving the lamp toward

the skin (increasing temp) or away from the skin (decreasing temp). [50-90cm]

After 5-10 minutes the vasodilatation has occur then the radiation can be increased

Instruct the patient to summon assistance if the intensity of the treatment becomes too great.

Treatment duration will be 15-30 minutes,

Tunnel Bath MethodTunnel Bath Method

• It is used for several surfaces of part to be treated.• Temperature increases rapidly.• Specially used for Chronic condition.

Mode of Heat transfer•Radiation•Convection and conductionNOTE: •IRA- Dermis and Subcutaneous level•IRB- Epidermis level•It is useful for heating superficial large areas•Intensity varies inversely with square of the distance from the lamp•It’s a dry heat compared to WAX and HOTPACK

Therapeutic uses of IRTherapeutic uses of IR• Relief of Pain

–When mild heating pain relief is due to sedative effect on superficial nerves–Strong heating irritates the superficial sensory nerve relives pain by counter irritant–Acute condition pain relief by mild heating–In chronic condition pain relief by intense heating

• Muscle Relaxation–IR relax muscle by warmth and heating–This relives muscle spasm and induce relief of pain–Some time given before exercises

• Increase blood supply–It helps to increase the blood supply so help in superficial wound, infection–Also increases WBC and remove waste products–It is used to arthritis joints, other inflammatory conditions and after the effect of injuries