Thermotherapy involves the application of Heat. The most common heating agent used in rehabilitation is a hot pack. Hot packs transfer their heat energy to the body by conduction. Superficial heat usually produces temperature elevation in the underlying tissues to a depth of up to 1cm. Adipose tissue acts as an insulating layer, which decreases the depth of heat. Commercial hot packs are canvas, usually filled with a hydrophilic substance, that is immersed in 1700F (770C), water in a thermostatically controlled heater. The packs can retain heat up to 30 minutes. With superficial heat, local metabolism is increased and local vasodilatation with hyperemia occurs. Initial vasoconstriction is produced in deep tissue layers, followed by vasodilatation. Hot packs also promote muscle relaxation as well as sedation of sensory nerve endings.

The aim of thermotherapy is to alter the tissue temperature of the targeted area to induce a desired Biological response. The increase in the temperature of the skin/soft Tissue leads to the

• Increase in the blood flow by vasodilatation.
• Increases the oxygen uptake thus increasing tissue healing
• Increases the metabolic rate
• Increases tissue extensibility

Heating of tissues can be achieved using Hot Packs, Wax Baths, Towels, Sunlights, Saunas, Heat wraps, Steam Baths/Rooms. We can also get the heat in deeper tissues through Electrotherapy (Ultrasound). The temperature should be comfortable and should not cause a burn. Exercise in warm water is an effective treatment for pain relief for patients with Neurological and Musculoskeletal problems. The warmth enhances the blood flow and muscle relaxation and also relieves the pain by reducing peripheral edema.

• Osteoarthritis.
• Strains and Sprains.
• Tendonitis.
• Warming up stiff Muscles or Tissue before activity.
• Relieving pain or spasms relating to neck or back injury, including lower back, sub-acute or chronic traumatic and inflammatory conditions.
• Preheating before electrical stimulation.

• New Injury
• Open wounds.
• Acute inflammation conditions.
• If fever already noted
• Metastasis of malignancies.
• Areas of active bleeding.
• Cardiac insufficiency.
• Patient who has received x-ray therapy to the tissue.
• Peripheral vascular disease.
• If the skin is hot, red, or inflamed and if the area is numb.
• People with Diabetic Neuropathy or another condition that reduces sensations of heat. It may be hard to know when the heat is excessive in these cases.