Hot Packs .
Hot packs are the packs which are immersed in an apparatus called hydrocollator . They provide superficial moist heat to the part where applied. They contain the substance which absorbs heat like silica or gel. They are stored in a thermostatically controlled water bath inside the equipment. The temperature inside the hydrocollator ranges between 65–80ºC. The aim of the hydrocollator pack is to rise the body
temperature at 40–45ºC.
Hydrocollator packs are available in various sizes and shapes . The size and shape of pack should be chosen on the basis of area being treated. The common sizes are small (for smaller joints like elbow, ankle), large (for large joints like hip and back), contoured (for cervical spine). When used, hydrocollator packs are taken out of apparatus by means of tongs and wrapped inside a towel. Electromyography
Six to eight layers of towel is made around the pack. The total treatment time is around 8-10minutes . Hot pack is one of the superficial heating agents used for thermotherapy. They are used to alleviate muscle spasm, increase range of movement, and for pain relief. However, hot packs should not be used in an area of impaired sensation, recent hemorrhage, open wounds and impaired circulation.
Types of Hot Packs .
1. Hydrocollator Packs .
Hydrocollator packs provide superficial moist heat. The commercial hot packs consist of canvas bags. These bags are filled with silicate gel or some other hydrophilic substance. They are stored in a thermostatically controlled water bath inside equipment . Inside the bath, it absorbs the water with its high heat content. Short Wave Diathermy
Hydrocollator packs are available in variety of sizes and shapes and should be chosen on the basis of size and contours of the body part to be treated. The temperature of packs when applied should be in between 70 to 75 °C so that it raises the body tissue temperature to 40 to 45 °C during the treatment period.
Technique .
Explain the procedure to the patient, expose the body part to be treated and check the thermal sensation (remember with SEE, S for sensation, E for expose and E for explanation). Position the patient. Lift the hydrocollator pack with scissor forceps from the hot pack machine. Wrap it in dry terry towel; usually six to eight layers of towel are used in order to wrap the hydrocollator pack. Place the pack wrapped in towel over the area of treatment, so that it will cover the treatment area adequately.
Do not secure it tightly so that patient can remove it, if it becomes too hot. Ask the patient about sensation, it should be mild and perceptible warmth and disregard the patient’s feeling ‘hotter the better’. Continue the treatment for 20 minutes and adjust the dosimetry by varying the thickness of the terry towel which in turn slows down the heat transfer. If the patient feels too hot, then increase the toweling layer or remove the hydrocollator pack.
Advice the patient not to lie with body weight on the hydrocollator pack, since it may squeeze the water; decrease circulation and thereby dissipate the heat. Advantages of hot packs are; ease of application, it offers comfortable heat and it is relatively inexpensive from purchase and maintenance point of view.
However, the disadvantages of hot packs are; there is no temperature control once applied to the patient. It is sometimes awkward to secure it in place, on a patient. Hot packs do not retain heat longer than 20 minutes, it is a passive form of the treatment and do not require any active participation by the patient.
2. Hot Water Bag .
The rubber bags containing hot water can be used in the same fashion as like hydrocollator packs. Usually hot water bags are advised for the home treatment. Neuromuscular Electrical Stimulation
3. Kenny Packs .
Kenny packs are named after Sister Kenny. Kenny pack consists of a woolen cloth, which is steered and then surplus water content is removed by spinning. The relatively dry pack is then applied quickly to the skin. It is usually applied at a temperature of 60°C. As it contains little water, it has a little heat carrying capacity and the temperature drops down suddenly to normal level within a span of five minutes. It is a short-term but vigorous heating application, which produces a marked reflex response. Nerve Conduction Velocity
4. Chemical Hot Packs .
Chemical hot packs are recently available for therapeutic applications. The chemical hot packs are portable. These packs are flexible container bag-like structures in which by moving the container a compartment is broken. This allows ingredients to get mixed or come together and produce elevation of temperature by exothermic reaction. All these packs are poorly controlled. Ingredients are irritating or harmful when outer pack breaks and the content comes in contact with the skin. Hence, this type of application is least advantageous.
Electrical heating pad .
Electrical heating pad is a form of superficial heating agent. It can be advised to the patients for their home treatment. The advantages of electrical heating pads are cheaper, flexible, patient can control the heat during the treatment through a knob and they provide comfortable heat. However, the patient should remain awake during the treatment with the electrical heating pad, as there is a possibility that patient may go to sleep during the treatment and will get up to find a thermal burn.
The temperature elevation occurs through the conduction of the heat from the heating pad to the body tissues where the electrical heating pad is applied. This can be used as an adjunct to diathermy especially when diathermy machine goes out of order or for home visits.
Hot packs application .
Hot Packs application is the Procedure of application of heating agent in form of hot water , that is warmer than the normal core temperature of the body Skin in a from of moist or dry heat on the Surface of the body .
- To Provide Comfort .
- To Promote healing of the tissue .
- To relax the Muscle .
- To Stimulates initiation of Peristalsis .
- To Soften the Exudates .
- To decrease the Joint Contracture .
- To decrease Muscle Stiffness .
- To relief Pain .
- To decrease Muscle Tone .
- To Promote Suppuration .
Indications of Hot Packs .
- Subacute Chronic Inflammatory Conditions .
- Subacute or Chronic pain .
- Subacute or Chronic Muscle Spasm .
- Decreased Rom .
- Joint Contractures .
- Hematoma resolution .
- Backpain .
- Arthritis ( Osteoarthritis ) .
- Menstrual Cramps .
- Muscle Sore .
- Stiffness .
Contraindications of Hot Packs .
- Impaired skin sensation .
- Open wounds .
- Recent hemorrhage .
- Skin allergy .
- Impaired circulation.
- Fever .
- Peripheral Vascular disease .
- Malignancy .
- mentally retarded Person .
- Varicose Veins .
- Stomach and Bowel Ulcers .
- Paralyzed parts of the body .
Therapeutics Effect of Hot packs .
1. Effect on muscular spasm .
The most important physiological effect of hot pack is that it relieves the muscular spasm very quickly. Moist heat provided by the hydrocollator pack is beneficial for relieving the muscular spasm.
2. Local rise in temperature .
The rise in local body temperature occurs following hot packs application. The heat is transferred by means of conduction from hot packs to skin and superficial tissues. Local rise in temperature has many effects including increasing circulation, relieving spasm and thus relieving pain.
3. Increase of local circulation .
The local circulation around the area is also increased. It provides fresh supply of blood and nutrition. It reduces the waste products of
metabolism from the area.
4. Skin and connective tissue .
Skin becomes supple and elasticity of connective tissue is also increased when combined with stretching.
5. Relieve of pain .
Pain is relieved by application of hot packs. Pain relief following hot pack application may occur due to decreased nerve conduction velocity or elevated pain threshold. It may be due to sedative or counter irritation effect by heat. Pain relieve may be associated with relieve of muscular spasm and increase in joint range of motion.
Physiological Effects of Hot packs .
1. Local Temperature .
Rise in local body temperature occurs following hot packs application. It is due to the conduction of heat from hot pack to the skin and superficial tissues. The increase of body temperature is expected to be less than 45°C otherwise tissue burn will occur. This rise of temperature is proportional to the area of tissue exposed and the temperature of the hot pack.
2. Circulation .
Increase in tissue temperature is associated with vasodilation. As a result of vasodilation, local increase in the blood supply, especially in superficial tissue is likely to occur. It may be manifested by hyperemia. Vasodilation may be due to release of chemical mediators, local spinal
cord reflex and cutaneous thermoreceptor.
3. Pain Relief .
Hot packs can be used to obtain analgesia. Pain relief following hot pack application may occur due to decreased nerve conduction velocity or elevated pain threshold. It may be due to sedative or counter-irritation effect by heat. Pain relief may occur due to relief of muscle spasm if pain is associated with muscle spasm.
4. Muscle Spasm .
Hot pack can bring about the relief of muscle spasm, but the exact mechanism is unknown. It may be due to decreased alpha motor neuron firing as a result of reduced muscle spindle activity.
5. Connective Tissue Extensibility .
Hot packs may increase the extensibility of connective tissues. It is due to the effect of heat on the elastic tissues. This effect is more if it is
combined with stretching.
