| Cryotherapy (ice packs) |
| Cryotherapy
is generally more effective in terms of depth of penetration than other superficial
thermal modalities. Intramuscular
temperatures can actually be reduced by 3-7 degrees C.This
is helpful in reducing local metabolism, inflammation, and pain. The
analgesic effects of ice result from a decreased nerve conduction velocity along
pain fibers and a reduction of the muscle spindle activity responsible for mediating
local muscle tone. It is usually
most effective in the acute phase of treatment, though the patient can use it
after physical therapy or the home exercise program to reduce pain and the inflammatory
response. It is applied over an
area for 15-20 minutes, 3-4 times per day initially and then on an as needed
basis. Peripheral nerve injury and
local frostbite secondary to prolonged cryotherapy has been previously described,
emphasizing the need for monitoring of cryotherapy use< |
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| Heat Therapy (superficial heat) |
| Can
produce heating effects at a depth limited to 1-2cm. Deeper tissues are generally
not heated due to the thermal insulation of subcutaneous fat and the increased
cetaceous blood flow, which dissipates heat.It
has been found to be helpful in diminishing pain and decreasing local muscle
spasm.Superficial heat, such as
the hydrocolater pack, should be used as an adjunct to facilitate an active exercise
program. It is most often used during
the acute phases of treatment when the reduction of pain and inflammation are
the primary goals. If beneficial,
it can be incorporated into the education program and utilized on a home basis
prior to the therapy program.< |
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