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Physiotherapy or physical therapy, is the treatment of disease, injury, or wound by methods, such as massage, heat treatment, and exercise rather than by drugs or surgery. Physiotherapy is typically treatment for problems related to tissues, joints, muscles, or nerves. Physiotherapists use various different devices and machines depending on the problem at hand. The most common physiotherapy equipment are Interferential Therapy machine (IFT), Ultrasound Therapy machine, Short Wave Diathermy machine (SWD), Traction Table/ Unit, Continuous Passive Motion machine (CPM), TENS device, Wax Bath etc.
Which machine is used under what circumstances? What are the technologies involved? How do Physiotherapy equipment help heal and relieve pain? Read on… to know more.
Objective – Healing, pain relief or Exercise to improve range of motion
The course of treatment depends primarily on the objective.
Physiotherapy at its basic level is most commonly a heat treatment, which itself serves the purpose of improved blood circulation and healing. The simplest forms of heating techniques are infrared therapy, hot-packs, wax bath etc. Wax therapy, uses molten paraffin wax. Wax bath is mainly used on hands. All of these provide heat externally on the skin and at the surface level, with not much penetration.
Healing of Deeper tissues
For deeper level of heating, healing and pain relief, the most common methods and physiotherapy equipment in use are Ultrasound therapy, Short Wave Diathermy and Interferential Therapy.
- Ultrasound refers to sound waves with frequencies between 20 kHz to several Gigahertz. Ultrasound Therapy is mostly used for the treatment of chronic pain conditions and to expedite healing. Ultrasound therapy increases blood flow in the area on which it is treated, eases muscle tension, reduces pain where there is swelling and it also gives gentle massage to the treated area thereby easing the concerned tissue.
- Shortwave is nothing but electromagnetic radiation in the frequency range 2 to 100 MHz. Shortwave diathermy machine is used for heating of body tissues by using short wave radiation as the source of heat either in pulsed or continuous energy waves. It’s commonly used for conditions that cause pain and muscle spasms such as sprains and to treat pain from kidney stones, and pelvic inflammatory disease etc. Short wave diathermy is usually prescribed for treatment of deep muscles and joints that are covered with a heavy soft-tissue mass.
- Interferential Therapy (IFT machine) actually employs medium frequency currents for treatment. In order to produce the required low frequency stimulation, two medium frequencies are used. A constant frequency e.g. 4000 Hz is applied to one pair of electrodes and a little different frequency of say 3900 Hz is applied to the other pair of eletrodes. The interference between these two currents produce amplitude modulated medium frequency in the tissue which impacts its healing. The use of medium frequency currents results in moderate skin sensation, more comfort to the patient and higher penetration depth. This is why it is called Interferential Therapy.
Pain Relief without heating
A few Physiotherapy equipment that treat pain without heat are Traction, TENS etc. Traction machine is most commonly used for treatment of neck, cervical, lumbar, lower back pain etc.
- Traction is a method used to relieve pain by stretching the spine. Stretching the spine separates the vertebrae and helps to relieve nerve pressure and stress on the vertebral discs. Cervical traction is a common nonsurgical treatment for a herniated disc in the neck that relieves pain and reduces pressure on compressed nerve roots exiting the spinal canal. Traction can either be applied manually than for lower back pain or by spinal traction devices. Traction is more useful to relieve pain and restore muscle function by mobilizing muscles, ligaments and joints. Traction Machine helps in reducing disc pressure, relax muscles, relieve nerve root compression and improve blood flow.
- Electric stimulation therapy is a treatment that applies electrical stimulation in treating muscle spasms and pain. It can help prevent deterioration of muscles and strengthen patients with injuries. The electrodes attached to the skin deliver impulses that cause muscular contraction. Also known as Electrical muscle stimulation (EMS), this is generating muscle contraction using electric impulses generated by a device and delivered through electrodes on the skin near the muscles being stimulated.
- A Transcutaneous electrical nerve stimulation or TENS machine provides short-term pain relief. A TENS machine stimulates nerves via an electrical current conveyed to the nerves through the skin (Transcutaneous) stimulating them for therapy. TENS unit is usually connected to the skin using two or more electrodes and is typically battery-operated with ability to modulate the input electric current for different effects.
Improvement in range of motion
A different approach is required for post-surgical treatments, which not only require healing and pain relief but also improvement in range of motion.
- Continuous Passive Motion Therapy is generally used after surgery and it gives several important benefits to patient like maintenance or improvement in the range of motion reduction in pain and discomfort.
CPM machine is used for rehabilitation in the immediate phase following a soft tissue surgical procedure or trauma. The objective is to control post-operative pain, reduce inflammation, provide passive motion in a specific plane of movement, and protect the healing repair or tissue. CPM machine constantly moves the joint through a controlled range of motion.
Type and depth of tissues
Almost all machines used in physiotherapy treat various musculoskeletal disorders/ injuries.
In Ultrasound Therapy, as the sound wave passes through the various tissues of the body, it causes molecules to vibrate, some of the energy in the wave is converted from kinetic energy to heat. For sound wave the intensity, decreases exponentially with the distance travelled. Different types of tissues have different absorption levels. The absorption increases in the following order – fat (lowest), muscle, skin, tendon, cartilage and bone (Highest). Bones reflect a high percentage of incident ultrasound.
SWD therapy is done by application of electromagnetic energy at shortwave frequencies which ensures thermal energy generation through the induction of circulating currents in the tissue. Shortwave therapy is normally applied to encourage healing, pain relief, reduction of muscle spasm, increase in mobility etc.
If however deeper penetration is required to heal bones and tissues closer to bones, IFT is a popular treatment. Interferential Therapy impacts deep muscles and nerves, stimulates voluntary muscles, promotes an increase in peripheral blood flow, accelerates bone healing as well as reduces pain.
Traction relieves pain by stretching the spine, Electric stimulation therapy acts by applying electrical stimulation in treating muscle spasms and pain, while a TENS machine assists in short-term pain relief, by stimulating nerves via an electrical current through the skin.
Individual or Combination Treatment in physiotherapy equipment
For more difficult cases, more effective treatment depth can be gained with combination of treatments such as Ultrasound & IFT or IFT or SWD with TENS or exercise. It is believed that a combination of treatment modalities may have complementary effects accelerating healing with lower doses as compared to if individual treatments were provided in isolation.