Title: Physiotherapy modalities hot pack using heat transfer(conduction)

to patient body

Introduction:
Hot packs or heat packs are a type of physical modality often used in physical therapy clinics.
They are applied to your injured body part by your physical therapist. This type of physical
modality is using heat transfer which is called conduction. Conductive heating is defined as heat
transfer from one point to another without noticeable movement in the conducting medium.
Typically, direct contact takes place between the heat source and the target tissues. Superficial
heat is usually conductive heat.

Types of Hot pack:

There is various form of hot pack such as hydrocollator packs, chemical hot pack that has short-
term stimulation or heating, rubber hot bottles and electric heating pad. Typically,
physiotherapist uses hot packs or hydrocollator packs that contain silicate gel in a cotton bag.
These packs are placed in a hot water tank, which is thermostatically controlled at 71.1-79.4°C.
The silicate gel absorbs a large quantity of water and has a high heat capacity. On the other hand,
there are chemical hot packs that we can easily buy at the nearest pharmacy store. This type of
hot pack activates when we rub it together or squeeze it. Pressure and air trigger a chemical
reaction with the iron sand that contain inside the pack making them heat up. They are perfect to
ease backaches or muscle aches with heat. It doesn’t contain medicine, so it can also be used to
stay warm. Even though it supposedly heats up to 40 degrees Celsius, they don't get as hot as the
other heat packs. It can only stay warm for 5 to 8 hours. Next, rubber hot bottles retain heat after
a person fills them with hot water. When an individual applies heat to the skin, the blood vessels
open, and blood flow to the area increases. This blood flow helps relax muscles and reduce lactic
acid buildup, which soothes aches and pains. Lastly, electric heating pad uses internal coils to
produce various levels of heat based on the user's setting. Though many models plug into a wall
outlet, others use a battery pack for power. Battery-powered products may be more convenient
for people who require a heating pad on the go. Many electric heating pads come with an
automatic shut-off timer to prevent injury.
How heat applied to patient body in physical therapy:

During physical therapy sessions, sometimes the physiotherapist chooses to apply heat to the part
of the body that is injured. It can be helpful to know how that process happens. That way, we
know how to prepare if heat has been used in the sessions. Hence, the heat is applied in specific
ways.

Firstly, the body must be positioned comfortably. Second, the body part to be treated with heat
should be exposed. Third, the physiotherapist will obtain a hot pack from a device called a
hydrocollator. Lastly, the hot pack is wrapped over layers of cloth towel and applied to body part
for 20-30 minutes.

When the heat is first applied, it may not feel hot , it takes a few minutes for the heat to penetrate
the toweling. After a few minutes, the heat starts to be felt penetrate the skin. Increasing the
towel thickness reduces the heat flow and produces an intentional slowing in the temperature
rise.

Patient Conditions and benefits of using hot pack:

Patients with certain conditions typically benefit from using hot packs in the physical therapy
clinic. These conditions may include arthritis, chronic pain, joint contracture, muscle spasms and
Chronic injury where increased blood flow is desired. Firstly, heat therapy such as using hot
packs may help soothe stiff joints, particularly if arthritis causes morning stiffness. Heat therapy
may help by increasing blood flow, causing the blood vessels to dilate and pull in more oxygen
and nutrients to the joints and muscles. Next, if chronic pain happens, the recommendation is to
use heat before to increase the blood flow to the area, which helps muscle flexibility and joint
movement. Besides, the heat from the hot pack can promote the healing process by increasing
oxygen uptake in the tissue which helps to relieve pain during joint or muscle contracture.
Furthermore, muscle spasms can occur during intense exercise, this happens because there may
not be enough blood flow to eliminate all the chemicals such as lactic acid. It is the buildup of
chemicals that cause muscle ache. Hence, heat can be used to help sore muscles after exercise.
Lastly, heat treatments should be used for chronic conditions to help relax and loosen tissues and
to stimulate blood flow to the area. Use heat treatments for conditions such as overuse injuries
before participating in activities.

Disadvantages and limitation in the use of hot pack:

Hot pack is usually a simple modality that can be taught to the patient for independent home use.
The disadvantages of this modality include potential burns, difficulty with its application to
regions exhibiting abnormalities such us foot and a skin-drying effect. Another complication that
may occur is impairment of local vascular supply, due to the weight of the modality on the limb
or the weight of the limb on the modality. This phenomenon also may be caused by an uneven
distribution of pressure on the anatomical region that the medium contacts. Next, acceleration of
heat transfer occurs if the hot pack leaks into the towel. The patient should never lie on the hot
pack, as the body weight could squeeze hot water out of the pack into the towel and potentially
cause a burn. The maximum skin temperature is obtained after 8 minutes, followed by a
reduction in temperature due to increased blood flow. Besides, Repeated application of hot packs
may prolong the period of temperature elevation but does not alter the temperature distribution
which can cause contact burns. Lastly, complications that can arise from using an electric heating
pad include shock hazard if the device is not insulated properly and burns if the patient falls
asleep lying on the pad. Heat output increases over time until equilibrium is achieved. We should
keep in mind that heat may be sufficiently analgesic to produce burns.

Summary:

Hot pack is one of the modalities in physiotherapy that use heat transfer (conduction) to patient
body. It uses heat in therapy, such as for pain relief and health. It can take the form of a hot cloth,
hot water bottle, electric heating pad, hydrocollator packs and others. It can be beneficial to those
with arthritis and stiff muscles and injuries to the deep tissue of the skin. Heat may be an
effective self-care treatment for conditions like rheumatoid arthritis. Heat therapy is most used
for rehabilitation purposes. The therapeutic effects of heat include increasing the extensibility of
collagen tissues, decreasing joint stiffness, reducing pain, relieving muscle spasms, reducing
inflammation, edema, and aids in the post-acute phase of healing, and increasing blood flow. The
increased blood flow to the affected area provides proteins, nutrients, and oxygen for better
healing. As with all treatment from modalities such as hot pack, heat therapy carry some risk and
potential complications. For example, skin rash or burn, impairment of local vascular supply,
shock hazard and others. Hence,
 Reference:

1. Brandon Kambach, MD. (2015, August 21). When and Why to Apply Heat to an
Arthritic Joint. Arthritis-Health-knowledge from Veritas-.
url: https://www.arthritis-health.com/treatment/alternative-treatments/when-and-why-
apply-heat-arthritic-joint

2. Scott Curtis, DO. (2023, October 2). Benefits of Heat Therapy for Lower Back Pain.
Spine-Health-Knowledge from Veritas-.
url: https://www.spine-health.com/treatment/heat-therapy-cold-therapy/benefits-heat-
therapy-lower-back-pain

3. Beth Levine. (2022, March 24). Heat or Cold for Chronic Musculoskeletal Pain?.
EverydayHealth.
url: https://www.everydayhealth.com/pain-management/using-cold-and-heat.aspx

4. Laura Inverarity, DO. (2022, June 07). Hot Packs Used in Physical Therapy.
VerywellHealth.
url: https://www.verywellhealth.com/hot-packs-physical-therapy-modalities-2696130

5. Scott Curtis,DO. (2021, December 06). Potential Risks and Contraindications of Heat
Therapy. Spine-Health-Knowledge from Veritas-.