Several methods for applying therapeutic heat are available. Some provide superficial heat, while others provide heat to deeper tissue structures. Safe use of heat requires that certain precautions be taken in patient selection and choice of modality.


Factors to consider in the selection of heat modality:

(1) stage of injury, with cold often preferred during early acute inflammation

(2) area to be treated

(3) medical condition of the patient

(4) condition of the target area

(5) patient preference


General contraindications to the use of therapeutic heat:

(1) person unable to safely report pain sensation

(2) use over an anesthetic region

(3) person with bleeding disorder

(4) use over an area with decreased circulation with inadequate oxygen delivery to meet the metabolic needs of the tissue

(5) acute inflammation or trauma

(6) heat sensitivity


Contraindications and precautions in the use of shortwave or microwave diathermy:

(1) use over metal implants or jewelry

(2) use over intrauterine device (IUD) in women

(3) use over pelvis during pregnancy or menstruation

(4) use near cardiac pacemaker due to potential for electrical interference

(5) use over the eyes

(6) use over open wounds or moist dressings (risk of selective heating)

(7) use over areas of increased perspiration (risk of selective heating)

(8) use over epiphyseal growth plate in children

(9) use over the gonads

(10) use over an area of infection (risk of spread)

(11) use over subcutaneous fat deposits in obese persons (selective heating of the subcutaneous fat)


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