In health care, there’s no substitute for clinical skill, judgment and decision making. These essentials help you diagnose, manage and treat a host of patients. But sometimes, you need help to achieve treatment goals. In those cases, you can turn to modalities to jumpstart the healing process. The following is a brief primer on shortwave diathermy.
Shortwave diathermy uses high-frequency electric current to produce heat using either a condenser field or an induction field. The condenser field uses the patient’s tissues as the dielectric between two electrodes. With the induction field, the patient is in the electromagnetic field so that current flows between the patient’s conductive tissues.
Shortwave diathermy heats the tissue by causing oscillations of electromagnetic energy of high frequencies. With the changes in the new diathermy units, therapists can now provide treatment over pins and screws, prostheses and other noncircular metals. These areas were previously contraindicated.
Shortwave diathermy can reach deep tissue, a primary advantage of this modality. The diathermy head is approximately 25 times the size of an ultrasound head, thus allowing therapists to treat a large muscle group in less time.
Producing a variety of physiological changes, diathermy increases local metabolism and white blood cell concentration to the injured area. It also removes bacteria and toxins with increased cell membrane permeability, reduces muscle spasm and sedates nerve endings. In addition, it increases connective tissue elasticity, body temperature, respiratory and pulse rates and decreases blood pressure.
Diathermy is indicated for subacute and chronic inflammatory conditions of superficial joints, subacute and chronic traumatic muscle inflammation, indirect heating for peripheral vascular disease, contusions and post-surgery sites, sprains, strains, bursitis and tendinitis. It also can enhance epithelialization.
Very young and very old patients aren’t candidates for diathermy. Nor are those who are pregnant, have cardiac disease, a known cancer, an infection, an existing fever or a tendency to hemorrhage. Diathermy can’t be used over any metal that forms a circular pattern or has the same circumference as the diathermy coil. It also shouldn’t be used over the epiphyses of growing bones.
Therapists must remove electronic or magnetic equipment from the condenser field or induction field. Be careful with patients who are poor judges of heat, are obese and have sensory impairment. Avoid ischemic areas, open wounds or moist dressings, uneven spacing of the electrodes and uneven pressure of the electrodes.
Making Progress: Modalities can jumpstart the healing process
By Danielle Montbriand, MPT, and Jessica F. Broussard, OTR/L