Diathermy

Diathermy is a non-invasive, therapeutic technique that uses electrical energy to produce heat deep within the body. It has been used for many years to treat various medical conditions, including pain, inflammation and muscle spasms.

Diathermy is based on the principle that electrical energy can be converted into heat when it flows through a conductive medium, such as water or tissue. The process involves the application of an alternating current (AC) to the body, which causes the tissues to resist the flow of electricity. This resistance generates heat in the affected area.

There are three primary types of diathermy:
1. Shortwave Diathermy: Also known as microwave diathermy, this type uses frequencies between 2.45 and 10 GHz to produce heat. Shortwave diathermy is commonly used for deep tissue heating.
2. Ultrasonic Diathermy: This type employs high-frequency sound waves (20-40 kHz) to produce heat through cavitation and thermal conduction. Ultrasonic diathermy is often used for superficial heating.
3. Radiofrequency Diathermy(RF Diathermy): Also known as radio wave diathermy, this type uses frequencies between 10 kHz and 100 MHz to produce heat. Radiofrequency diathermy is commonly used for deep tissue heating.

Benefits:
1. Pain Relief: Diathermy has been shown to be effective in reducing pain by increasing blood flow, relaxing muscles, and releasing endorphins.
2. Inflammation Reduction: Diathermy can help reduce inflammation by increasing blood flow and promoting the removal of waste products.
3. Muscle Relaxation: Diathermy can help relax muscle spasms and reduce muscle tension.
4. Wound Healing: Diathermy has been shown to improve wound healing by increasing blood flow, promoting collagen synthesis, and reducing bacterial growth.

Diathermy can be classified broadly into two types:
1. Continuous Wave (CW) Diathermy: This type of diathermy uses a continuous wave of energy to produce heat.
2. Pulsed Wave (PW) Diathermy: This type of diathermy uses pulses of energy to produce heat, which can be more effective than CW for deep tissue heating.

Diathermy is primarily used in the following conditions:
1. Orthopedic Conditions: Diathermy is commonly used to treat musculoskeletal conditions such as arthritis, tendonitis, and bursitis.
2. Chronic Pain Management: Diathermy is often used to manage chronic pain conditions, including fibromyalgia and complex regional pain syndrome.
3. Muscle Spasms: Diathermy can help relax muscle spasms and reduce muscle tension.
4. Post-Surgical Rehabilitation: Diathermy is sometimes used as part of post-surgical rehabilitation protocols to promote healing and reduce pain.

Contraindications:
1. Pacemakers and Implantable Cardioverter-Defibrillators (ICDs): Diathermy can interfere with the functioning of these devices.
2. Metallic Implants: Diathermy should not be used near metallic implants, as it may cause heating or sparking.
3. Cancer: Diathermy is generally contraindicated in cancer patients, as it may stimulate tumor growth.
4. Pregnancy and Breastfeeding: Diathermy is generally contraindicated during pregnancy and breastfeeding, as there is limited research on its safety in these populations.

Electrocoagulation: This minimally invasive method employs high-frequency electric currents to seal blood vessels through heat, thereby achieving hemostasis. Electrocoagulation is based on the principle that a high-frequency electric current can be used to generate heat, which in turn causes coagulation of blood vessels and surrounding tissue. This process creates a localized thermal effect that seals off blood vessels, stopping bleeding and allowing for precise surgical dissection.

Electrical Current: High-frequency electrical currents (often in the range of 0.3 to 5 MHz) are delivered through an electrode.
Heat Generation: The electrical current generates heat as it passes through tissues, leading to coagulation.
Tissue Effect: The heat causes proteins in the tissue to denature, leading to coagulation, which seals blood vessels and stops bleeding.

1. Surgical Hemostasis: Electrocoagulation is commonly used during surgical procedures to make bloodless incisions, reducing the risk of bleeding complications and enabling more accurate tissue dissection. It is especially useful in procedures involving highly vascular tissues.
Tumor Resection: Used to remove tumors while minimizing blood loss.
Polypectomy: Removal of polyps, particularly in gastrointestinal and gynecological surgeries.

2. Nosebleed Control: This technique is also effective in controlling nosebleeds, allowing for prompt and safe management of this common condition.

3. Abnormal Vessel Treatment: Electrocoagulation can be used to treat abnormal blood vessel formations, such as spider naevi, by delivering the electric current through a fine needle. This minimizes tissue damage and promotes targeted treatment.

4.Dermatology: Removal of Skin Lesions: Effective for removing warts, moles, and other benign skin lesions.
Acne Treatment: Used to reduce the size of sebaceous glands and treat severe acne.

5. Gastroenterology: Endoscopic Procedures: Used during endoscopy to treat bleeding ulcers, remove polyps, and manage gastrointestinal bleeding.
6. Gynecology: Cervical Procedures: Used in procedures such as loop electrosurgical excision procedure (LEEP) to remove abnormal cervical tissue.
7. Urology: Bladder and Prostate Surgery: Used to control bleeding during transurethral resection of the prostate (TURP) and other urological surgeries.

Physiotherapy

Physical therapy also known as physiotherapy, includes evaluating, diagnosing and treating numerous disorders and disabilities through the physical way. This branch of medicine helps people restore, retain and maximize their strength, function, movement and overall well-being.

People who practice this branch of therapy are called physiotherapists. Diagnosis, treatment and rehabilitation of patients are their main areas of work. They primarily work with physical disorders and disabilities. Physiotherapy helps a person

• Become flexible
  
• Improve mobility
  
• Reduce pain
  
• Stay active
  
• Prevent injury
  
• Recover from injury

Physiotherapy helps the human body to remain functional. Physiotherapy is recommended when the human body suffers some physiological trauma. During physiotherapy the patient is examined physically and if required imaging studies are carried out so as to decide the right type of therapy. It is recommended in the following conditions:

• Post injury rehabilitation like fracture recovery, post surgical recovery.
  
• Spine problems like spina bifida, sciatica.
  
• Neck problems
  
• Muscular problems
  
• Joint disorders like osteoarthritis
  
• Neurological disorders like stroke, multiple sclerosis
  
• Backaches
  
• Headaches
  
• Urinary problems like urinary incontinence
  
• Lung and heart disease like chronic obstructive pulmonary disease

Heat therapy: Heat therapy improves the blood flow to the injured area thus speeding up healing. Heat therapy also loosens the tight tissues thereby relieving pain. Various heat treatments include ultrasound, hot pack, infrared heat, Paraffin wax bath, Diathermy

Cryotherapy: Cold therapy helps in minimizing the swelling and pain. It is very useful in acute injuries. Various treatments include ice massage and ice pack application

Strengthening exercises with Physical Therapy: Certain conditions may have caused the muscles to weaken, there are certain types of exercises aimed at strengthening the muscles thereby helping rehabilitation and improving performance.

Range Of Motion exercises: ROM exercises help in improving and maintaining the flexibility of joints. They also help in reducing the stiffness of the joints. Various exercises include:

Passive Range of Motion exercises: (PROM)

Active Range of Motion exercises: (AROM)

Active Assistive Range of Motion exercises: (AAROM)

Soft tissue mobilization/Therapeutic massage:This relaxes the tight muscles thus relieving pain and reducing swelling

Electrical stimulation: This method is used to prevent muscle atrophy in people with paralysis. Electrodes are placed on the surface of the skin thus causing the muscle to shorten.

TENS: Transcutaneous Electrical Nerve Stimulation is a type of never stimulation wherein a low degree electrical current is passed through the surface of the skin to the affected part. This process helps in relieving pain momentarily.

Other types of physical therapy treatment include taping, bandaging, joint mobilization, ergonomic training, postural training, balance exercise, traction, fitting of orthosis, etc. Physiotherapy has various specializations like geriatric, pediatric, orthopedic, neurological, sports, cardiovascular and pulmonary.

Endometrial Ablation

Heavy menstrual bleeding may happen due to underlying conditions such as hormonal imbalance, uterine polyps and ovarian dysfunction. Menorrhagia is also an inherited disorder as it is associated with blood clotting impairments like Von willebrand's disease. In most cases, endometrial biopsies are done to determine histological overview of the conditions. Many treatment options are suggested depending upon the age, lifestyle and medical history of the patient. Among many prophylactic measures, endometrial ablation or uterus ablation is increasingly becoming the most preferred method.

The inner layer of the uterus called as the endometrium is removed using the diathermy electrode. The patient is subjected to general anesthesia during the procedure. Careful examination of the uterine wall is done to identify any underlying uterine disorders. The electrode is 4mm and it helps in cutting of the endometrium. In addition to this, the myometrium is also destroyed to eliminate the underlying endometrial basal cells.

The basal cells of the endometrium are also called basalis. They enable the multiplication and thickening of the endometrium forming the superficial layer of the endometrium which is shed out. The walls of the uterus are examined for bleeding points and then the patient is sent to the recovery room. Other modern techniques such as the administration of microwave endometrial ablation, cryoablation, diode laser phototherapy are considered.

Endometrial ablation is not advisable for patients who might be in early pregnancy, have a history of uterine cancer and menopause. Women who undergo endometrial ablation have a chance of conception; however there is a possibility of miscarriage. This happens because the uterine lining has been removed.

Endometrial ablation is also recommended as an alternative to hysterectomy. Endometrial ablation is also done on an outpatient basis with a given recovery time. The results of the endometrial ablation treatment include absence of menstrual bleeding. In some cases, there is a possibility of reduced bleeding. Consult a doctor in the case of spotting to identify the emergence of conditions such as fibroids or polyps of the uterus. Endometrial ablation procedure is widely administered among women in the age group of 30 to 45.

Endometrial Resection : The Loop Electrosurgical Excision Procedure(LEEP) is used to destroy the uterine lining. The use of LEEP is faster and provides faster recovery than any comparable surgical procedure.

Complications of Endometrial Ablation

The most significant complication is perforation caused to the uterus. In these cases laparoscopy is done. Other possibilities include perforations to organs such as the bladder, blood vessels and the organs in pelvic region.

The fluid absorption during the endometrial ablation procedure may result in the lowering of blood salt levels causing damage to the lungs and brain. In post-operative cases, vaginal bleeding is common for a few days. However, if the discharge or bleeding from the vagina is associated with foul smell, infections of the uterus are suspected. Women who have undergone the endometrial ablation procedure are generally advised to take progestogens which help in reducing the risk of uterine cancers. Sexual intercourse is advised only after two weeks to prevent vaginal bleeding or pain.

Tags: #Diathermy #Physiotherapy #Endometrial Ablation