2. CONTENTS
• INTRODUCTION
• METHODS OF APPLICATION
• PHYSIOLOGICAL EFFECTS
• THERAPEUTIC EFFECTS
• INDICATIONS AND CONTRAINDICATIONS
• ADVANTAGES AND DISADVANTAGES
• ARTICLES
• REFERENCES
3. INTRODUCTION
• Paraffin wax bath is the therapeutic application of molten mixture of paraffin wax and
mineral oils for relief of pain and joint stiffness ,suitable for peripheral joints like small joint
of hands, elbow, knee , ankle and feet.
• Temperature of the paraffin wax is maintained at 40-45°C.
• Melting point is at 51-55°C(129°F).
• This can be lowered further by adding more paraffin oil and mineral oil .so that the wax
remains molten at temperature between 113°F and 129°F (45°C and 54°C).
• If the molten wax at 51-55°C is poured on the body parts, it may cause burn over the body
tissues, to avoid or lower the risk of burn the impurities like liquid paraffin oil and mineral
oil is added to lower down its melting point.
4. • The mixture of paraffin wax , liquid paraffin and petroleum jelly , in a ratio of 3:1:1,melts at 42-45°C
and is self sterilizing in nature.
• Temperature is sustained by thermostat controlled heating.
• Paraffin wax bath therapy provides about 6 times the amount of heat available in water because the
mineral oil in the paraffin lowers it’s melting point.
• Paraffin has a low specific heat , which means that it does not feel as hot as water of same
temperature.
• But it conducts heat more slowly than water at the same temperature.
• Molten wax mixture solidifies on contact with the skin, giving up latent heat of solidification ,which is
transferred to the body by conduction.
5. Paraffin wax bath unit
• CONTAINER
• MAINS
• THERMOSTAT
• THERMOSTAT PILOT LAMP
• POWER PILOT LAMP
• LID AND CASTER
6. • Container contains the wax and paraffin oil.
• Mains function is to switch on or off the heating element, which is located in the casting of
paraffin wax bath unit
• Thermostat keeps the temperature fixed or static in the range which is adjusted with knob.
• Thermostat pilot lamp indicates whether thermostat is on or off.
• Power pilot lamp function is to slow whether power is on or off.
• Lid covers the container
• Caster allows the paraffin wax bath container to be moved from one place to another.
7. PREPARATION OF PATIENT
• The nature of wax treatment should be explained.
• The area to be treated is inspected for contraindications.
• Look for any wounds, skin infections , rashes etc.
• Clean the skin using tissue paper or cotton.
• The jewellery from the part Should be removed.
• The part to be treated must be cleaned by soap
8. POSITION OF THE PATIENT
• The position of patient should be such that the part to be treated comes closer to the wax
bath container.
TREATMENT METHODOLOGY:
• Before treatment must ensure that there should be no moisture over the body tissues
otherwise burn could occur.
• The warm wax is placed on the body tissues by various techniques and the treatment is
given for about 10-20 minutes.
9. METHODS OF APPLICATION
DIPPING METHOD:
• Commonly used for distal parts of the extremities such as hands and feet
• In this method the part is immersed for a second in the wax and then withdrawn and
allowed to cool for 2 to 3 seconds and then re immersed
• This procedure is repeated for 6 to 12 times to produce a coating of wax 2 or 3 mm thick
over the body part
• The part is then put into a plastic bag or paper bag cover and wrapped in a blanket/towel to
limit the rate of heat loss to the air
• If there is provocation of edema , the part should be kept elevated
• After 15 to 20 minutes of solidification of the wax , it has turned into a glove of wax , the
wax is removed and reused for next time
10. • To achieve higher skin temperature for long periods dip and leave method
• In dip and leave method after forming a thick layer of wax have been built up then
the part is left in the bath for 15 to 20 minutes
BRUSHING METHOD:
• This method is used when the part cannot be dipped inside the bath
• The wax is coated over the body surface with the help of a large brush
• After 2 to 3 mm thickness of wax is painted, the part is covered by a plastic sheet to
prevent heat loss
11. • After solidification [15 minutes later] the wax glove is removed into the tank for reuse
• This method is commonly used for areas like the hip , knees , elbow , shoulder , etc
POURING METHOD:
• This method is used as an alternative to brushing and dipping
• In this method , the part is positioned over a large bowl then using a shallow spoon with
insulated handle molten wax is poured over the part
• After 2 to 3 mm of wax is built over the part it is covered with a plastic sheet to prevent
heat loss
12. • The treatment is terminated after 15 minute by removing the wax layer from
the body into the tank
WRAPPING METHOD:
• In this method , bandages of a suitable size and mesh are soaked in hot
wax and then wrapped around the limb
• Additional wax can also be brushed over the bandage
• After wrapping , the part is covered by a plastic sheet
13. • After 15 minutes the bandages of wax are removed and the wax is separated
into the tank
• This method is suitable for areas like back , shoulder , hip , etc,.
14. PHYSIOLOGICAL EFFECTS
EFFECTS OF HEAT:
• There is a marked increase in skin temperature in the first 2 minutes upto 12-
13°c.
• This drops , later upto 8°c at the end of the treatment.
• In subcutaneous fascia-↑ in 5°Temperature at the end of the treatment.
• In superficial muscles-↑ in 2-3°c at the end of the treatment.
15. CIRCULATORY EFFECTS:
• Stimulation of superficial capillaries and arteries causes local hyperemia and reflex the
vasodilation.
• Hyperemia is due to the response of the skin to its function of heat regulation.
• Skin and subcutaneous tissue temperature drop after 15-20 minute, reducing the
vasodilation.
• Exercise after the wax is essential to increase the muscle circulation and sedative effect of
heat to obtain more range of movement and muscle strength.
16. ANALGESIC EFFECT:
The most important effect of wax it’s marked sedative effect on tissues.
• This effect is used before the exercises ,In the treatment of superficially placed joints.
• Moist heat→ soothens the patient.
• Soothing effect → provide comfortable to patients↓
hence, used prior to exercise
17. EFFECT ON SENSORY NERVE:
• Mild heating appears to have a sedative effect on sensory nerve endings.
• Increases the sensory nerve conduction.
• Reduces the muscle spasm.
• Inhibits the muscle contraction.
EFFECT OF STRETCHING:
• Paraffin wax makes the skin moist, soft and pliable.
• This useful for stretching scars and adhesions before applying mobilization techniques.
18. THERAPEUTIC EFFECTS
ARTHRITIC CONDITIONS:
• In arthritic conditions like rheumatoid arthritis and other poly or oligoarthritic conditions,
particularly for the stiff and painful joints in the distal parts of the body such as hands ,knee
or feet, paraffin wax bath is of immense help if applied before mobilization exercises.
PAIN:
• For painful conditions affecting the joints due to trauma or disease, paraffin wax bath is of
value in decreasing Pain and enhancing function.
19. STIFF JOINTS:
• For joint stiffness particularly Following trauma, as well as due to diseases, paraffin wax is
applied before stretching and mobilization.
CHRONIC INFLAMMATION:
• In chronic inflammatory conditions with an indurated edema and stiffness affecting joints,
paraffin wax is of value but in case of aggravation of the inflammation, the treatment
should be discontinued.
21. CONTRAINDICATIONS
• OPEN WOUNDS: Though wax is sterile, still if the open wound is treated with wax, it
may enter into the wound and aggravate the wound.
• SKIN INFECTIONS: Patients with Skin infections should not be treated with wax as the
same may aggravate the inflammation.
• DEFECTIVE SKIN SENSATION: Patients with defective thermal sensation , such as
patients with hansen disease should not be treated with wax .
22. • ISCHEMIC CONDITIONS: conditions with deficient arterial supply such as recently
healed skin grafts should not be treated with wax.
• SKIN ALLERGY: some individuals develop an allergic reaction in the skin on prolonged
treatment and in such cases, treatment should not be applied.
• BURNS: If the skin sensation is defective or if the temperature of the molten wax is not
regulated properly, there is the danger of a burn occurring .
23. ADVANTAGES
• Improves the texture of the skin
• Increase pliability of soft tissue
• Prolonged analgesia
• Reusable and cost effective
24. DISADVANTAGES
• Messy application procedure
• Regulation of temperature is different and may cause burn
It is effective only for distal extremities
• It is a passive treatment
• It is highly inflammable composition , hence fire hazard.
25. PURIFICATION OF WAX BATH
• After use the wax needs to be purified periodically by transferring it into a purifier before it
is re-used.
• The container with wax is added with water and the mixture is heated till the wax is melted
• After melting of the wax, the mixture is left undisturbed and allowed to cool gradually.
• After, cooling it will be found that the dirty materials have been deposited at the bottom of
the container whereas the wax has solidified at the top layers.
• With proper care, the pure wax is removed into the wax tank, leaving the dirty materials in
the purifier
26. ARTICLES
• İlknur Aykurt Karlıbel , Meliha Kasapoğl Aksoy , Ayşe Alkan Paraffin bath
therapy in De Quervain's tenosynovitis: a single-blind randomized controlled
trial 2021 Aug;65(8):1391-1398.
• Hafiz Muddassir Riaz , Saeed Ashraf Cheema Paraffin wax bath therapy versus
therapeutic ultrasound in management of post burn contractures of small
joints of hand2021 Jun 15;11(3):245-250.
• Adil Öncel , Sami KüçükşenComparison of efficacy of fluidotherapy and
paraffin bath in hand osteoarthritis: A randomized controlled trial 2020 Sep
28;36(2):201-209.
27. REFERENCES
• Handbook of practical electrotherapy- Pushpal Kumar Mithra.
• Textbook of electrotherapy simplified- Basanta Kumar Nanda.
• Physical agents in rehabilitation-Michelle H Cameron.
