Overview of Thermotherapy | Physiotherapy


What is thermotherapy?

Thermotherapy consists of the application of heat or cold (cryotherapy) in order to change the skin, intra-articular and central temperature of the soft tissues with the intention of improving the symptoms of certain conditions.

Cryotherapy and thermotherapy are useful assistants for the treatment of musculoskeletal injuries and soft tissue injuries. The use of ice or heat as a therapeutic intervention decreases pain in the joints and muscles, as well as in soft tissues, and has opposite effects on tissue metabolism, blood flow, inflammation, edema, and tissue extensibility connective. Thermotherapy can be used in therapy facilities or at home.

Types of thermotherapy

There are two kinds of thermotherapy: superficial and deep. Methods for providing surface heat include hot moist compresses, fluid therapy, hydromassage, and paraffin (warm wax). Surface warming agents raise skin temperature and tissue 1 to 2 cm from the skin surface.

Indications for thermotherapy

Indications for heat modalities are subacute or chronic inflammatory conditions, muscle spasms or joint protection and contractures, and decreased range of motion.

Purpose of thermotherapy

Heat: As skin / soft tissue temperature increases, blood flow increases through vasodilation. It will also increase the metabolic rate and the extensibility of the tissue. Heat increases oxygen approval and accelerates tissue healing, also rises the action of destructive enzymes, such as collagenase, and increases the catabolic rate.

Cold: As the temperature of the skin / soft tissues decreases, blood flow decreases due to vasoconstriction. This will be followed by vasodilation to prevent hypoxic damage (hunting reflex: if the cold pack is left on the skin for more than 10 minutes, the blood vessels will dilate). Tissue metabolism will decrease as will neuronal excitability, inflammation, conduction velocity, and tissue extensibility. At joint temperatures of 30 ° C or less, the activity of enzymes that degrade cartilage, including collagenase, elastase, hyaluronidase, and protease, are inhibited. the decreased metabolic rate limits further injury and helps tissue survive the cellular hypoxia that occurs after injury.

Benefits of thermotherapy

Benefits of thermotherapy include:

Benefits for the body

  • Promotes physical health
  • Promotes better and deeper sleep
  • Stimulates the immune system
  • Deep cleans the body eliminating toxins
  • Cleanses, tones, and firms the skin and gives it elasticity and firmness
  • Improves blood circulation
  • Promotes better absorption and digestion of nutrients

Delays body aging

Please note that body temperature variations may not be recommended for everyone. Consult your doctor if you have questions about the benefits of thermotherapy on your body and/or medical condition.

Benefits for psychological and emotional health

  • Promotes mental health
  • Promotes relaxation and eliminates fatigue
  • Reduces accumulated stress and tension
  • Improves memory and mental alertness
  • Create peace of mind

Benefits for athletes

  • Improves sports performance
  • Relieves muscle aches and pains
  • Improves breathing (slower and deeper)
  • Helps with body remineralization

Procedure of thermotherapy

Treatment rest on the type of application and the type of disease.

There are 3 phases of the healing process: The provocative phase, the proliferation phase, and the remodeling phase.

The first phase, known as the inflammatory phase, protects the injured area from additional injury while the body holds the damaged tissue. During this phase, cryotherapy can help reduce swelling. Never use heat during this phase because heat increases blood flow to the injured area and increases the amount of swelling. The inflammatory phase lasts for 2 days.

During the second phase, the proliferation phase, new tissues, and scars are formed. Heat can now be applied to the injured area to facilitate the healing process.

The third and final phase, the remodeling phase, is the health recovery process: restoring the structure and function of injured or diseased tissues. The healing process includes blood clotting, tissue repair, scarring, and healing.

Side effects of thermotherapy

Many of the local physiological effects of heat and cold have been thoroughly studied. For illustration, heat increases the temperature of the skin and joints, improves blood circulation and muscle relaxation, and reductions the stiffness of the joints. The cold will numb the pain, decrease swelling, constrict blood vessels, and block nerve impulses to the joint.

Deep heating is thought to decrease nerve sensitivity, increase blood flow, increase tissue metabolism, decrease muscle spindle compassion to extending, cause muscle relaxation, and increase elasticity. The heat stimulates the cutaneous thermotherapy that is connected to the cutaneous blood vessels, causing the release of bradykinin that relaxes the smooth muscle walls and produces vasodilation.

Muscle relaxation occurs as a result of a decrease in the activation rate of gamma effects, which lowers the threshold of muscle spindles and increases afferent activity. There is also a decrease in alpha motor neuron firing to the extra fugal muscle fiber, resulting in muscle relaxation and decreased muscle tone.


A very important note to be made is that thermotherapy is safe for people with normal skin sensation. When a patient has thermal sensitivity issues, it can be dangerous. They cannot feel if they are burning from the application.


Complications of cryotherapy include nerve damage, frostbite, Raynaud’s phenomenon, cold-induced urticaria, and slow wound healing. With thermotherapy, skin burns can occur, especially in patients with diabetes mellitus, multiple sclerosis, poor circulation, and spinal cord injuries.

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