Introduction

Paraffin Wax bath is a form of deep heating therapy which mainly use paraffin oil and wax to promote pain relief to hand, feet, sore joints and muscles. The actual temperature of paraffin wax is 42-52°C whereas its melting point is 51-54.4°C. The melted wax should not be poured directly on the body tissue as it may lead to thermal injuries. In order to avoid this, melting point of wax is usually lowered by adding an impurity in the form of paraffin oil.^[1]

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Physical Principle

The heat transfer during paraffin wax bath therapy occurs through conduction from the layer of solid paraffin wax into the skin. When the warm paraffin wax are applied to the skin, it causes the blood vessels to get expand by improving the circulation, promote healing and removing toxins out of the skin.^[1]

Paraffin Wax Bath Unit

• Parts of paraffin wax bath (PWB) includes container, mains, thermostat, thermostat pilot lamp, cap and casters.
• The container of paraffin wax bath (PWB) is usually made up of steel.
• The ratio of paraffin wax and mineral oil is 6:1 or 7:1
• The composition of the solid wax : liquid paraffin : petroleum jelly is 2:1:1 ^[3][1]

Preparation of Patient

• Explain the procedure to the patient prior applying paraffin wax bath (PWB).
• Expose the body part to be treated.
• Remove jewelry or metal if any.
• Check for the sensation of the patient.
• Check for the contraindications if any.
• Thoroughly inspect the body part to be treated.
• Ensure comfortable position of the patient.
• Check the temperature selected on thermostat before treatment.
• Check the temperature of the bath.
• Select convenient or appropriate method of application.
• Inspect the body part after the treatment. ^[4] 

Method of Application

There are various methods used for the application of paraffin wax such as-

• Dip method
• Immersion method
• Brush method
• Bandage method
• Pouring method ^[3]

Dip method

In this method, the therapist will instruct the patient to dip his/her extremity to be treated in the paraffin wax bath (PWB). Remove the extremity once the paraffin solidifies or becomes thick which covers the skin. Dipping should be done for 8-12 times until a thick coat is formed. Once thick coating of wax is formed the treated area should be wrapped 1st in a plastic and then wrapped with a towel. This method of paraffin wax bath (PWB) promotes mild heating. The treatment duration should be 10-15 minutes. ^[3][4]

Immersion method

In this method, the therapist will instruct the patient to dip his/her extremity for 3-4 times in the paraffin wax bath (PWB) until a thin coat is formed and then left immersed in paraffin for 20-30 minutes. This method of paraffin wax bath (PWB) promotes vigorous heating to the affected extremity. ^[3][4]

Brush method

In this method, the therapist will apply 8-10 coats of wax on the affected body part with the help of paint brush using even and rapid strokes. Once thick coating of wax is formed the treated area should be wrapped 1st in a plastic and then wrapped with a towel for 10-20 minutes. This method of paraffin wax bath (PWB) is more commonly used. ^[3][4]

Bandage method

A towel or a bandage of suitable size will be immersed in paraffin wax and then wrapped around the body part to be treated. Additional wax then can be poured or brushed over the bandage. This method can be commonly used for treating proximal parts of the body. ^[3][4]

Pouring method

In this method, the therapist will be using a mug or utensil to directly pour a wax on the part to be treated. Wax should be poured 7 to 10 times to create a thick coat, then covered with a plastic cover and wrapped around with a towel. Treatment duration includes 10-15 minutes. This method will be commonly used for knee and elbow.^[3][4]

Indications

1. Osteoarthritis
2. Rheumatoid arthritis
3. Tenosynovitis
4. Joint stiffness
5. Leprosy
6. Scleroderma
7. Dupuytren’s contracture
8. Sudeck’s atrophy
9. Soft tissue contractures^[4][5]

Contraindications

1. Open wounds
2. Infective conditions
3. Allergic rashes
4. Deep vein thrombosis
5. Impaired sensations
6. Acute dermatitis^[4][5]

Clinical Effects of Paraffin Wax Bath

• Relieving musculoskeletal pain
• Reducing stiffness
• Increase in local temperature
• Increase sweating
• Increase in local circulation ^[1][5]

Precautions

•Temperature of the paraffin wax should be checked prior applying.

•The skin must be dry, as water droplets may result in burns.^[4]

References