In the natural sciences, the term diathermy means “electrically induced heat” the use of high-frequency electromagnetic currents as a form of physical or occupational therapy and in surgical procedures. It is commonly used for muscle relaxation. It is also a method of heating tissue electromagnetically or ultrasonically for therapeutic purposes in medicine. Diathermy is used in physical therapy and occupational therapy to deliver moderate heat directly to pathologic lesions in the deeper tissues of the body.
The three forms of diathermy employed by physical and occupational therapists are ultrasound, short wave and microwave. The application of moderate heat by diathermy increases blood flow and speeds up metabolism and the rate of ion diffusion across cellular membranes. The fibrous tissues in tendons, joint capsules, and scars are more easily stretched when subjected to heat, thus facilitating the relief of stiffness of joints and promoting relaxation of the muscles and decrease of muscle spasms.
Ultrasound diathermy employs high-frequency acoustic vibrations which, when propelled through the tissues, are converted into heat. This type of diathermy is especially useful in the delivery of heat to selected musculatures and structures because there is a difference in the sensitivity of various fibers to the acoustic vibrations; some are more absorptive and some are more reflective. For example, in subcutaneous fat, relatively little energy is converted into heat, but in muscle tissues there is a much higher rate of conversion to heat.
The therapeutic ultrasound apparatus generates a high-frequency alternating current, which is then converted into acoustic vibrations. The apparatus is moved slowly across the surface of the part being treated. Ultrasound is a very effective agent for the application of heat, but it should be used only by a therapist who is fully aware of its potential hazards and the contraindications for its use.
Short wave diathermy machines utilize two condenser plates that are placed on either side of the body part to be treated. Another mode of application is by induction coils that are pliable and can be molded to fit the part of the body under treatment. As the high-frequency waves travel through the body tissues between the condensers or the coils, they are converted into heat. The degree of heat and depth of penetration depend in part on the absorptive and resistance properties of the tissues that the waves encounter.
Short wave diathermy operations use the ISM band frequencies of 13.56, 27.12, and 40.68 megahertz. Most commercial machines operate at a frequency of 27.12 MHz, a wavelength of approximately 11 meters.
Short wave diathermy usually is prescribed for treatment of deep muscles and joints that are covered with a heavy soft-tissue mass, for example, the hip. In some instances short wave diathermy may be applied to localize deep inflammatory processes, as in pelvic inflammatory disease.
Microwave diathermy uses radar waves, which are of higher frequency and shorter wavelength than radio waves. Most, if not all, of the therapeutic effects of microwave therapy are related to the conversion of energy into heat and its distribution throughout the body tissues. This mode of diathermy is considered to be the easiest to use, but the microwaves have a relatively poor depth of penetration.
Microwaves cannot be used in high dosage on edematous tissue, over wet dressings, or near metallic implants in the body because of the danger of local burns. Microwaves and short waves cannot be used on or near persons with implanted electronic cardiac pacemakers.
Hyperthermia induced by microwave diathermy raises the temperature of deep tissues from 41°C to 45°C using electromagnetic power. The biological mechanism that regulates the relationship between the thermal dose and the healing process of soft tissues with low or high water content or with low or high blood perfusion is still under study. Microwave diathermy treatment at 434 and 915 MHz can be effective in the short-term management of musculo-skeletal injuries.
Hyperthermia is safe if the temperature is kept under 45°C or 113°F. The absolute temperature is, however, not sufficient to predict the damage that it may produce.
Microwave diathermy-induced hyperthermia produced short-term pain relief in established supraspinatus tendinopathy. Microwave diathermy is used in the management of superficial tumors with conventional radiotherapy and chemotherapy. Hyperthermia has been used in oncology for more than 35 years and has been introduced in several countries of the European Union as a modality for use in physical medicine and sports traumatology. its use has been successfully extended to physical medicine and sports traumatology in Central and Southern Europe.