CONTRAST BATH

INTRODUCTION
• Contrast bath therapy is a method of application which involves
soaking the area to be treated in alternating baths of hot and cold
water.
• The temperature of hot water ranges from 36-45 degree Celsius and
the cold water from 15-20 degree Celsius.
• Contrast baths combine alternating hot and cold water applications
to increase blood flow and to decrease joint stiffness
• The part is immersed first in the hot water and then in the cold water
and the treatment is repeated thereafter.
 PHYSIOLOGICAL EFFECTS
• contrast therapy produces a cycle of local vasoconstriction and
vasodilation resulting in a “pumping effect” to facilitate the removal
of oedema by venous and lymphatic removal.
• Believed to alleviate
o pain,
o stiffness, and
o edema
• By induced vasodilatation and vasoconstriction that is usually
produced by normally contracting muscles.
• The effectiveness of heat and cold in therapeutic circumstances can
be attributed to two basic physical rules. Heat expands, cold
contracts.
• Physiologically this translates into the use of heat as a vasodilator –
bringing nutrient rich blood to surface areas – and the use of cold
acting as a vasoconstrictor – driving blood to the body’s core –
nourishing and protecting the inner organs of the body.
• Used alone, heat can help to relax aching muscles, while cold reduces
inflammation and inhibits pain.
• Pain reduction happens, in part, because the body’s pain receptors
are particularly sensitive to changes in temperature.
• Cooler temperatures slow the velocity of nerve transmission, while
heat tends to increase the velocity.
• Variations in heat and cold also have a physiological effect on
the body’s pain gate mechanism. In very simple terms, the
brain is momentarily distracted away from sending or
receiving pain messages through the use of contrasting
temperatures.
• The regular change in temperature also leads to consolidate
change in the sensory stimulus.
• This stimulus is relatively vigorous because each time neural
stimulation starts to occur, the temperature stimulus is
reversed.
• This stimulus acts to suppress pain by means of gate
mechanism and accounts for suppression of pain in many
patients receiving this treatment.
 PROCEDURE
• Always begin with the warm water and end with the warm water.
• Place part in the warm water for 10 minutes
• Move the part around through the full, pain-free range of motion.
• Remove and place immediately in cold water for 1 minute.
• There will be an initial short period of tingling until the part becomes
accustomed to the cold.
• Continue alternating parts in hot water for 4 minutes and cold water
for 1 minute
 PROCEDURE
• In Summary, soak in
• Warm water for 10 Minutes
• Cold water for 1 Minute
• Warm water for 4 Minutes
• Cold water for 1 Minute
• Warm water for 4 Minutes
• Cold water for 1 Minute
• Warm water for 4 Minutes
METHODS OF APPLICATION
• Heat and cold, as a therapeutic tool, can be used independently of each other or
alternating every few minutes.
• Used in an alternating mode it is often referred to as contrast therapy, and can be
used either locally using hot and cold packs or systemically using contrast baths
or steam rooms and cold pools.
• Heat and cold can be applied to the body in several ways.
• Perhaps most commonly is through the use of water or hydrotherapy. Steam
baths, ice, wet compresses, immersion baths, hydrocollator heated pads and
saunas are the most familiar tools of moist heat and cold. Heating pads and
infrared lamps can provide dry heat, while vasocoolant topicals and sprays or
sealed ice packs can provide dry cold.
• Warmed or cooled stones can provide wet or dry, heat or cold, depending on the
method used to control the temperature.
• Total Immersion vs. Local Use
• There are two basic methods using contrast therapy.
• Total immersion – would be where the person’s whole body is exposed
alternately to heat and cold. A prime example of this would be in the use
of a hot sauna, followed by a quick dip in to a cold pool of water. In a
medical setting this might be done through the use of temperature
controlled water-filled tubs and should only be used with proper training.
• Used locally – contrast therapy has less of a systemic effect and can be
useful in the easing of pain, reducing localized inflammation and increasing
superficial circulation. With practice, and the understanding of the basic
dilation and contraction action provided by the contrast in temperatures,
the use of localized contrast therapy can be effective in assisting the body’s
own pumping action, both in the superficial portion of the circulatory
system and the lymph system.
• Indications for general contrast bathing:

• Hypotonia,
• Myocardio-dystrophy with circulatory inefficiency of the 1st stage,
• Functional disorders of nervous and cardiovascular systems,
• Obesity,
• Atherosclerosis,
• Tempering.
• Contraindications for local contrast baths :
s
• Varicosity,
• Insomnia,
• Sweatiness and skin chilliness,
• Leg ulcers,
• Skin diseases
• Obesity of 4 th stage
• Musculoskeletal disorders in the exacerbation phase