Infrared Radiation
Therapy 9
LEARNING OBJECTIVES
On completion of the chapter, the student will be able to:
• Describe different generators used in the production of infrared rays.
• Understand how infrared rays produce superficial heating effects in the tissues.
• Describe the physiological effects of infrared rays.
• Explain the clinical uses of infrared rays.
• Describe the procedure of application of infrared rays.
CHAPTER OUTLINE
• Production • Indications
• Physical Characteristics of IRR • Contraindications
• Physiological Effects • Dangers
• Clinical Uses • Application Procedure
KEY TERMS
Far Infrared Rays: Infrared rays with wavelength of 3000 nm to 0.1 mm are called far infrared rays.
Infrared Rays: Infrared rays are electromagnetic waves which are invisible to the human eyes, unless reflected off an
object. The wavelength ranges from 760 nm to 1 mm (106). The frequency of infrared rays lies between 4×1014 Hz and
7.5×1011Hz.
Luminous Infrared Lamp: These lamps are the incandescent lamps consisting of a wire filament with an inert gas at low
pressure within the glass. Luminous IRR produces near infrared rays, with some visible light, with a wavelength of 770 to
1500 nm. The filament of lamp is made up of tungsten, which is a coil of fine wire.
Mid Infrared Rays: Infrared rays with wavelength of 1400 nm to 3000 nm are called mid infrared rays.
Near Infrared Rays: Infrared rays with wavelength of 700 nm to 1400 nm are called near infrared rays.
Nonluminous Generator: Nonluminous generators contain metal spiral coil around a nonconducting material such as
fireclay or porcelain. These types of generators are used to produce far infrared electromagnetic rays with wavelength of
1500 nm to 0.1 mm.
Electrotherapy: Principles and Practice
INTRODUCTION
Unit III ▶ Actinotherapy
Sir Frederick William Herschel discovered infrared rays in 1800. The German astronomer split light using
a prism (an object that can split white light into a spectrum or rainbow) and used three thermometers with
blackened bulbs to measure heat of different colors. He concluded that colors are associated with heat. Sir
Frederick studied beyond red light and discovered below red, infrared and light red radiation. Today infrared
rays are used for heating food, TV remote control, consumer goods, in the space, and heating the superficial
tissues. The medical use of infrared lamp is now primarily limited to drying seeping open wound or sedating
superficial sensory nerve. Infrared rays lie between the visible and microwaves.
Must Know
Infrared rays are electromagnetic waves which are invisible to the human eyes, unless reflected off an object. The
wavelength is ranged from 760 nm to 1 mm (106). The frequency of infrared rays lies between 4×1014 Hz and
7.5×1011Hz.
PRODUCTION
The infrared rays can be produced by any hot body, like sun, electric bulb, coal fire, gas fire, etc., however; sun
is the natural source of the infrared rays. Any material above absolute zero emits IR by molecular vibration;
of different wavelengths and frequencies. Higher is the temperature, lower the wavelength. The infrared rays
used in the physiotherapy clinical practice for producing superficial heating effect can either be produced by
non-luminous or luminous generators.
Nonluminous Generators
These generators are also known as infrared radiation generators (Fig. 9.1B) as these produce far infrared
electromagnetic rays with wavelength of 1500 nm to 0.1 mm. The nonluminous generators consist of simple
type of element or metal spiral coil around a nonconducting material (cylinder of some insulating material)
such as fireclay or porcelain (Fig. 9.1A). As the electricity flows through the coil, it encounters resistance,
thus producing heat. All the nonluminous generators require 5-10 minutes to heat up and reach the peak
intensity. Hence, these lamps should be switched on 5-10 minutes before application. The body experiences
nonluminous heat as a gentle radiant heat which can penetrate up to 1.5 inches or 4 cm; beneath the skin
(Table 9.1).
Luminous Generators
These lamps are the incandescent lamps consisting of a wire filament with an inert gas at low pressure within
the glass (Fig. 9.2). Luminous IR lamp produces near infrared rays, with some visible light, with a wavelength
of 770 to 1500 nm. The filament is made up of tungsten which is a coil of fine wire. The inner layer of the glass
is often silvered to reflect the rays. Filters are used to limit the output to a particular wave band. Red filter is
used to filter out the blue and green light waves. The tungsten filament is heated up to 3000°C which emits
70% near infrared rays, 24% long infrared rays and 1% ultraviolet rays. The glass absorbs the ultraviolet rays;
therefore, these rays are not emitted from the lamp.
Must Know
The luminous source is found to be more effective in tissue heating as it penetrates deeper and energy is distributed
in larger areas of the tissues.
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Chapter 9 ▶ Infrared Radiation Therapy
Unit III ▶ Actinotherapy
A B
Figures 9.1A and B: A. Nonluminous filament; B. Lamp with stand
TABLE 9.1: Wavelength and Depth of Penetration of Different Types of Infrared Radiation
Types of Infrared Radiation Near IR Mid IR Far IR
Wavelength 700-1400 nm 1400-3000 nm 3000 nm-.1 mm
Depth of Penetration Up to 5 mm 2 -3 cm 4 -5 cm
Figure 9.2: Luminous lamp
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AQ: Not clear. Please explain how/why sweat absorbs infrared rays.
Electrotherapy: Principles and Practice
PHYSICAL CHARACTERISTICS OF IRR
Unit III ▶ Actinotherapy
Infrared rays follow the law of cosines. As soon as the rays strike the body, they may reflect, transmit or get
absorbed in the tissues. Penetration of IRR depends upon the structure vascularity, pigmentation of skin and
wavelength of IRR.
• Reflection: The reflection depends upon the angle of incidence and composition of the soft tissues. Larger
the angle of incidence, greater the reflection of the rays. If the angle of incidence is perpendicular to the
treatment area, it reduces reflection of the rays.
• Transmission: The infrared rays are transmitted into the tissues where they are either absorbed or reflected.
The transmission of infrared rays depends upon the composition of the tissues. If the difference in the
density of two mediums through which the rays are transmitted is high, that would cause more reflection
of the ways. The depth of penetration also depends upon the wavelength. The luminous infrared rays
(wavelength between 350 and 4000 nm) are transmitted into the deeper structure than the nonluminous
(wavelength between 750 and 15000 nm) infrared rays.
• Absorption: The structures that contain water and protein contents absorb infrared rays effectively.
Energy transmission of infrared rays decreases exponentially with depth, as most of the energy is absorbed
in epidermis and dermis, therefore, most of the heating due to infrared rays will occur superficially.
The maximum depth of penetration of the shorter wavelengths would be 3 mm, for the long infrared
wavelength would be 1 mm. The absorption of IRR in the tissues depends upon the wavelength, angle of
incidence, density of tissues and the distance of lamp from tissues. Far infrared rays penetrate up to 1.5
inches beneath the skin.
PHYSIOLOGICAL EFFECTS
• Cutaneous Vasodilatation: The physiological effects of the infrared rays would be similar to the other
superficial thermal agents such as cutaneous vasodilatation (due to secretion of the chemical such as
histamine and due to axon reflex mechanism). IRR-induced vasodilatation results in erythema which may
last up to 30 minutes of the exposure to IRR.
• Increased sweat gland activity: Infrared rays increase the activity of sweat gland that results in sweating.
This absorbs the infrared rays, which helps in surface cooling as it evaporates the sweat.
• Increased metabolic rate: There is increased metabolic rate and demand of oxygen following application
of infrared rays. The increased blood flow removes waste metabolites.
• Sensory stimulation: There is a stimulation of the thermal receptors situated on the skin in response to
heat.
CLINICAL USES
• Pain and muscle spasm: Infrared rays produce superficial thermal effect in the subcutaneous tissues,
which results in an increase in the blood flow. The exudates and metabolites which are responsible for
pain are removed from the area. This process helps in decreasing pain; and reduction in pain eventually
reduces muscle spasm. There is no direct effect of infrared rays on the muscle spam. Spasm in the muscles
is secondary due to injury or pathological changes in the soft tissues and epidermis or dermis. Due to pain
in the superficial structure, muscles guard the joint to avoid movement. Limitation in the range of motion
further contributes to pain and spasm.
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Chapter 9 ▶ Infrared Radiation Therapy
• Skin infection: Skin lesions, fungal infection such as paronychia, and psoriasis may be resolved by
Unit III ▶ Actinotherapy
the therapeutic infrared rays. The increased superficial temperature helps in reduction of the plaques
associated with psoriasis. The superficial pressure sores or ulcers in the epidermis and dermis are resolved
with infrared radiation as it enhances the healing by increasing blood circulation, and retarding bacterial
growth.
• Edema: Infrared-induced vasodilatation releases histamine and reflex mechanism which increases blood
circulation of the local area. There is increased fluid exchange that helps in removing waste metabolites,
thereby reducing edema and swelling of the area.
INDICATIONS
• Pain and inflammation
• Muscle spasm
• Adhesive capsulitis
• Post fracture joint stiffness
• Psoriasis
• Osteoarthritis, rheumatoid arthritis and ankylosing spondylitis
• Localized edema
Must Know
The decline in popularity appears to be the result of changes in practice style and concern about overheating patients
if they are placed or move too close to the lamp, rather than excessive adverse effects or lack of therapeutic efficacy
CONTRAINDICATIONS
• Impaired cutaneous thermal sensations
• Impaired arterial cutaneous blood circulation
• Dermatitis or eczema over the eyes
• Active infective diseases or tumors
• Active bleeding or hemorrhage
• Metal or jewelry over the superficial tissues
DANGERS
• Burn: Infrared rays can raise the temperature of the superficial structures to therapeutic temperature of
44.5°C. The patient receives it comfortably. If the distance between the lamp and the treatment area is
shortened or the intensity of the heat is higher, it can raise the temperature above the therapeutic range
which can cause burn. The patients with sensory deficit and vascular impairment are also prone to the
burn injuries during the exposure of infrared rays.
• Gangrene: Prolonged exposure of the treatment area to the infrared can cause gangrene especially if
arterial circulation of the area is compromised.
• Dehydration, faintness and low blood pressure: The exposure of a large area for prolonged period of
time can cause excessive sweating. If the fluid is not replaced with water, it can cause dehydration. The
excessive loss of water also leads to hypoxia. The blood pressure decreases. The patient experiences fainting
especially when he or she gets up or stands suddenly from the lying position after the end of the treatment.
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Electrotherapy: Principles and Practice
• Eye cataracts: The exposure of eyes to IRR can cause cataracts, therefore, eyes should be protected from
Unit III ▶ Actinotherapy
IRR.
APPLICATION PROCEDURE
• The patient is screened for contraindications such as sensory deficit, vascular impairment, infection and
sensitivity to heat.
• Patient is placed in a comfortable and relaxed position.
• The part which is being treated is exposed appropriately. All the jewelry and metal (like chain) should be
taken off the treatment area. If jewelry is not removable, it should be covered with reflecting tape to avoid
heating up of the metal and burn.
• The luminous infrared rays lamp is the choice of treatment modality for chronic conditions which provides
deeper heating effects in the subcutaneous tissues. The nonluminous infrared rays lamp is used for acute
inflammatory conditions and recent injuries for more superficial thermal effects.
• Place the infrared lamp at an appropriate distance from the treatment area. The infrared rays should strike
the body at the right angle (90°) to avoid reflection and to maximize the absorption of the rays. Ideally,
the nonluminous lamp is placed at a distance of 18-24 inches. The distance from the treatment area can be
increased or decreased as per the tolerance of the patient.
Practical Tip
To treat the patient with decubitus ulcers or to produce minimal heating effect for prolonged period of time, the
distance between the patient and treatment area can be increased to 40 inches.
• Switch on the nonluminous infrared rays lamp 15 minutes prior to the treatment as the generators take
5-10 minutes to reach the peak intensity. Luminous lamps do not require much time to get heated.
• The treatment area should be inspected regularly during the treatment session. The therapist should
observe any unwanted signs such as mottling, red and white patches, erythema and skin pigmentation that
may occur due to over exposure.
• Stop the treatment in case of any discomfort or allergy to the radiation.
• Switch off the lamp at the end of treatment.
Summary
• Infrared rays are electromagnetic waves with a wavelength of 760 nm to 1 mm, are invisible to the human eyes,
unless reflected off an object. These rays can by produced by any hot body like the sun, electric bulb, coal fire,
gas fire etc.
• Nonluminous generators produce far infrared rays with a wavelength of 1500 nm to 0.1 nm, whereas luminous
infrared lamp produces near infrared rays with a wavelength of 770 to 1500 nm.
• Infrared rays emitted from luminous and nonluminous lamps follow the law of cosines and may get reflected,
refracted, or transmitted into the tissues.
• Infrared rays produce physiological effects similar to other superficial thermal modalities such as cutaneous
vasodilatation due to secretion of histamine and by axon reflex mechanism. There is increased sweat gland
activity, metabolic rate, demand of oxygen and nutrients following the application of infrared rays.
• These physiological effects help in improving pain, muscle spasm, skin infection, and edema. Infrared induced
blood flow helps in removing waste metabolites from the local area.
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Chapter 9 ▶ Infrared Radiation Therapy
Bibliography
Unit III ▶ Actinotherapy
Assess Yourself
Basant Kumar Nanda, Electrotherapy Simplified, Second edition, the Health Science Publishers, pp407.
Long Answer Questions
Vatanserver F, Hamblin MR. Far infrared radiation (FIR); its biological effects and medical applications. Photonics
1. &Describe
laser indifferent
medicine,generators
2012 Nov;used1(4),
in the production of infrared rays.
255-66.
2. Explain the physiological effects of infrared rays.
3. Elucidate the physical characteristics of infrared rays.
4. Explain the clinical uses of infrared rays.
5. Describe the procedure of application of infrared rays.
Short Answer Questions
1. What are the infrared rays?
2. What is the wavelength of IRR?
3. What is the frequency of IRR?
4. What is the natural source of IRR?
5. What are different generators used in the production of IRR?
6. Which type of different rays are produced by the luminous infrared rays?
7. Luminous lamp produces 1% ultraviolet rays, however, these are not emitted, why?
8. Which metal is used to make a filament of luminous infrared lamp?
9. Which type of filter is used in luminous IRR?
10. Why nonluminous lamps are heated up 5 to 10 minutes before application?
11. What are the physical characteristics of IRR?
12. Which IRR lamp is used for acute and recent injuries?
13. Which IRR lamp is used for chronic conditions and deeper heating effects?
14. Why is the IRR lamp placed at the right angle of the treatment area?
15. What should be the distance between IRR lamp and the treatment area?
Short Notes
Write short notes on:
a. Infrared rays
b. Luminous Infrared Lamp
c. Clinical uses of infrared rays
d. Indications and contraindications of infrared rays