INFRARED

RADIATIONS
[Link] singh(PT)
Assistant Professor
Department of Physiotherapy
CONTENT

• Production of IRR,
• Types of IR generators,
• Physiological & Therapeutic effects of IRR

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INTRODUCTION

• Radiation therapy may be defined as treatment by means of radiations.

• The term Actinotherapy is also used for this.
• Radiation therapy may include:
• 1. Infrared radiations
• 2. Ultraviolet radiations.

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Infrared radiations
• The infrared rays are electromagnetic waves with the wavelengths of 750 to 400000 nm and
frequency 4 × 1014 Hz and 7.5 × 1011 Hz.
• It lies beyond the red boundary of visible spectrum.
• Any hot body can produce infrared rays like the sun, electric bulb, coal fire, gas fire, etc.
• Sun is the natural source of infrared radiations.
• Infrared radiations can be produced by artificial generators.
• In the Physiotherapy departments infrared rays are produced by two types of generators:
• 1. Nonluminous generators
• 2. Luminous generators.
• Nonluminous generators provide infrared rays only whereas luminous generators emit infrared
rays, visible as well as ultraviolet rays.
• Therefore, nonluminous generators are termed as infrared radiation generators because they
emit only infrared rays.
• The heat produced by luminous generator is called the ‘radiant heat’.

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Nonluminous Generators

• Nonluminous generator consists of a simple type of element or coil

wound on a cylinder of some insulating material such as fireclay or
porcelain.
• An electric current is passed through the wire which results in the
production of heat.
• This heat produces infrared rays which are transmitted through the
porcelain.
• Porcelain gets heated by the method of conduction but the radiations
generated in this way also include some of the visible rays.
• Therefore to avoid this, the coil is embedded in fireclay or porcelain or
placed behind fireclay.
• Now the emission of rays is entirely from the fireclay which is
commonly painted black and thus very few visible rays are produced.
• The element or the coil is thus placed at the focal point of a parabolic
or spherical reflector.
• The reflector is mounted on a stand and its position can be adjusted as
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• In another type of nonluminous generator, a steel tube within which an electric coil is
embedded on some material which is electric insulator but good conductor of heat is used.
• Electric current is passed through the central coil and thus heat is produced.
• The steel tube thus emits infrared rays.
• The construction of the outer part of the apparatus should be such that the reflectors and other
parts do not become excessive hot and there should be wire mesh surrounding the element.
• All of these nonluminous generators take some time to get heated up for the production of
infrared radiations, so they should be switched on before 5–7 minutes of the treatment.

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Luminous Generators

• Luminous generators emit infrared, visible and a few ultraviolet rays.

• These generators are in the form of incandescent lamps or bulbs
• An incandescent lamp consists of a wire filament enclosed in a glass bulb, which may contain
an inert gas at low pressure.
• The filament is a coil of fine wire which is usually made up of tungsten.
• Tungsten is a metal which is used because it can tolerate repeated heating and cooling.
• The exclusion of air prevents oxidation of the filament, which would cause an opaque deposit to
form on the inside of the bulb.
• Incandescent bulb is usually mounted at the center of the parabolic reflector and the reflector
is mounted on an adjustable stand.
• These luminous generators emit the electromagnetic waves with the wavelength in between
350 and 4000 nm, the maximum proportion of the rays having wavelength in the region of 1000
nm.
• The front of the bulb is usually red so as to filter out the shorter visible and the ultraviolet rays.

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Depth of Penetration of Rays
• Luminous generator produces infrared rays
having wavelength between 350 and 4000 nm.
• It can penetrate into dermis and epidermis of
the subcutaneous tissue.
• Nonluminous generator produces infrared rays of
wavelength 750 to 15000 nm which can
penetrate the superficial dermis only.
• The depth of the penetration depends upon the
wavelength and the nature of the material (Fig.
5.2).
• Thus, infrared rays produced from a luminous
generator have more penetration power than
that produced from nonluminous generator.
• Fig. 5.2: Cross-section of the skin, showing the
extent of penetration of radiations of different
frequencies.

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Techniques of the Treatment
The choice of apparatus
• When there is acute inflammation or recent injury, the sedative effect of rays obtained from
nonluminous generator may prove more effective for relieving pain than the counter-irritant
effect of those from the luminous source. ‘
• For lesions of a more chronic type, the counter-irritant effect of the shorter rays may prove to
be of value, and under these circumstances a luminous generator is chosen.
• Selection of the generator according to the area to be treated is done.
• If only one surface is to be treated, a lamp of a single element mounted on a reflector is used.
• If several aspects are required to be irradiated, a tunnel bath is more effective.
• The temperature reached in a tunnel bath is higher than produced by other lamps and this may
be advantage if chronic lesions are to be treated.
• Before application the lamp must be checked to ensure that it is working correctly.
• Nonluminous generators must be switched on an adequate time before application.

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Preparation of the Patient

• The clothes must be removed from the area to be treated and skin is checked for its sensation
against heat and cold.
• It is unwise to give treatment if the skin sensation is found defective.
• The patient should be comfortable and fully supported so that he does not move unduly during
treatment.
• The patient is warned that he should experience comfortable warmth and he should report
immediately if the heating become excessive as undue heat may cause burn.
• He should be instructed not to touch the apparatus and nor to move nearer to the apparatus.
• Arrangement of the lamp and patient:
• The lamp is positioned so that it is opposite to the center of the area to be treated and the rays
strike the skin at the right angle thus ensuring maximum absorption.
• The distance of the lamp from the patient should be measured.
• Optimum distance is around 50–75 cm depending upon the output of the generator.
• Care must be taken that the patient’s face is not exposed to infrared rays, eyes must be
shielded to avoid this.
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Laws Governing the Effects of Electromagnetic
Radiations
• When electromagnetic radiations strike or come in contact with other objects they may be
reflected, refracted or absorbed.
• As a general rule, those radiations that have a longest wavelengths tend to have greatest depth
of penetration, regardless of the frequency.
• It should also be noted that a number of other factors can also contribute to the depth of
penetration.
Various laws regulating the depth of penetration are:
1. Arndt-Schultz principle:
• It states that no reaction or changes can occur in the body tissues if the amount of energy
absorbed is insufficient to stimulate the absorbing tissues.
• Addition of threshold energy and above quantity of energy will stimulate the absorbing tissue to
normal function and if too great a quantity of energy is absorbed then added energy will
prevent normal function or will destroy tissue.
2. Law of Grothus-Drapper:
• It states that the rays must be absorbed to produce the effect and the effects will be produced
at that point at which the rays are absorbed. Contoso
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3. Cosine law:
• It is also known as Lambert-Cosine law. Cosine law explains the effect of angle at which the
rays strike.
• It states that the proportion of rays absorbed varies as per the cosine of the angle between the
incident and the normal.
• Thus, the larger angle at which the rays strike at the body surface, lesser will be the absorption
and vice versa.
• If the rays strike at 90º to the body part, then angle between the incident and normal are
perpendicular will be zero and the cosine of 0º is maximum, i.e. 1.
• Thus, there will be maximum absorption if the rays that will strike the body part at 90º as per
this law.

4. Law of inverse square:

• Law of inverse square explains the effect of distance on the intensity of infrared rays.
• It states that the intensity of a beam of rays from a point source is inversely proportional to the
square of the distance from the source.

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 Application of infrared treatment
• At the start of the treatment exposure the intensity of the radiation should be low, but after 5–
10 minutes when vasodilatation has taken place and the increased blood flow has become
established, the strength of the radiation may be increased.
• This can be achieved by moving the lamp closer to the patient or by adjusting the variable
resistance.
• The physiotherapist should be near the patient throughout the treatment session and should
reduce the intensity of radiation if the heat becomes excessive.
• If the irradiation is extensive, it is desirable that sweating should occur to counteract any
excess rise in body temperature.
• Sweating is encouraged if the patient is provided water to drink during treatment.
• At the end of the treatment the skin should be mild red, not excessively red.
• After extensive irradiation the patient should not rise suddenly from the recumbent position or
go out into the cold immediately.
• Duration and frequency of treatment:
• In cases of acute inflammation or recent injuries and for the treatment of wounds, an exposure
of 10–15 minutes is adequate, but it may be applied several times during the day.
• In cases of chronic conditions longer exposures may be used.
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Physiological effects

• Infrared treatment produces heating effect in the superficial epidermis and dermis, thus
resulting in vasodilatation which increases blood circulation in that area.
• This will lead to more oxygen supply and nutrient supply in that area leading to draining of
waste products resulting in the relief of pain.
• The sedative effects on nerve endings lead to reduction in the muscle spasm.

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Therapeutic Effects

1. In relieving pain:
• Mild heating on the superficial tissues by infrared radiations causes sedative effects on the
superficial sensory nerve endings. Pain may be due to accumulation of waste products of
metabolism, an increased flow of blood through the part removes these substances and thus
relieves the pain.
• The pain due to acute inflammation or recent injury is relieved most effectively by mild heating.
When pain is due to chronic injury or inflammation, stronger heating is required. The treatment
may last up to 30 minutes.

In muscle relaxation:
• Relaxation of muscles is achieved by heating the tissues. Mild heating by infrared causes
relaxation of muscles and thus relieves spasm.
• Relief of pain also induces relaxation in muscles and helps relieving muscle spasm associated
with injury or inflammation.
• Relaxation of muscles provides greater range of motion to the exercising part as it relieves
muscular spasm.
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3. In increasing blood supply:
• Infrared radiations increase the temperature in the superficial tissues, causing vasodilatation in
the superficial tissues.
• It provides more white blood cells and fresh nutrients to the area being treated.
• It also accelerates removal of waste products and helps bring about resolution of inflammation.
• It is most beneficial in the treatment of various arthritic conditions of joints which leads to
inflammation and stiffness.
• Cases of post immobilization stiffness, open wound and infections can also be effectively
treated.
• Fresh supply of blood rejuvenates the tissues, removes waste products of metabolism and also
relieves muscular spasm.

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Dangers of Infrared Radiations

1. Burn:
• Excessive heating of superficial tissues causes burn. Sensation must be checked before starting
the treatment. If sensation is not proper, the patient may not appreciate the extent of heating.
• The burn may be caused due to the following reasons:
• i. If intensity of radiation is too high
• ii. If sensation is not proper
• iii. Patient fails to report over heating
• iv. Unconscious patient
• v. Patient moves closer to the lamp
• vi. Falls asleep during the treatment.
• The patient must be warned to inform undue heating immediately. The spacing must be
reduced gradually in order to increase the heating. Impaired blood flow through the part, which
may be due to some circulatory defect or due tight garments reduces circulation and thus
causes burn.
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2. Electric shock:
• Electric shock can occur if some exposed part of the circuit is touched by the patient.
• Due to heating of the wires in the circuit, insulation of wires may go off and thus regular
checking of wires is necessary to avoid electric shock.

3. Faintness or giddiness:
• Extensive irradiation may cause fall in blood pressure which may result in faintness or giddiness
due to hypoxia of the brain.
• This is particularly common when the patient rises up suddenly from the recumbent position
after extensive treatment.

4. Headache:
• Irradiation of the back of the head may cause headache. Headache may also occur when
treatment is given during hot weather. Lots of fluid goes off the body in the form of sweating
during treatment.
• Plenty of water needs to be replenished during or after the treatment especially in hot weather.

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5. Gangrene:
• Gangrene may be caused in the areas of defective arterial blood supply following prolonged
irradiation by infrared radiation.
• Arterial supply to the area being treated needs to be proper to avoid gangrene.

6. Injury to the eyes:

• Direct heating over the eyes causes drying up and thus leads to corneal or retinal burns.
• Eyes needs to be protected following treatment to avoid injury.

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Contraindications

Infrared radiations should not be applied to the areas of:

• 1. Defective arterial blood supply
• 2. Areas where there is danger of hemorrhage
• 3. Defective skin sensation
• 4. Directly over the eyes
• 5. After deep x-ray or cobalt therapy
• 6. Known cases of tumors.

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Methods of treatment

• Treatment of patient’s condition

• 1. Low back ache
• 2. Post immobilization stiffness
• 3. Edema.

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Low back ache
• General contraindications:
• 1. Hyperpyrexia
• 2. Tuberculosis
• 3. Inflammation
• 4. Deep X-ray therapy or cobalt therapy
• 5. Photosensitivity
• 6. Epilepsy
• 7. Renal or cardiac problems.

• Local contraindications:
• 1. Skin conditions: allergy, ulcer, etc.
• 2. Tumor, etc.
• 3. Abnormal skin sensation.
• Checking skin sensation

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Positioning of the Patient
• Sitting position: With back unsupported and exposed toward the lamp.
• Side lying position: comfortable with support of pillows and back exposed toward the lamp.

Placement of Infrared Lamp

• Place the lamp at about 1–2 feet away from the treatment area so that rays are at right angles
in order to achieve maximal penetration. Record the distance between the lamp and the
treatment area.

Duration:
• Acute condition – 10 to 15 minutes
• Subacute condition – 15 to 20 minutes
• Chronic condition – 20 to 30 minutes.

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Home Instructions

• 1. Patient is advised to avoid flexion strains

• 2. Advise to avoid weightlifting
• 3. Advise to sleep on a firm mattress and not on saggy mattress
• 4. Advise to do spinal extension exercises
• 5. Ask to avoid two wheelers
• 6. While traveling in bus sit in the middle or front seat
• 7. Avoid prolong standing.

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POSTIMMOBILIZATION STIFFNESS

Preparation of apparatus:
• The infrared lamp is conveniently positioned at about 1–2 feet away from the treatment area.
Positioning the patient:
• Comfortable with good support and exposing the part to be treated toward the lamp.
Application:
• Maintain the lamp so that rays are at right angles in order to achieve maximal penetration.
Duration:
• 10 to 15 minutes and later duration can be gradually increased upto 20 to 30 minutes.
Check for excessive redness:
• Immediate increase or decrease of pain needs to be recorded. Check for any headache,
faintness or giddiness. Advise the patient not to rise suddenly from the recumbent position.

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Absorption of exudates or edema

Positioning of the patient:

• Comfortable with good support.
Correct positioning of Physiotherapist:
• Position of Physiotherapist should be in closed vicinity of the patient and at appropriate
reachable distance from the lamp.
Placing of infrared lamp:
• The infrared lamp is conveniently placed at about 1—2 feet away from the treatment area.
Maintain the lamp so that rays are at right angles in order to achieve maximal penetration.
Duration:
• 10 to 15 minutes and later duration can be gradually increased upto 20 to 30 minutes.
• Check for any redness or excessive rise in skin temperature. If there is excessive rise in skin
temperature which could lead to burn, treatment can be discontinued. Check for any headache,
faintness or giddiness. Advise the patient not to rise suddenly from the recumbent position.

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Large Image Slide

THANK
YOU

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