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SWD, Rising Tissue Warmness for Decreasing Back Pain

by. Tim Dr. Eko Agus Subagio, Sp. BS - Spine (Tulang Belakang), Dokter Saraf Kecetit
21 April 2016
SWD, Rising Tissue Warmness for Decreasing Back Pain

Short Wave Diathermy (SWD)

a. understanding

Diathermy is the application of high-frequency electromagnetic energy that is primarily used to generate heat in the body tissues. Diathermy can also be used to produce nonthermal effects. Diathermy is used as a therapeutic modality consisting of Short Wave Diathermy (to be discussed) and Micro Wave Diathermy.

Short wave diathermy is a treatment modality that generates electromagnetic energy with high-frequency alternating current. Federal Communications Commission (FCC) has established three frequencies used on short wave diathermy, namely:

1) The frequency of 27.12 MHz with a wavelength of 11 meters.

2) frequency of 13.56 MHz with a wavelength of 22 meters.

3) The frequency of 40.68 MHz (rarely used) with a wavelength of 7.5 meters.

Frequencies are often used in the SWD for medicinal purposes is the frequency of 27.12 MHz with a wavelength of 11 meters.

b. Current

Short Wave Diathermy is used in the treatment of two currents that have a continuos flow and pulsed SWD SWD.

1) Continuous Short Wave Diathermy (CSWD)

In the continuous application of SWD, the dominant thermal energy occurs in the network. Every network that receives heat resistance, which is different. Fatty tissue absorbs heat faster than muscle (1: 10), while the muscle tissue absorbs heat faster than the skin. Physiologically, muscle tissue does not have the "thermosensor" but only in the skin tissue, so that with the burning sensation in the skin when giving Continuous SWD then it should happen "overthermal" to the underlying muscle tissue because muscle tissue more quickly receive heat than the skin. From some research shows that if the heat received by the network exceeds a certain threshold then the network will be broken; by Thomas H (2003) Subjective size as a certain limit is if people feel warm.

According to Hollander JS (2009) that the researchers stated Award Continous SWD on condition artrose is contraindicated, and even most of the research prohibit Continous SWD in arthritis. This is because there is an acid in the joints "Hyaluronik" the optimum temperature is 36,7o, and is very sensitive to temperature increase. With the addition of only 1o temperature (occur in the CSWD) then the temperature becomes 37,4o, while at a temperature of 37o N will enable liquid / hyaluronidase enzymes that can damage the ends of joint cartilage, and we know that the destruction of joint cartilage will never experienced regeneration / repair.

Continous SWD main cause thermal effects, resulting in physiological effects include increased blood circulation and metabolic processes.

2) Pulsed Short Wave Diathermy (PSWD)

Around 2000, began in earnest new research on pulsed SWD as one of the effects of new therapies for SWD. In the study conducted on the application of pulsed SWD smear of milk, and the milk turns on the swab looks a form of "string necklace". Then it also occurs in the form of liquid blood, spleen and eiwit. These findings indicate that pulsed SWD are very helpful in generating a therapeutic effect, while the physiological effects occur only a little (just a minimal effect of heat). In pulsed SWD, has energy / maximum power output to 1000 W. Nonetheless, energy / power output on average was significantly lower at between 0.6 to 80 watts (depending on the pulse repetition frequency selection) to enable the application of treatment subthermal with improved biological effects. Therefore, SWD pulsed therapy is suitable for the treatment of acute disorders where heat therapy is contraindicated.

If we apply the pulsed SWD (PSWD), it will generate rectangular pulses with a pulse duration of 0.4 ms. The maximum power of the pulse can be set to 1000 W. When using a condenser application, the energy power can be adjusted to the maximum value. Interval pulsation produced depends on the selection of pulse repetition frequency (15-200 Hz), while the size of heat production in pulsed SWD is the mean power (watts). Mean power produced is very dependent on the selection of current intensity and pulse repetition frequency. The lower the pulse repetition frequency is selected, the lower the mean power. Thus, the application of pulsed SWD can allow us to choose the high current intensity (power pulse) with a pulse repetition frequency selection and selective in accordance with the conditions of the disease / disorder.

c. Physiological effects

1) Changes in the heat / temperatu

a) The reaction of local / network

(1) Increase metabolism local cells of about + 13% per 1 ° C rise in temperature

(2) Improve the sphincter vasomotion causing local homeostatic and eventually local vasodilation.

b) general reaction

(1) Enable thermoregulator system in the hypothalamus which results in increased blood temperature to maintain body temperature in general.

(2) Penetration and temperature changes occur deeper and wider

2) Connective Tissue

Improves the elasticity of connective tissue better as the skin collagen tissue, tendons, ligaments and joint capsule due to the reduced viscosity of the tissue matrix; This heating will not increase the length of the connective tissue matrix thereby granting the SWD will be more successful if it is accompanied with stretching exercises.

3) Muscle

a) Increase the elasticity of muscle tissue.

b) Decrease in muscle tone through normalization nocisensorik, except hipertoni due to emotional and CNS damage.

4) Nerves

a) Increase the elasticity wrapping neural networks.

b) Increase the nerve conductivity and increase the threshold of stimulation (threshold).

d. Indication

Indications SWD SWD both continuos and pulsed SWD are conditions in subacute and chronic neuromuskuloskeletal disorders (such as sprains / strains, osteoarthritis, cervical syndrome, NPB and others).

e. contraindications

Contraindications of continuos SWD is the installation of metal on bone, tumor or cancer, cardiac pacemaker, tuberculosis of the joints, RA in the joints, the condition of menstruation and pregnancy, the eye region (contact lens) and testis. Contraindications of pulsed SWD is a tumor or cancer, cardiac pacemaker, the region of the eyes and testicles, menstruation and pregnancy conditions. In the acute disruption of continuos neuromuskuloskeletal is contraindicated for pulsed SWD SWD but can be given with low pulsation.

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