With the face of health care constantly changing, we as practitioners must be able to adapt to the changes. One of the most consistently changing aspects of health care is insurance coverage and reimbursement for alternative health care.These changes are prompting DCs to look at new ways to increase revenue.
Product placement and sales is a growing industry for chiropractors and an effective way to recover some of the lost bottom line during the down economy. Supplying products to your patients not only provides additional income for your clinic, but also presents effective tools to continue their rehabilitation between appointments. Home-use heat therapy packs are no exception.
Heat therapy is widely used in chiropractic care prior to or after an adjustment, often in conjunction with other therapeutic modalities such as electrical stimulation. Many different heat modalities are used in the therapeutic setting, including ultrasound, cold laser and infrared light treatment. Most often chiropractors rely on the age-old standard: the hydrocollator. Unfortunately none of the above is readily available or very practical for the patient once they leave your office.
At-home heat therapy packs can be an excellent substitution for clinical heat modalities.
The At-Home Advantage
The strongest benefits of providing at-home heat therapy for your patients are at the physiological and therapeutic level. The application of superficial heat has been used in the clinical setting for many years. Some scholars believe that the use of heat therapy dates back to ancient Greece. The benefits and therapeutic effects of heat therapy are vast and include increase in muscle flexibility, reduction of chronic inflammation, decrease in muscle spasm, decrease in joint stiffness, and pain reduction associated with muscle spasms.
As we all know, flexibility and stretching are important aspects of rehabilitation and injury prevention. Increases in flexibility have been found to increase joint range of motion, resulting in a decrease in severity of joint injury. The use of thermal agents and physical warm-up prior to stretching has been shown to increase tissue elongation, assisting in pre-exercise stretching. Using a heating pad at home is a great way to facilitate the introduction of at-home exercise and rehabilitation protocols.
The increase in tissue temperature will also cause vasodilation around the area being treated and increase blood flow. The elevated vascular response will subsequently increase cell metabolism and capillary permeability, allowing for an increase in venous return, as well as the introduction of healthy blood flow and nutrients. Vasodilation is an important effect of the heat modality, especially when reduced blood flow or chronic swelling and inflammation are hindering the healing process. Chronic tendonitis such as tennis elbow and chronic low back pain are excellent examples of conditions that can be treated with heat therapy.
Superficial heat can also have a positive effect on joint mobility by increasing muscle and connective-tissue elasticity, thus decreasing joint stiffness, and aid in decreasing joint contractures. The application of heat to superficial joints can also assist in the longitudinal stretching of connective tissue, resulting in permanent elongation without causing tissue damage. Joint mobility can also be increased by reducing pain through the use of heat.
One study found that joint stiffness in the metacarpophalangeal joints can be reduced by 20 percent when heated to therapeutic temperatures (Bissell, 1999). Treatment of joint contractures or "frozen joints," as they are commonly referred to, can be difficult when collagen tissue is preventing range of motion. The use of superficial heat prior to and during static stretching of joint contractures can assist in the restoration of normal joint range of motion.
A common symptom associated with musculoskeletal dysfunction and low back pain is muscle spasm and myofascial pain. These spasms are often centered on trigger points and are palpable as tight bands or "knots" within the muscle. Commonly known as the pain spasm cycle, the body's response to injury can result in muscle spasm and pain. Sometimes it is unclear which is causing which: Is the pain causing the spasm or is the spasm causing the pain?
Researchers have found that application of a moist heat pack to subjects with musculoskeletal pain significantly increases the pain threshold at the trigger point. Heat therapy can also reduce pain by acting as a soothing stimulation of the nerve fibers, blocking the signal of the pain perception. Superficial heat modalities have been effective in treating patients with muscle spasm and trigger-point pain. Providing heat therapy packs to your patients can extend this treatment beyond the clinic and into the home. Heat therapy is one of the few superficial modalities that can be used to treat both the pain and spasm simultaneously.