Lecture 3: Shortwave Diathermy Therapeutic Equipment

Diathermy
Diathermy is a Greek word meaning through heating.
Diathermies are of following types:
1. Shortwave diathermy
2. Microwave diathermy
3. Ultrasound diathermy

Shortwave diathermy
Short wave diathermy (seen in the Fig) is the use of high frequency electromagnetic
waves of the frequency between 107 and 108 Hz, and a wavelength between 30 and
3 m to generate heat in the body tissues. It provides the deepest form of heat
available to the physiotherapist. The therapeutically used frequencies and
wavelengths are 27.12 MHz and 11 m (commonly). The less common frequencies
and wavelengths are 40.68 MHz and 7.5 m and 13.56 MHz and 22 m.

Fig: Shortwave diathermy

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Lecture 3: Shortwave Diathermy Therapeutic Equipment

Construction
The system consists of two circuits:
1. The machine circuit
2. The patient circuit.

The Machine Circuit

The machine (or oscillator) circuit is composed of a high-frequency generator,
amplifier (to raise the output to therapeutic levels), and a power supply.

The Patient Circuit

The second circuit is the patient circuit, which is composed of a variable capacitor
(to account for the changing capacity of the resonator circuit due to the type of
tissue treated) and a method of transferring energy to the tissues; this is achieved
by either capacitive or inductive electrodes.

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Lecture 3: Shortwave Diathermy Therapeutic Equipment

Methods of Applications
The transfer of electrical energy to the patient tissues occurs either by electrostatic
field or by electromagnetic field. Therefore, two methods of applications are used:
1. Condenser/capacitor field method
2. Cable method.
When shortwave diathermy is applied by the condenser field method, the
electrodes and the patient’s tissues form a capacitor. The capacitance of such a
capacitor depends upon:
1. The size of electrodes
2. The distance between the electrodes
3. The tissue between the electrodes.
Electrode: Is an object made up of conductive material which works as interface
between patients’ body and electric simulator machine.
When short wave diathermy is applied by the cable method, the cable and the
patient’s tissue form an inductance, the value of which varies according to its
arrangement.
Consequently, either the capacitance or inductance of the patient’s circuit is varied
at each treatment, and so a variable condenser is incorporated in the patient’s
circuit to compensate for this.

Capacitor field method

The electrodes are placed on each side of the part being treated. The electrodes
are separated by the skin by means of an insulating material. The electrodes act as
the plates of the capacitor, while the patient’s tissues together with the insulating
material which separates them from the electrodes for the dielectric. When the
current is applied, rapidly alternating charges are set-up on the electrodes and
gives rise to a rapidly alternating electric field between them. The electric field also
influences the material which lies within it.

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Lecture 3: Shortwave Diathermy Therapeutic Equipment

Fig: Capacitor field method

Cable Method
In this method, a thick insulated cable is used for treatment purposes. Electric field
or magnetic field or both are achieved by the use of cable method. When the high
frequency current oscillates in the cable, a varying electrostatic field is set up
between its ends and a varying magnetic field around its center. The cable is coiled
around the patient’s body and is separated from the patient’s body by a layer of
insulating material.

Fig: Cable Method. a: The cable is wrapped around the body

b: The cable is coiled flat and placed on the skin

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Lecture 3: Shortwave Diathermy Therapeutic Equipment

Advantages of cable method

The cable method is useful:
1. for the treatment of an extensive area which could not be included between the
condenser electrodes.
2. when the area is irregular.

Dosage
The treatment dosage should have an intensity that causes sufficient warmth
(thermal dosage) of the tissues and the duration of the treatment should be 20–30
minutes. The treatment may be given daily or on an alternate day. As a general
rule, for the treatment of acute inflammation or any recent injury the intensity of
the treatment should be less but it should be carried out more frequently, i.e. twice
daily. The duration of treatment is reduced to 5–10 minutes.

Physiological Effects of Heating the Tissues

The principal effect of shortwave diathermy to the body is heating of tissues. This
is the modality which provides deepest heating of the tissues. The main
physiological effects due to heating of the body tissues are:
1. Effects on metabolism of the body
2. Effects due to increased blood supply
3. Effects of heat on the nervous tissues
4. Effects of heat on the muscular tissue
5. Effects of heat on the sweat glands.

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Lecture 3: Shortwave Diathermy Therapeutic Equipment

Dangers of Shortwave Diathermy

• Burns: Short wave diathermy can cause burn; therefore, the word ‘burn’
must be used to warn the patient of this possible danger. In milder cases
tissue is not destroyed but a bright red patch, i.e. erythema is seen.
• Scalds: A scald is caused by moist heat. It may occur if the area being treated
is damp or moist, e.g. due to perspiration, or if damp towels are used for
treatment.
• Electric shock: An electric shock can occur if contact is made with the
apparatus circuit with the current switched on. It is less possible in modern
systems to come in contact with the apparatus circuit.
• Overdose: Overdose of application of treatment may cause an increase in
symptoms, especially pain and is most liable to occur when there is acute
inflammation within confined space. It can occur under other circumstances
as well and any increase in pain following treatment is an indication to
reduce the intensity of subsequent applications.
• Faintness: Faintness is produced by hypoxia of the brain following a fall in
blood pressure. It is particularly liable to occur if, after an extensive
treatment, the patient rises suddenly from the reclining to the erect position
from the bed. So, patient should not be allowed to rise up suddenly from the
bed after the treatment. Patient should be allowed to drink water after
treatment.

Therapeutic Effects of Shortwave Diathermy

• Effects on Inflammation
• Effects in bacterial infections
• Relief of Pain
• Effects on muscle tissue
• Reducing healing time

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Lecture 3: Shortwave Diathermy Therapeutic Equipment

Pulsed Short wave diathermy

Pulsed short wave diathermy is referred to as pulsed electromagnetic energy or
field. which is created by simply interrupting the output of continuous shortwave
diathermy at regular intervals. The frequency of pulsed shortwave diathermy is
same as that of continuous shortwave diathermy, i.e. 27.12 MHz but interpulse
interval or off-time is added to it. Pulse frequency is between 25 and 600 pps, pulse
width is between 20 and 40 ms (65 ms is most commonly used). By adding rest
period to the treatment, the average power is considerably reduced. The heat
developed in the tissues is dispersed by the circulation and treatment is thus
referred to as nonthermal treatment. Pulsed short wave diathermy increases the
cellular activity, reduces inflammation, reduces swelling and increases the repair
process. The treatment duration varies from 15 to 60 minutes.

Transmission of High Frequency Currents (Shortwaves) in to the Tissues

Conductors are the substances in which electrons can easily be displaced from their
atoms. When such a material lies within a varying electric field, there is rapid
oscillation of electrons and heat is produced.
An insulator is a substance in which the electrons are so firmly held by the central
nuclei that they cannot be easily displaced and results in the distortion of molecules
when varying electric field is applied.
An electrolyte is a substance which contains ions and when a varying electric field
is applied, the ions tends to move from one direction to the other. Electrolytes also
contain diploes which contain two oppositely charged ions, when a varying electric
field is applied, they rotate their direction. These dipoles are electrically neutral,
but one end bears positive and the other a negative charge. As a result of electric
field, they rotate themselves and come in an alignment with the electrodes (see
the Fig).
Thus, the electric field influences the material that lies between the plates; this
causes the oscillation of the ions, distortion of molecules and rotation of dipoles.
This causes production of heat in the tissues by the electric field of shortwave

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Lecture 3: Shortwave Diathermy Therapeutic Equipment

diathermy, which is the primary function of shortwave diathermy. The heat

production is in accordance with Joule’s law, i.e. Q = I2RT, but depends upon the
distribution of the electric field.

Fig: Diploe Rotation