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	Physiotherapy, also called physical therapy, is the treatment of disorders with physical agents and methods.
	Some types are: massage, moving muscles and bones, exercises, cold, heat, and light therapy.
	They are done to assist in treating patients and in bringing back normal function after an illness or injury.

	Short wave diathermy is the production of heat in body tissues by short waves, generated by Short wave diathermy equipment, to treat certain disorders. This heat results from high-frequency electric currents.
	The currents are not intense enough to destroy tissues or to damage function.
	Diathermy is used to treat arthritis, bursitis, fractures, gynecological diseases, and swelling of the sinuses (sinusitis).
	The penetration of short waves is up to bony structures ,unlike superficial heat applied by conventional hot water fomentation. It helps in the following ways.

	Reduces pain rapidly .
	Decreases inflammation and swelling in joints and surrounding tissues, including muscles.
	Relieves spasm of surrounding structures ,especially of muscles, thereby relieving distress associated with arthritis.
	Increases circulation to joint structures thereby providing better oxygenation, nutrition; removing toxins and pain causing chemical mediators; alleviating swelling and inflammation.
	Improves secretion and circulation of joint fluid and reduces inflammation of joint lining (synovial membrane), there by resulting in better lubrication of joints.
	Reduces nerve compression by reducing inflammation and swelling in tissues. e.g. 'sciatic nerve' is compressed in a condition known as 'sciatica' due to arthritis in lower spine.
	By reducing pain, inflammation, swelling, and nerve compression and improving lubrication of joint, it helps the patient to recover quickly ,and can be back to active exercises .

	Ultrasound is a therapeutic method of aiding the healing process.
	The ultrasonic waves massage the injured area, promoting blood flow and reducing swelling. Because swelling can be a significant source of pain, the reduction in swelling as a result of ultrasound treatments also relieves pain.
	Ultrasound relieves pain by treating the cause of the pain.

	Mainstay of physiotherapy is, strengthening of muscles around an arthritic joint, so as to take away weight from bony structures of a joint.
	The muscles so strengthened will move the joint without actually straining an already ageing arthritic joint.
	Strengthening of muscles require controlled and gentle regular exercises under medical supervision. The nature and extent of exercises is determined by age, weight of patient, nature of arthritic problem and associated complications.
	Over enthusiastic exercises, without medical advise can not only make things worse, but can precipitate severe pain, swelling, inflammation, and even paralysis due to nerve compression (e.g. paralysis of lower limbs due to intervertebral disc prolapse, thereby causing spinal cord compression). Ligament tears and muscle rupture may occur due to faulty methods of exercise.

	Means, active exercises done by the patient himself.
	Achieving active movement of muscles around a joint, and thereby preserving joint function is the ultimate goal of physiotherapy.
	Initially, during severe pain, inflammation and swelling in an arthritic joint; and more so if nerve compression is an associated complication; the active exercises are not possible, and may be even detrimental.
	During this period, when the patient is bed ridden and unable to undertake any active exercises, passive exercises are a must.

	As the name suggests, it is a passive way of exercises of muscles done by an attendant without any effort on part of patient.
	Latest techniques have been developed to strengthen muscles around a joint by muscle contractions, induced by signals given by equipments from outside.

	The muscles atrophy (degenerates) rapidly if not used regularly .
	This is known as 'Disuse atrophy' . Examples are atrophy of limb muscles in polio patients, and in severe incapacitating 'rheumatoid arthritic' patients.
	Passive exercises help to maintain joint function, lubrication, prevents muscle spasms and preserves power of muscles.

	Less effective than active exercises in strengthening muscles.
	May be painful, as movement at joint is required.
	Time consuming and requires days or even months of therapy to have appreciable effect.
	Requires help of a professional for desired results.
	Patient may become ambulatory (able to walk) only after several days causing complications like: deterioration of diabetes due to lack of active movement, development of bed sores in bed ridden patients, clot formation in limbs, and loss of working hours.

	also called wax bath.
	Placing heat on a surface of the body using paraffin.
	The part is quickly sunk in heated liquid wax and then taken out so that the wax surrounds it.
	It is done several times, and then the whole surface is wrapped in a loose-fitting plastic bag or in paper towels.
	It is effective for heating injured or swollen areas, especially the hands, feet, and wrists.
	It is used for patients with arthritis and rheumatism or any joint problem.

 

	Traction involves the use of a pulling force either directly or indirectly to bones.
	Traction can be used to prevent or reduce muscle spasms, keep a joint or other part of the body from moving, or restore a fractured bone to its normal position.
	The process of putting a limb, bone, or group of muscles under tension by means of weights and pulleys to align or to keep rigid the part or to relieve pressure on it.
	Kinds of traction include Bryant's traction, Buck's traction, Russell traction, skeletal traction, skin traction, and split Russell traction.
	There are two main types of traction--skin and skeletal.

 Skin traction

	Skin traction is applied to the skin surfaces, usually by a pelvic belt, head halter, traction boot, or moleskin straps covered with elastic wraps.
	It is attached to ropes and weights appropriate to the age and condition of the patient.
	Skin traction uses lower amounts of weight because skin cannot tolerate the pull of large amounts of weight over long periods.
	Thus skin traction is sometimes used intermittently or for short periods while skeletal traction, once applied, is always continuous and is used for longer periods and with heavier weights.
	Skin traction is used to treat muscle injuries, bone fractures, ruptured or herniated discs, muscle contractures, and arthritic conditions.
	It can be applied to an arm, the head, a leg or the pelvis.
	Some types of skin traction, such as the head halter and Buck extension, can be used at home.

 Considerations for use of skin traction at home include

	Look over all areas of the skin where the traction is to be applied.
	The traction will pull on the skin and could cause additional injury to the already compromised skin.
	It should not be applied over open sores, rashes, bruises, marked swelling, or raised moles or warts.
	Do not shave the skin under the areas where the traction is to be applied. Shaving could cause small cuts that could become inflamed under the traction.
	Make sure the skin is clean and dry to prevent chafing or maceration caused by excess water on the skin.
	Be sure you have an explanation of the traction equipment and how it is to be applied.
	Have the instructions in writing so there is no chance of forgetting a vital piece of information.
	Also, have the phone number of the physician ordering the traction and the supplier of the equipment to clarify any concerns you may have before or after the traction is in use.
	Find out if the weights can be removed at times--especially at night. The doctor may give an order that the patient can be in 2 hours, then out 2 hours, and off at night. Being in traction at night often prevents the patient from relaxing muscles to allow rest and sleep.
	Usually the patient will receive relief of muscle spasms and pain from the effects of the traction.
	If the spasms or pain increase, however, be sure to notify the doctor.
	Adjustments in the amount of weights, positions, or time in traction may be needed for benefits to be achieved. At times, the use of traction may need to be stopped if there are adverse reactions.
	Usually, you will be shown how to feel and count the arterial pulses in the extremities or area in traction, how to feel for temperature, color, and swelling.
	You will also be shown how to wrap the elastic bandages (if used) properly to prevent over tightness leading to more swelling, numbness or tingling, or throbbing under the bandages.
	Elastic bandages should be removed and reapplied more loosely if these symptoms occur after the traction has been applied.
	If possible, an orthopedic technician, a nurse, or a physical therapist should check the traction while in use at home. Arrangements can be made with your doctor.

 Skeletal traction

	When the injury is severe and demands longer periods of immobilization, skeletal traction is needed.
	Skeletal traction is applied directly to the bone by nails or pins inserted into the bone.
	Because your bones can tolerate more pres- sure than your skin, up to 30 pounds of pull may be applied by means of weights, ropes, and pulleys.
	Skeletal traction is done in a hospital.
	Your doctor and nurse will tell you on what you are allowed to do while in traction. Many times you can help with your own personal care.
	The one important thing to remember is not to disturb the traction apparatus or remove any weights. Skeletal traction must remain in continuous use until the doctor says it can be removed, usually when bone healing has occurred or when surgical repairs are done so healing can continue at home and out of traction.