Cindy W.
Bogalusa, LA

"I purchased my Fomentek Bag from my physical therapist. I had surgeries and the use of your product has saved me. I cannot sleep or exercise without it..."

Rosemary G.
Albany, NY

 WHAT ABOUT HEAT?
By Duane Brassette
The mere mention of the name Hyppocrates conjures the image of an old man in flowing robes tending the sick and wounded immediately comes to mind. Hyppocrates (460 BC) who is considered the father of modern medicine, used hydrotherapy as his main healing agent. His patients were positioned so that clay dams could be built around the injured or painful part of the patient's body and hot water was poured into the dammed-in area. Not only in ancient Greece, but also in all parts of the world the use of heat has long been considered to be the cornerstone of therapeutic endeavors. The appreciation for the healing qualities of heat existed long before the mechanics of heat therapy was fully understood. The American Indians were not strangers to the use of therapeutic heat either. Warm springs were so revered that the land near the spring was considered neutral, thus too holy a place to fight! Even warring tribes respected this strong medicine and laid down their arms when they were near the medicinal springs. The use of heat as a therapeutic medium continues today throughout the world. While the physiological effects of heat are now understood on a more scientific level, heat therapy, or hydrotherapy as it is often called has lost none of its magic.

FOMENTATION TOOLS
The definition of the word fomentation is "the use of a warm moist substance to promote healing or relieve pain." Therefore all therapeutic devices that deliver heat to the body are fomentation devices. The list of fomentation devices is long: Heating pads, Thermophore® heating pads, heat lamps, hot water bottles, hot soaks, microwavable hot packs, paraffin baths, Hydrocollator® packs, and Fomentek™ bags to name a few. Each product has qualities that make it better for a particular type of use. For example, a heating pad offers the convenience of being able to simply plug it in, but you should not use it if there is a chance that you might fall asleep while using it. The Thermophore®, being an electrical appliance, raises concerns that many people have regarding the presence of electromagnetic fields or EMFs. While there is no empirical evidence that EMFs are harmful, many people shy away from voluntary exposure to electrical appliances in close quarters. A Paraffin bath for the hands is a great tool for the treatment of arthritis pain, but use of can be difficult, as the unit requires warm-up time and the paraffin must constantly be replenished. The use of liniment on the hands before immersing them in paraffin is verboten. Hydrocollator® packs are great in that the pack itself does not emit electromagnetic fields. They offer the additional advantage of not requiring hot running water to use. The disadvantages are that the electric vessel that they are stored in must be kept plugged in whether or not the packs are needed immediately. Another disadvantage is that they must be placed on top of the client. Putting a Hydrocollator® pack beneath the client can result in burns because a relatively dry towel must insulate the 150°F clay pack. Lying the body on top of the pack compresses the towel, thereby rendering its insulating properties ineffective. Hot baths have long been recognized as a beneficial therapeutic modality, but they are not usually appropriate in a massage setting. Heat lamps are quite effective, and despite the fact that they do not even touch the body, the infrared light penetrates deeply into tissues. Because of their physical presence and proximity to the massage table, Heat lamps are difficult to work around and often considered clumsy. Hot water bottles generally work very well, but they do not stay warm for very long and do not cover a large area. Also, in order to store sufficient thermal energy (heat) they are often super heated with scalding water then wrapped in a towel to prevent burns. Wrapped this way, their effectiveness is compromised because they cannot conform to bodily curves.

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MOIST HEAT IS ABOUT CONDUCTIVITY
It is important to understand that inside the body everything is moist. The term "moist heat" actually has more to do with how well the heating medium transfers heat into the body through conduction rather than whether the medium is actually wet. The therapeutic temperature range for the body is between 104ºF and 113.7ºF. Immersing the entire body in water hotter than 104ºF is not recommended. Heating any part of the body above 127ºF will cause injury. The irony here is that many heating devices exceed these temperatures. Paraffin baths for the hands, for example hold the melted paraffin at temperatures as high as 135ºF, however, the hands are immersed in the paraffin for only a few seconds, however. If a person were to leave a hand in the paraffin for 5 minutes, there would be extensive tissue damage. Common sense and the body's natural response to pain prevent this from occurring. Often we hear that "moist heat" is better than "dry heat". To dispel any notions that the moisture content of a fomentation device determines its therapeutic quality, I would like to offer the following examples: If a person opens a pre-heated 350°F oven and sticks a hand in for 3 seconds then pulls it out, the heat will be felt, but there is no likelihood that 3 seconds in this environment would cause injury. Take the same oven and the same hand, but instead of just sticking the hand into the oven, imagine grabbing an oven rack for 3 seconds. Third degree burns would occur. The 350ºF temperature is shared by both the air inside the oven and the steel rack. The steel burned the hand because it is a solid whereas the air is a gas. When a person lies on a dry flannel-covered heating pad, the contact area is composed of cotton fibers, but most of the body is bridged over air space and supported by the small percentage of the total area, which is comprised of cotton fibers. Now imagine that the flannel heating pad cover is moist. Wet flannel interspersed with areas of air will have greater contact area than dry flannel. The wet flannel has many times the contact area of the dry flannel alone. The moist pad feels hotter because in addition to having greater contact area than cotton fibers alone, the water (moisture) itself conducts heat far more efficiently than the cotton. Now lets take our scenario a little further by imagining that we remove the flannel outer covering (pillowcase) from the heating pad exposing the plastic pad cover. This plastic surface of the electric heating pad is about 140°F. OUCH! These examples help us to understand that it is not the moisture itself that assists therapeutic values, but how well the substance in contact with the body conducts heat. Remember! Inside the body everything is moist. It is not uncommon for advocates of therapeutic heat to insist that only moist heat is therapeutic. The real intention here is to direct the user to a fomentation device that delivers therapeutic heat efficiently. Another thing to remember is that the body in contact with warmth will supply its own moisture in the form of perspiration.

BENEFICIAL EFFECTS OF USING HEAT
Applying heat to the body has the effect of dilating the blood vessels, increasing the metabolic rate of the heated area, and relaxing the muscles on a deep level. The use of heat is an important therapeutic tool and often crucial to the massage experience. Heat can deliver nurturing comfort to the client while enabling a far deeper state of relaxation than massage alone. Pain relief is a specific goal for most massage therapy sessions and much discomfort can be alleviated by tapping into the body's own parasympathetic nervous system to facilitate the release of endorphins, the body's own "feel good" pain reliever. In addition to causing the brain to create comfort hormones, an important physiologic effect of applying heat to painful areas of the body is the reduction of pain by interference with pain transfer mechanisms. In the body, the pain and temperature sensing pathways are close together. When the heat message occupies these pathways, the pain message becomes distorted and the pain is diminished. Totally aside from the therapeutic benefits of using heat, the use of heat on the client during massage allows the treatment room to be cool enough for the therapist to work hard without overheating, while the client, wearing little or no clothing, can relax without feeling cold.