What is included in physiotherapy. Physiotherapy treatment. History of the development of physiotherapy

Physiotherapy I Physiotherapy

Physiotherapy (Greek physis nature + therapeia; synonym: physical, physical therapy,) - ​​a field of medicine that studies the physiological and therapeutic effects of natural and artificially created physical factors and develops methods for using them for preventive and therapeutic purposes; a set of physical methods of treatment and their practical application.

With stable angina pectoris, postinfarction cardiosclerosis I and II functional classes with circulatory failure not higher than stage I and without cardiac arrhythmias, general contrast baths are prescribed: the patient is immersed in a pool of warm (38 °) fresh water for 3 min, then it goes into a pool of cool water (28°) for 1 min while performing active . Three transitions to the procedure are recommended, which ends with a cool bath (by the middle of the course, its temperature is lowered to 26-25 °). Total for the course 12-15 baths, per week - 4-5 baths. In post-infarction cardiosclerosis and after coronary artery bypass surgery (starting from the 30-35th day), foot contrast baths are used (with a temperature of 38 and 28 °, from the second half of the course - 40 and 20 °): a total of 12-15 baths per course.

For the treatment of patients with a painless form of coronary heart disease, cardiosclerosis, which can manifest itself as heart failure and heart rhythm disturbances, balneotherapy and hydrotherapy are used. When choosing the type of treatment, methods of its implementation, determining the degree of violation of the functional state of the cardiovascular system according to the results of tests with physical activity, as well as the nature of cardiac arrhythmias, is of decisive importance.

Hypertonic disease. When choosing the F. method, one should take into account not only the stage of the disease, but also the variant of hemodynamic disorders (hyperkinetic or hypokinetic). In the hyperkinetic variant, to reduce the increased sympathetic activity of the hypothalamic centers, central electroanalgesia, galvanotherapy and medicinal, low-frequency magnetic field, microwave therapy, negatively charged electroaerosols are used.

In the treatment of patients with stage I and II hypertension without frequent vascular crises, significant cardiac arrhythmias and circulatory failure not higher than stage I, balneotherapy is widely used: carbonic, radon, hydrogen sulfide, sodium chloride, iodine-bromine, arsenic-containing, as well as nitrogen baths. The temperature of all baths is 35-36°, except for sodium chloride baths (35-34°). take every other day, 4-5 baths per week, for a course of 10-12 baths.

Patients with stage IIB hypertension in combination with coronary heart disease, as well as with circulatory failure not higher than stage IIA, use 2- and 4-chamber baths or dry carbonic baths (temperature 28 °, duration 15-20 min, for a course of 10-12 baths).

In hypertension stage I and II without signs of coronary and heart failure, cardiac arrhythmias, hydrotherapy is used: coniferous, pearl, oxygen baths, wet wraps and healing showers, incl. underwater shower-massage, as well as sauna treatments.

Cardiopsychoneurosis. In order to influence arterial hyper- and hypotension, cardialgia, disturbed heart rhythm, electrosleep is used, drug electrophoresis (, anaprilin) ​​is carried out according to the method of general exposure or the collar method; in the hypotensive type, caffeine-bromo-electrophoresis is used: in severe asthenic syndrome, a galvanic anode collar according to Shcherbak. In the cardiac type of the disease with severe cardialgia, novocaine electrophoresis is prescribed according to the segmental method, darsonvalization of the heart area, ultraviolet in an erythemal dose or heart area.

Carbonic, sodium chloride, iodine-bromine baths are prescribed for hypotensive type of the disease and severe asthenic syndrome; radon, nitrogen baths - for hypertensive, cardiac, incl. arrhythmic, symptom complexes and a pronounced predominance of the process of hypersympathicotonia, insomnia; hydrogen sulfide baths - with hypertensive and cardiac types with relatively balanced nervous processes and without signs of hypersympathicotonia and cardiac arrhythmias.

Hydrotherapy in the form of therapeutic showers (rain, circular, Scottish, underwater shower-massage), dry and wet wraps, contrast, pearl, coniferous baths are used for all types of diseases. In violation of the heart rhythm, a pronounced predominance of excitation processes, do not use circular and Scottish showers, as well as contrast baths.

Myocarditis cardiosclerosis(consequences of rheumatic and infectious-allergic myocarditis) in patients with circulatory failure not higher than stage I, cardialgia, incl. with mild heart rhythm disturbances, is an indication for balneotherapy in the form of general carbonic, radon, sodium chloride and iodine-bromine baths, and in the absence of heart rhythm disturbances, hydrogen sulfide baths. In patients with severe mitral stenosis or after commissurotomy, preference should be given to carbon dioxide baths. In such patients, inhalations of aero- or electric aerosols are used, to improve immunogenesis in order to prevent exacerbations, inductothermy is performed on the adrenal region (at the level of Th X -L IV).

Physiotherapy for nonspecific respiratory diseases aimed at eliminating inflammation, achieving faster resorption of the inflammatory focus, preventing the transition of an acute inflammatory process to, improving the function of external respiration, especially bronchial conduction, lymph and blood circulation of the bronchopulmonary system, restoring impaired immune status, providing a hyposensitizing effect, training thermoadaptive mechanisms.

pneumonia(acute, prolonged, chronic). In the complex treatment of acute pneumonia, electromagnetic fields of ultra-high, ultra-high, extremely high and high frequencies, variable low-frequency magnetic fields, ultraviolet irradiation, electroaerosol therapy, applications of paraffin, ozocerite, and therapeutic mud are most widely used.

In the first days of the disease, exposure to the UHF electric field on the chest is prescribed in continuous (with a power of 40-100 Tue) or impulse (4.5-6 Tue) modes. Also recommended are inhalations of antibiotics, phytoncides, bronchodilators, alkaline solutions, herbal decoctions with expectorant action, erythemal ultraviolet irradiation of the chest (usually in separate fields) according to the affected lobe of the lung, one field daily. Irradiation intensity 2 to 4 biodoses; 4-5 exposures are prescribed per course.

In the period of resolution of the process and resorption of the inflammatory focus, microwave therapy is prescribed to the area of ​​the lesion or lower lobes of the lungs. According to the same principle, inductothermia is carried out using low-thermal and thermal doses, mainly for central and radical pneumonia (in the absence of coronary heart disease and hypertension), as well as microwave therapy or UHF therapy (especially in pulsed mode). In the same period of the disease, magnetic therapy is carried out using a low-frequency (50 Hz) magnetic field in continuous or intermittent modes, which favorably affects the functions of the cardiovascular system, causing the advantage of this method in the treatment of patients with concomitant cardiovascular pathology. Contraindications for magnetic therapy are severe, hemoptysis, diseases accompanied by a tendency to bleeding. To improve the resorption of the inflammatory focus and eliminate bronchospasm, pain, and difficult sputum discharge, electrophoresis of calcium, magnesium, heparin, aminofillin, aloe extract, ascorbic acid, lysozyme is used. At the same time, one (100-150 cm 2) are located in the interscapular region, the second - taking into account the localization of the focus of inflammation. A good effect (including at the stage of infiltration) is given by the use against the background of pharmacotherapy (and others), galvanization of the chest (20-40 min), which is carried out with intravenous drip after 1/2 - 2/3 of the volume of the solution has been consumed, and with intramuscular injection - after 1-1 1/2 h after injection. This increases the concentration of the drug in the inflammatory focus. In the period of resolution of the process and resorption of the inflammatory focus, aerosol therapy with expectorant, mucolytic, tonic drugs, as well as applications of ozocerite, paraffin, silt and peat mud are used. On the 2-3rd week. you can prescribe climatotherapeutic procedures (day stay on the veranda, air baths). All F. methods are combined with exercise therapy, massage.

In the treatment of prolonged pneumonia or residual effects of acute pneumonia, hardening methods (water wiping, dousing, showers), (in a sanatorium or rehabilitation department), general UV irradiation, expectorant, mucolytic and restorative drugs, as well as sodium chloride, turpentine , "dry" carbon dioxide baths according to generally accepted methods.

The principles of treatment of exacerbation of chronic pneumonia are the same as the treatment of acute pneumonia. In the stage of remission, spa treatment is widely used: climatotherapy (Climatotherapy) , heliotherapy (Heliotherapy) , thalassotherapy (thalassotherapy) , as well as gymnastics (Gymnastics) and in the pool, various methods of hydro- and balneotherapy.

Chronical bronchitis. With an exacerbation of the disease, the presence of an active inflammatory process, the same methods are used as in the treatment of acute pneumonia. Particular attention is paid to the drainage function of the bronchi, to improve which electroaerosol therapy is used using bronchodilator mixtures, mineral waters, proteolytic enzymes, etimizol, glucocorticoid hormones, and herbal decoctions. The same methods are used in the chronic course of the process, outside the stage of exacerbation. In the treatment of chronic obstructive bronchitis, as well as bronchial asthma, electromagnetic fields of high and ultrahigh frequency are used when localizing the impact on the projection area of ​​the adrenal glands, amplipulse therapy (Amplipulse therapy) .

Bronchial asthma. In order to block pathological impulses from the bronchopulmonary system during amplipulse therapy, the impact is also carried out on the region of the cervical sympathetic nodes. With bronchospastic syndrome, they are successfully used, which, as a rule, act alternately on 3 fields (2-3 min for each): paravertebral, on the area of ​​VI-VII and VII-VIII intercostal zones and subclavian zones. If bronchospastic is caused by psychoneurological reactions or is accompanied by functional disorders of the central and autonomic nervous systems, the use of electrosleep is effective (with the orbito-occipital location of the electrodes). For the same purpose, a galvanic collar, electrophoresis of calcium, bromine is used on the collar zone. Patients with pulmonary hypertension, pulmonary heart disease are recommended "dry" carbon dioxide baths. Mitigation of the symptoms of obstructive bronchitis can be achieved with the help of vibration therapy.

To improve pulmonary ventilation and gas exchange in patients with respiratory failure of I-III degree, transcutaneous electrical stimulation (Electrical stimulation) of the diaphragmatic can be used. In order to increase the overall resistance of the body in patients with chronic nonspecific lung diseases, desensitization in case of allergic phenomena, UV irradiation of the chest with suberythemal doses is prescribed.

Patients with chronic bronchitis with minimal activity of the inflammatory process are treated with mud , imposing sulfide silt or peat mud on the back surface of the chest with the capture of the projection zone of the adrenal glands. Outside the stage of exacerbation, balneotherapy (“dry” and aqueous carbonic, radon, turpentine baths), heat treatment in baths, incl. in sauna. In the stage of remission, patients with chronic nonspecific lung diseases are referred for sanatorium treatment in a familiar climate (local sanatoriums) or a dry warm climate (Southern coast of Crimea), or middle mountains (Kislovodsk, Issyk-Kul resort area, etc.).

Physiotherapy for diseases of the musculoskeletal system usually complements other types of treatment, but in some cases becomes the leading treatment method, an alternative to drug therapy.

Arthritis. In brucellosis arthritis with a pronounced exudative component in the subacute stage, UV irradiation of the affected joints is prescribed (no more than two at a time) after 1-2 days (with an increase of 1-2 biodoses); only 3-4 irradiations of each joint. With the predominance of proliferative changes in the affected joints and periarticular tissues, ultrasound, hydrocortisone are used (also not more than 2 joints at the same time, on average 5-6 min per joint), for a course of 10-12 procedures daily or every other day. Patients with chronic brucellosis arthritis are prescribed balneotherapy: hydrogen sulfide, sodium chloride, iodine-bromine and radon baths, as well as (applications in the form of trousers, half-trousers - for damage to the joints of the lower extremities, in the form of a jacket, half-jacket - for damage to the joints of the upper extremities), therapeutic exercises and massage.

With gonorrheal arthritis, even against the background of acute events, you can use UV irradiation in erythemal doses after 2-3 days (with the addition of 1-2 biodoses), only 3-4 irradiations of each affected joint. In the future, with exudative-proliferative changes in the joints, UHF therapy is prescribed (power 30-40 Tue, duration of daily procedures 10-15 min. 10-12 procedures per course). With the predominance of proliferative and fibro-destructive changes, inductothermy and microwave therapy are used on the affected and lumbar region. In the chronic course of arthritis with pain syndrome, joint contractures, treatment with pulsed currents is prescribed (Pulsed currents) .

With exacerbation of gouty arthritis, UV irradiation of the affected joint has an anti-inflammatory and analgesic effect, and UHF therapy is also advisable. At an early stage of reactive arthritis, UV irradiation of the joints in erythemal doses is indicated after 1-2 days with an increase of 1-2 biodoses (for a course of 3-5 sessions), as well as UHF or microwave therapy. With the predominance of arthralgia, ultrasound is used, hydrocortisone ulgraphonophoresis on the affected joints (but 3-5 min for each joint every other day, 6-10 procedures per course). With minimal activity of the process, therapeutic exercises, massage, radon, sodium chloride baths with a duration of 10-12 min every other day, for a course of 10-12 baths. In the remission phase, mud therapy, calcium and salicylate electrophoresis, and general UV irradiation are carried out.

In rheumatoid arthritis, a pronounced therapeutic effect is exerted by high-frequency electric currents (HF therapy, or) on the Th X -L II segments and on the joints; you can also use microwave therapy or UV irradiation. If there are contraindications for these methods of treatment, electrophoresis of acetylsalicylic acid (0.5-1% solution), analgin (2-5% solution), sodium salicylate (2-5% solution), novocaine (5% solution), and with degenerative changes in the joints - electrophoresis of hyaluronidase, lidase, ronidase in a 1% solution of novocaine. A good effect is the use of ultrasound on the area of ​​​​the joints and paravertebral in patients with predominantly proliferative changes in the joints. With minimal activity of the process and severe arthralgia, proliferative phenomena, contractures, amplipulse and diadynamic therapy are indicated. , as well as diadynamophoresis of analgesic drugs. Balneo-mud treatment is also widely used, incl. radon, hydrogen sulfide, sodium chloride, iodine-bromine baths.

On the inflammatory process in the spine and joints in Bechterew's disease, a pronounced effect is exerted by HF and microwave therapy on the Th X -L II segments, as well as on the region of the spine and joints. In the inactive phase and with minimal activity of the process, hydrocortisone ultraphonophoresis is also performed paravertebral and on the affected joints. With a pronounced spastic state of muscles, contractures, pain syndrome, amplipulse therapy and diadynamic therapy, electrophoresis of novocaine (2-5% solution) and iodine (potassium iodide 1-5% solution) are used according to the general method, on the spine and on the affected joints (duration 15- 20 min, for a course of 15-20 procedures). Also shown are applications of dimexide (50% aqueous solution), as well as heparin (250 U / ml), analgin (0.025 g/ml), hydrocortisone (0.75 mg/ml), nicotinic acid (0.4 mg/ml), therapeutic and massage.

Of the balneotherapeutic procedures, radon and hydrogen sulfide baths are of the greatest importance; with a pronounced violation of the function of the musculoskeletal system, mud therapy is indicated, as well as applications of paraffin and ozocerite, therapeutic exercises and massage. With the activation of the inflammatory process, it is advisable to prescribe HF therapy (inductothermy) and microwave therapy on the Th X -L II segments.

In case of traumatic arthritis, from the second day after, UHF therapy is used, from the 1-6th day - HF therapy (inductothermy) and microwave therapy. With severe arthralgia, from the 2-3rd day, UV irradiation of the joint in an erythemal dose is used, as well as amplipulse therapy, diadynamic therapy and interference currents (100-200 Hz). In order to normalize micro-circulation and reduce edema, it is possible to use an alternating magnetic field (50 Hz) in continuous or intermittent mode. On the 5th-7th day, an ultrasonic effect on the joint is shown, and in case of manifestations of synovitis, hydrocortisone ultraphonophoresis is indicated. In order to resolve the exudate and prevent the development of contractures, electrophoresis of novocaine (2-5% solution), potassium iodide (3-5% solution), lidase, hyaluronidase is performed. At the final stage, applications of mud, paraffin and ozocerite are used, as well as hydrogen sulfide, slag, sodium chloride, iodine-bromine baths in combination with massage, therapeutic exercises and mechanotherapy.

Diseases of the periarticular tissues. With periarthritis, which is often combined with tendovaginitis, UV irradiation of the joint is indicated, irradiation with a solar lamp or infrared rays (20-30 min 1-2 times a day daily, total 8-10 procedures). A good therapeutic effect in traumatic periarthritis is given by paraffin applications. In subacute periarthritis, iodine-novocaine electrophoresis is indicated, as well as electronoresis of lidase, ronidase, hyaluronidase, the use of ultrasound and ultraphonophoresis of medicinal substances (, eufillin, gangleron, etc.). In the treatment of periarthritis, low-frequency currents are widely used - amplipulse therapy, diadynamic therapy with localization both on the joint area and paravertebral. Of the balneotherapeutic procedures, radon and hydrogen sulfide baths are shown, with pronounced contractures - mud therapy, applications of paraffin and ozocerite.

With heel spurs, ultraphonophoresis of hydrocortisone, analgin on the heel area is used (8-10 min daily, only 10-12 procedures), electrophoresis of lidase, ronidase, iodine (5% solution) and novocaine (5% solution). To stop the pain syndrome, amplipulse therapy and analgin (5% solution), novocaine (2-5% solution) with a solution of adrenaline at a dilution of 1: 1000, UHF and microwave therapy are used. In the case of attachment of neuritis of the branches of the tibial or sural nerve, UV irradiation of the lateral surfaces of the foot and the back of the leg is used. After subsiding of acute manifestations, paraffin applications are prescribed.

Physiotherapeutic treatment of osteoarthritis is aimed at unloading the affected joints, improving metabolism, blood circulation in the joint tissues, and reducing the effects of reactive synovitis. In the initial stages of the disease, when synovitis is absent or mild, HF therapy (inductothermia) and microwave therapy on the joint area, ultrasound and ultraphonophoresis of medicinal substances (analgin, hydrocortisone) are used daily or every other day. A pronounced analgesic effect is exerted by low frequency - and diadynamic therapy, as well as diadynamic electrophoresis of novocaine, analgin, etc. Electrophoresis on the joint area of ​​analgin (2-5% solution), sodium salicylate (2-5% solution), novocaine (0, 25-2% solution) in combination with adrenaline (1:1000). With exacerbation of secondary synovitis and severe movement disorders, UV irradiation, UHF therapy, and exposure to an alternating magnetic field are performed. After that, radon, sodium chloride and iodine-bromine baths, general and chamber hydrogen sulfide baths are prescribed, mud therapy, paraffin, ozokerite applications, massage and therapeutic exercises, mechanotherapy are widely used.

The basic principles and methods of physiotherapeutic treatment of osteochondrosis of the spine correspond to those for osteoarthritis, differing only in some features of the methods of using physical factors, depending on the localization of the pathological process. Usually they act on the corresponding spine or paravertebral. Thus, ultrasonic exposure and ultraphonophoresis of medicinal substances (one of the most effective therapeutic methods for this pathology) are carried out only paravertebral. The more acute the pain syndrome, the less should be the impact of microwave therapy, amplipulse therapy, diadynamic therapy. should be carried out according to the “lightweight” technique, especially on the cervical spine. The physiotherapy complex must include therapeutic exercises (see Therapeutic physical culture) , Massage , manual therapy (manual therapy) . In the treatment of this pathology, a special place is occupied by the so-called extension therapy - underwater static and dynamic orthotraction, or underwater spine, in mineral water. Dynamic orthotraction is especially indicated, which, in addition to decompression, has a training effect on the ligamentous-muscular spine, increasing its corset function, improves the locomotor function of the articular apparatus.

The tasks of physiotherapeutic treatment and rehabilitation of patients operated on the joints include, first of all, reducing the intensity of the pain syndrome, regeneration processes, preventing the development of inflammatory infectious processes, and restoring the locomotor function of the musculoskeletal system as fully as possible.

From the first days, UV irradiation is carried out, incl. wound surface and postoperative suture. An important factor in the early stages is UHF therapy; a solux lamp is also used. To reduce pain, iodine-novocaine-electrophoresis is indicated. It is advisable to prescribe amplipulse therapy and diadynamic therapy paravertebral to the corresponding segment of the spine; in the early stages, an alternating magnetic field is also used (50 Hz) on the affected joint. Ultrasound, electrophoresis of lidase, ronidase are used to prevent ankylosis and contractures. With the development of a purulent inflammatory process after the evacuation of the exudate from the joint cavity, erythemal UV irradiation of the joint is performed, and in the case of the formation of a fistulous tract, hypererythemic irradiation of its mouth. With sluggish repair processes, the effect of ultrasound on the fistulous mouth is shown. During this period, UHF therapy, darsonvalization of the wound surface, and franklinization are also used. Copper and zinc electrophoresis is used as an irritant for sluggish regeneration processes. The treatment complex must include massage, which is advisable to start already in the early stages (the so-called percussion, soft, absorbable massage). After 2 weeks after subsiding of acute phenomena, therapeutic exercises, mechanotherapy in combination with radon, hydrogen sulfide, sodium chloride baths are prescribed; in the formation of contractures - mud therapy, applications of paraffin and ozocerite, therapeutic exercises in the pool, neuromuscular stimulation.

Physiotherapy for diseases of the digestive system. With reflux esophagitis, amplipulse therapy has a good effect, because. sinusoidal modulated currents have an anti-inflammatory, analgesic trophic effect, affect the secretion and motility of the stomach and the functions of other digestive organs, improve blood circulation in tissues. In the presence of a pronounced pain syndrome, electrophoresis of ganglioblocking agents, in particular gangleron, is indicated. Patients with reflux esophagitis with concomitant peptic ulcer of the stomach and duodenum, severe hypersecretory disorders and disorders of the functional state of the liver are recommended microwave therapy (460 MHz). You can also use the UHF electromagnetic field from the Ekran-2 device. Due to the increased neurovegetative excitability, patients with diseases of the esophagus are shown electric sleep procedures. For the same purpose, galvanization of the collar zone according to Shcherbak is prescribed. Applications of sulfide silt or peat mud are effective on the epigastric region and the lower part of the sternum, as well as segmentally, especially in combination with drinking mineral water and diet therapy.

Physiotherapy is contraindicated in patients with severe reflux esophagitis, complicated by strictures, ulcers, bleeding from the esophagus, with suspected benign and malignant esophagitis.

Amplipulse therapy, microwave electromagnetic field (460 MHz). The use of ultrasound is also shown, usually after 1-2 h after taking liquid food (milk, jelly, liquid porridge, pureed soup without bread). The method of ultraphonophoresis of medicinal substances, in particular hydrocortisone, is also common. The use of high-frequency therapy (inductothermy) is effective.

Amplipulse therapy, which has a pronounced effect, is prescribed for pain syndrome; with concomitant damage to the liver, microwave therapy is indicated, and the pancreas - amplipulse therapy.

For gastritis with increased secretion, it is advisable to use amplipulse therapy and microwave electromagnetic field; with this form is not recommended, tk. it causes a pronounced stimulation of the glucocorticoid function of the adrenal glands, which is often accompanied by an exacerbation of the disease.

In chronic gastritis with severe pain syndrome, perigastritis, concomitant lesions of other digestive organs, mud therapy (sulfide silt, peat, sapropelic mud) is indicated in the form of applications on the stomach area and segmentally by 10-20 min in one day. Elderly patients, for whom mud therapy is stressful, can be recommended electrophoresis of therapeutic mud or a mud preparation of gumizol. In all cases, it is desirable to combine F. with mineral water drinking and diet therapy.

Physiotherapy is contraindicated in exacerbation of chronic gastritis, the presence of a single polyp of the mucous membrane or polyposis of the stomach, as well as patients with rigid antral gastritis.

Peptic ulcer of the stomach and duodenum. A good effect is exerted by the action of low-frequency currents according to the method of electrosleep, especially in the presence of pronounced neurotic phenomena, sleep disorders, and metabolism. Amplipulse therapy is recommended for patients with severe pain syndrome, concomitant diseases of the liver and intestines with a slowdown in its motor function. In the absence of devices for amplipulse therapy, diadynamic currents can be used. Galvanization has not lost its significance, during which an electrode connected to the positive pole is applied to the region of the stomach or pyloroduodenal region, the other - to the region of the lower thoracic spine.

Due to the fact that patients with peptic ulcer often do not tolerate the ingestion of a number of drugs, it is advisable to use drug electrophoresis, primarily novocaine (2-5% solution), which relieves pain well. With increased excitability of the nervous system and sleep disturbance, a general bromine electrophoresis (5% sodium bromide solution) is indicated; using galvanic current, it can be injected into ganglion blockers (1% benzohexonium solution, 0.1% ganglerone solution); trophic effect is exerted by electrophoresis of various microelements - copper, zinc and other substances. A pronounced antiulcer effect has a domestic analogue of leu-enkephalin - dalargin, which is also recommended to be administered by electrophoresis. The use of an alternating magnetic field and ultrasound is also effective. To enhance the effect of ultrasound, it is combined with mud applications.

Among the methods of F. peptic ulcer of the stomach and duodenum, one of the leading places is occupied by mud therapy. Therapeutic mud (3-4 kg) is applied to the epigastric region and segmentally. In the presence of concomitant diseases of the liver or gallbladder, mud is also applied to the region of the right hypochondrium, and in case of intestinal diseases - to the whole and segmentally. Applications of silt and firth mud are prescribed at a temperature of 38-40 °, acid peat and sapropelic mud - 42-44 °. The presence of an open ulcer or a symptom of a "niche" in X-ray examination is not a contraindication for mud therapy, as well as a single profuse bleeding that occurred a year ago or more.

Indications for mud therapy can be expanded when mud is applied not to the stomach area, but to the collar zone, which is most innervationally connected with the central nervous system. At the same time, mud applications with a total area of ​​800-1200 cm 2 impose on the back and side surface of the neck and shoulder girdle in the cervical and two upper thoracic skin segments. This technique can be recommended for patients with duodenal ulcer in the presence of large ulcers localized in the duodenal bulb, with severe pain, as well as for patients with a history of gastric bleeding. Such patients should be prescribed mainly "sparing" methods of F., incl. that do not have a pronounced local thermal effect: an alternating magnetic field, an electromagnetic microwave field on the thyroid gland, sinusoidal modulated currents on the cervical sympathetic nodes.

In case of poor tolerance of mud applications, galvanic mud or mud phoresis can be applied using sinusoidal modulated currents. In the absence of therapeutic mud, you can use it, which is applied to the epigastric region and segmentally.

When F. is used, exacerbations are possible, more often after 5-6 excessively “loading” procedures (muds of high temperatures, high concentration baths, electric current of great strength, etc.) or when taking several procedures within one day. In these cases, it is necessary to reduce the strength and duration of exposure, skip one or two procedures and resume them only after the pain syndrome and other signs of exacerbation subside.

Contraindications for F.: a sharp peptic ulcer, motor insufficiency of the stomach caused by stenosis of its outlet, ulcers to other organs, a tendency to bleed from an ulcer, suspicion of its malignancy.

Diseases of the operated stomach. The expediency of early use of F. after surgery on the stomach - after 8-10-14 days, is proved. it contributes to the rehabilitation of operated patients and the prevention of the development of diseases of the operated stomach. Usually, F. procedures are used for such patients according to “sparing” methods, i.e. in small doses, every other day, without prescribing several procedures during the day. Use galvanization, calcium electrophoresis (5% calcium chloride solution). For the purpose of a more complete functional recovery of the pancreas and prevention of the development of postoperative pancreatitis, electrophoresis of protease inhibitors, in particular contrical a and Gordox, is recommended. It is possible to prescribe microwave therapy to the area of ​​the stomach or thyroid gland, an alternating magnetic field or HF therapy (inductothermia) to the area of ​​the stomach.

Therapeutic mud (sulfide, silt, peat, sapropel) is advisable to apply in the early stages - after 2-3 weeks. after stomach surgery. Elderly patients, sharply weakened, use galvanic mud, mud electrophoresis. Such thermal factors, as well as ozokerite, are not recommended for patients in the early stages after surgery, because. they can cause complications.

It is more effective to use these methods in combination with balneological procedures. The complex of treatment also includes drinking mineral waters, exercise therapy, massage of the collar zone, climate therapy; be sure to follow the diet.

Indications for F.: conditions after resection of the stomach, suturing of a perforated ulcer, organ-preserving operations in combination with vagotomy, selective proximal vagotomy with the presence of asthenic syndrome, so-called small stomach syndrome, dumping and hypoglycemic syndromes of mild and moderate severity. Contraindications: surgery for ulcerative bleeding, but without removing the ulcer itself; bleeding in the postoperative period and other surgical complications, operations and general contraindications. Not completely healed postoperative and increased (up to 30-40 mm/h) ESR is not a contraindication for F.

Treatment of patients with late postoperative syndromes or the so-called diseases of the operated stomach is carried out taking into account the type of operation and the nature of the complications that have occurred. Patients after surgery for suturing a perforated ulcer of the stomach or duodenum should be treated according to the same principles as non-operated patients with peptic ulcer, but it is necessary to use physical factors that have a thermal effect more carefully.

The use of F. is indicated for patients who have undergone stomach surgery in the past with the presence of dumping and hypoglycemic syndromes of mild and moderate severity, gastritis, hepatitis, cholecystitis, pancreatitis, reflux esophagitis, etc. However, it is not carried out in patients with deep asthenia, nutritional decline, anemia, non-healing postoperative fistulas, afferent loop syndrome, peptic ulcer of the jejunum or anastomosis, severe dumping syndrome, exacerbation of chronic pancreatitis.

chronic hepatitis. The most favorable effect is exerted by moderately thermal or non-thermal factors, incl. mud applications on the area of ​​the right hypochondrium and segmentally. Sulfide silt and sapropelic muds are used, as well as peat applications. Applications of paraffin and ozocerite can also be used as thermal factors. Elderly patients and those for whom mud therapy is stressful can be recommended galvanic mud, mud electrophoresis on the liver area. HF therapy (inductothermy), as well as (combination of mud therapy and inductothermy) approaches mud therapy in terms of efficiency. Effective is the UHF electromagnetic field on the liver area, as well as sinusoidal modulated currents (amplipulse therapy). They also use an alternating magnetic field, an electromagnetic field of microwave (460 MHz) on the liver area according to standard methods.

Ultrasonic exposure is carried out on the area of ​​the right hypochondrium and paravertebral in the area of ​​Th V-IX . Galvanization, magnesium electrophoresis (10% magnesium sulfate solution), electrophoresis of the protease inhibitor aminocaproic acid are also used.

Physiotherapy is contraindicated in patients with chronic aggressive and cholestatic hepatitis, persistent hepatitis in the acute phase, cirrhosis of the liver with ascites, jaundice of any origin, tumors, liver echinococcus and cachexia.

Physiotherapy is successfully used in the rehabilitation treatment of patients with residual effects of viral hepatitis. One of the main methods of complex therapy for this disease is drinking mineral waters; general radon baths are shown (concentrations 20-40 nCi/l), coniferous, coniferous-radon, carbonic, carbonic-hydrogen sulfide baths with a hydrogen sulfide content of 10 mg/l. Therapeutic mud can only be used as applications on the right hypochondrium (temperature 37-38°C) in a short course (2-3 times a week, 6-8 procedures in total). More shows galvanic mud at a low current density and duration of the procedure up to 20 min. Locally, on the liver area, an UHF electric field, HF, microwave electromagnetic fields can be applied; to reduce asthenia, which is dominant in the picture of the disease, it is advisable to use electrosleep, effects on the collar zone (galvanic current, microwave therapy, etc.). Physiotherapeutic methods are contraindicated in patients with residual effects of viral hepatitis in the active phase.

Chronic cholecystitis. The use of F. is aimed at reducing inflammation in the gallbladder and biliary tract, improving the functional state of the liver, the physicochemical properties of bile, and normalizing the motor function of the gallbladder. These goals are most consistent with the use of drinking mineral waters, physiotherapy and balneotherapy procedures, incl. mud therapy, which, depending on the form and severity of cholecystitis, the presence of concomitant diseases and the individual characteristics of patients, can be modified. Patients tolerate galvanic mud more easily; mud pressing electrophoresis or mud solution can also be used. Of the thermal factors, you can use ozocerite applications, preferably in combination with drinking water and balneotherapy.

High-frequency and UHF electromagnetic fields have a good effect on the area of ​​the liver and gallbladder. Electrophoresis of 10% magnesium sulfate solution, 5% novocaine solution is used. It is possible to combine the effect of HF therapy and electrophoresis of a mixture of magnesium sulfate and nicotinic acid on the liver area.

microwave therapy (2375 MHz) on the liver area is used in a low-thermal dosage. In the hypotonic form of concomitant dyskinesia of the gallbladder, low-intensity ultrasound (0.2 W / cm 2), and in the hypertonic form - a higher intensity (0.8-1 W / cm 2).

Galvanization, sinusoidal modulated currents (amplipulse therapy), microwave therapy, an alternating magnetic field are prescribed according to the same methods as in chronic hepatitis.

In chronic cholecystitis, F., carried out in remission, has the best effect. With the appearance of pain in the right hypochondrium, increased pain during percussion and palpation of the gallbladder area, an increase in hyperesthesia zones and other signs of exacerbation, it is advisable to reduce the duration of the procedures, skip one or two of them, and with a more significant increase in pain, dyspepsia, and fever , a change in the blood picture should be interrupted for several days.

Patients with chronic calculous cholecystitis deserve special attention, in which the use of F. can lead to an increase in the motor function of the gallbladder, migration of the stone, its infringement in the bile ducts and an attack of hepatic colic. In this regard, physiotherapeutic methods of treatment are contraindicated for such patients, as well as in severe cholecystitis with frequent exacerbations and the presence of active infection and complications (purulent cholecystitis, gallbladder empyema, active, jaundice).

Chronic cholangitis. Given the presence of infection in the biliary tract, thermal factors (mud treatment, etc.) are not advisable to use. The anti-inflammatory effect is exerted by the UHF electromagnetic field, microwave therapy, amplipulse therapy using sparing methods. It is advisable to combine F. with antibacterial therapy, drinking mineral water, and an appropriate diet. F.'s use is contraindicated in case of a sharp exacerbation of cholangitis, stenosis of the major duodenal papilla, and jaundice.

Postcholecystectomy syndrome. The treatment of patients with nostcholecystectomy syndrome presents significant difficulties. To prevent it, it is important to apply F. in the early stages, 8-10-14 days after the operation. The most effective is complex treatment, which includes, in addition to physiotherapeutic methods, drinking mineral water, balneotherapy, exercise therapy, and massage. Of the physiotherapeutic methods, amplipulse therapy, microwave therapy, an alternating magnetic field, ultrasound in a pulsed mode on the liver area and on the right rear at the level of Th VI -Th X paravertebral are recommended. UHF and microwave therapy, galvanization, drug electrophoresis, which are applied both to the liver area and to the collar zone, have anti-inflammatory and analgesic effects. Electrosleep is also prescribed. Mud therapy (applications of sulfide silt, sapropel or peat mud on the right hypochondrium) is very effective after 2-3 weeks. after cholecystectomy.

Chronic pancreatitis. It is advisable for patients with pain syndrome to carry out electrophoresis of a 5-10% solution of novocaine on the area of ​​the pancreas. For severe pain, sparing techniques should be used. Procedures with a pronounced thermal effect (UHF and HF therapy, etc.) should be prescribed with caution, because they can exacerbate the disease and increase pain. In this regard, they are used in athermic or oligothermal dosage. (intensity 0.4-0.6 W / cm 2) is carried out, respectively, the projection of the pancreas on the anterior abdominal wall. In the presence of pain syndrome, diadynamic therapy is also indicated. A beneficial effect in chronic pancreatitis is provided by amplipulse therapy, microwave therapy (power 25-35 Tue) increases the production of enzymes and bicarbonates to a greater extent than amplipulse therapy, therefore it is indicated for patients with a moderate increase in the activity of pancreatic juice enzymes, and the microwave electromagnetic field can be recommended for patients who have a decrease in the amount of pancreatic juice and the content of enzymes in it. The presence of concomitant cholecystitis is an indication for magnesium electrophoresis. Applications of sulfide silt, peat and sapropelic mud are also used on the left upper half of the abdomen and segmentally. Mud treatment is carried out very carefully, taking a break at the first signs of exacerbation (increased pain, dyspepsia, etc.). The risk of exacerbation is less with the use of galvanic mud. F. should be combined with drinking mineral waters, baths (carbonic, radon, sodium chloride, etc.) and dietary nutrition.

chronic colitis. One of the most effective methods of F. is HF therapy (inductothermy). Microwave therapy, UHF electromagnetic field (pulse or continuous), amplipulse therapy are recommended. Diadynamic currents are also used.

With pain syndrome, electrophoresis of novocaine (2.5% solution), platyfillin (0.2% solution) or galvanization of the intestinal area has a good effect. Sometimes phototherapy procedures are effective: irradiation with a solux lamp, local and general UV irradiation.

An important therapeutic factor in chronic colitis is mud therapy (applications of sulfide silt, peat and sapropelic mud on the abdomen and segmentally); also appoint mud solution electrophoresis, mud inductothermia. With an exacerbation of the disease, the duration and frequency of physiotherapy procedures are reduced or they are temporarily canceled; sometimes antibiotics are prescribed in combination with antihistamines.

F.'s efficiency at chronic colitis increases in a complex with a diet, drinking of mineral waters, water procedures.

Physiotherapy in diseases of the nervous system. As a rule, in the treatment of neurological diseases, both local and segmental and general effects of physical factors are used. For example, local exposure (ultrasound, exercise therapy, massage, mud therapy, etc.) leads to accelerated regeneration of nerve fibers, protects against ischemia, edema, and improves the motor function of the limb.

With segmental exposure, in addition to a direct effect on (injuries and diseases of the spinal cord, condition after removal of a benign tumor, cysts, etc.), compensatory capabilities develop through intact, but previously inactivated nerve structures of the damaged limb, which leads to an improvement in spinal circulation and activity. motor neurons. Through the use of baths, heliotherapy, climatotherapy, the overall effect of physical factors on the body is carried out. In this case, afferent signaling (stimuli), specific for one or another effect, comes in a continuous stream from the peripheral parts to the central nervous system.

Complex treatment affects not only the local focus, but also the cortical and subcortical-stem levels, causing a number of vasomotor-hormonal shifts (hormones).

Due to the extensive influence of F. on various processes and functions of the body, physical methods of treatment are widely used in neurology for preventive, therapeutic, and rehabilitation purposes. For example, F.'s use in the initial stages of insufficiency of blood supply to the brain or discirculatory encephalopathy helps to prevent the development of more severe manifestations of cerebral vascular insufficiency.

With neurosis with visceral manifestations, vibration disease, initial manifestations of diseases of the peripheral, autonomic nervous system, atherosclerosis of cerebral vessels, arterial hypertension, drug electrophoresis is used according to various methods (reflex-segmental, transcerebral, according to the method of general effect, on vegetative formations, etc.). Widespread exposure to pulsed currents (according to the method of electrosleep), UHF electric field, as well as spa treatment for neuroses. General mineral baths improve microcirculation, the functions of the endocrine glands, prevent dystrophic changes in nerve cells and vascular walls, peripheral nerves, and therefore staying at climatic and balneotherapeutic resorts is indicated, for example, after transient cerebral ischemia, in the stage of remission of chronic recurrent diseases of the peripheral nervous system. systems in connection with osteochondrosis of the spine, etc.

As part of the treatment of diseases of the peripheral nervous system (traumatic, infectious, allergic, toxic, vertebrogenic origin), in order to combat pain (headaches, phantom pains, causalgia, neuralgia), short-pulse, diadynamic, sinusoidal modulated currents, ultrasound, ultraphonophoresis, laser irradiation are used. and other physical factors, as well as their combination. In order to improve cerebral circulation, brain metabolism, aggregation properties of blood in the early after ischemic disorders of cerebral circulation (mild and moderate strokes), electrophoresis of the so-called antiplatelet agents, amino acids, an alternating magnetic field, microwave and UHF therapy, hydrogen sulfide, iodine-bromine, carbonic (including "dry"), nitrogen, nitrogen-radon and other baths. In injuries and diseases of the spinal cord, where vascular disorders play an important role, along with these methods, eufillin electrophoresis, amplipulse therapy, high-frequency therapy, mud therapy are used, which not only improves blood circulation in the spinal cord, but also trains spinal compensation mechanisms, contributing to the involvement of inactivated motor neurons, as in cases of activation of the so-called silent neurons during strokes.

In the late periods of neurological diseases, along with the use of psychological, social, labor factors, F methods are also used to rehabilitate patients. Exposure to physical factors can be used even in the acute period of vascular, traumatic diseases of the brain or spinal cord, peripheral nervous system in order to prevent contractures, bedsores , the appearance of synkinesis (exercise therapy, massage, electrical stimulation, etc.). In the early recovery period, the range of F. methods expands: drug electrophoresis, amplipulse therapy, UHF and microwave therapy are prescribed, and after 4-10 weeks. artificial mineral baths.

In the late and residual periods of the disease, spa treatment is used - mineral baths, mud applications, climatoheliotherapy, etc.

Physical methods of treatment are also used before and after stereotaxic operations for parkinsonism (, amplipulse therapy, microwave therapy, levodopa electrophoresis, hydrogen sulfide, radon baths); with progressive muscular dystrophies (ultrasound, diadynamic therapy, amplipulse therapy, drug electrophoresis, exercise therapy, mud applications, etc.); syringomyelia (radon, radon steam baths); with myasthenia gravis (exercise therapy, electrophoresis, UV irradiation, baths); multiple sclerosis (hydrocortisone ultraphonophoresis, mineral baths, ultrasound, UHF therapy); after removal of benign tumors of the spinal cord (baths, exercise therapy, massage); after reconstructive operations on the vessels of the brain in case of injuries, vascular diseases (microwave therapy, amplipulse therapy, exercise therapy in the pool, oxygen, "dry" carbon dioxide baths); after removal of the disk and reconstructive operations on the nerves and plexuses (ultrasound, amplipulse therapy, mud therapy, exercise therapy, massage, electrical stimulation, etc.).

Contraindications for F. in neurological diseases: acute period of the disease, progredient forms of infectious diseases of the central nervous system, tumors of the brain and peripheral nerves, with frequent seizures, psychosis and cachexia.

Physiotherapy for diseases of the female genital organs. In gynecology, F. is used for the purpose of hemostasis, regulation of the menstrual cycle, elimination of vegetative-vascular disorders, elimination (reduction) of the inflammatory process, pain, adhesions, and for the prevention of complications after operations. In the absence of urgent indications, the optimal time for the first physiotherapeutic procedure is the 5-7th day of the menstrual cycle, when negative general and focal responses of the body are least likely; it is expedient to carry out procedures daily, because. rarer impacts are less effective. During menstruation, F. is not interrupted, replacing only intravaginal effects with intrarectal or extracavitary (cutaneous) effects. With an increase in menstrual blood loss during F., it is advisable to reduce the intensity of the physical factor; if this does not help, then F. is stopped and the patient is examined to exclude fibroids, internal endometriosis (adenomyosis) and other diseases of the uterus. It is also important to take into account the course of F., which in gynecological patients continues on average: after mud therapy 6 months, ozokerite therapy - 4-5 months, mineral baths and irrigation - 4 months, electrotherapy - 2 months. Due to the aftereffect period, the long-term results of F., as a rule, are more favorable than the immediate ones. A repeated course of the same physiotherapeutic procedures is justified only when the previous one was effective, and the interval between courses should not be less than the aftereffect period. During the entire course of F. and the period of its aftereffect, women of reproductive age need careful attention.

Menstrual irregularities. It is desirable that F. preceded hormonal treatment, tk. this will either avoid it or carry it out in smaller doses. With bleeding during puberty (the so-called juvenile bleeding), if they are associated with an acute infectious disease (, tonsillitis, etc.), endonasal calcium electrophoresis according to Kassil is performed; if irregular menstrual-like discharge against the background of hyperestrogenism precedes, electrophoresis of novocaine is prescribed to the zone of the upper cervical sympathetic ganglia (with increased sensitivity to novocaine, galvanization of this zone is possible). With frequent juvenile bleeding against the background of moderate or low estrogenic activity, a selection massage of the paravertebral zones at the level of the lower thoracic and cingulate vertebrae is indicated. In girls over 15 years old with genital infantilism, a hemostatic effect can be achieved by causing mammary-uterine, which provides the muscles of the uterus by galvanizing the mammary glands or vibrating nipple massage. Bleeding during puberty of central genesis can be eliminated by electrophoresis of novocaine in the area of ​​​​the upper cervical sympathetic ganglia or (if novocaine is intolerant) by excitation of the mammary-uterine reflex. In case of mastopathy, the effect of physical factors on the mammary glands is contraindicated, and therefore such patients undergo galvanization of the zone of the upper cervical sympathetic ganglia. With peripheral (ovarian) genesis of dysfunctional uterine bleeding and hyperestrogenism, electrical stimulation of the cervix with low-frequency pulsed currents is most effective, electrophoresis of novocaine on the zone of the upper cervical sympathetic ganglia or (if this drug is intolerant) its galvanization is also indicated.

With some violations of the menstrual cycle without bleeding (hypergonadotropic and hyperprolactinemia), it is advisable to refrain from F.. With emotional-neurotic and vegetative-vascular disorders, aerotherapy is carried out), after the exclusion of hyperestrogenism - heliotherapy, thalassotherapy, manual massage of the collar zone, dousing, rain. With previously transferred inflammatory diseases of the brain, coniferous, pearl, iodine-bromine baths, galvanization of the cervico-facial zone according to Kellat (to normalize cerebral circulation) are advisable. With vegetative-vascular, metabolic and trophic disorders, after exclusion of hyperestrogenism, carbonic baths are possible, and if it is present, radon and nitrogen-radon baths and vaginal irrigation; endonasal galvanization according to Kassil is effective. With hypoestrogenia of central origin, hydrogen sulfide baths and vaginal irrigations, arsenic baths and vaginal baths, as well as carbon dioxide, turpentine or nitrogen baths are used; copper electrophoresis is effective. In case of hyperestrogenism with insufficiency of the luteal phase of the menstrual cycle and especially anovulation, the use of ozokerite, hydrogen sulfide, arsenic, carbonic, nitrogen, highly concentrated sodium chloride waters, turpentine baths, mountain climate, ultrasound, vibration and gynecological massage, high-frequency therapy (inductothermy), copper electrophoresis is contraindicated . Recommended electrophoresis of iodine, in case of insufficiency of the luteal phase - iodine and (or) zinc; radon and iodine-bromine baths and vaginal irrigation. In case of menstrual irregularities, sanatorium-resort treatment, treatment in local sanatoriums, sanatoriums-dispensaries are usually indicated.

Climacteric and post-castration syndromes- indications for aerotherapy and hydrotherapy (including at home - dousing, washing, rain shower, coniferous, sage, contrast foot baths). If they are ineffective, central or endonasal galvanization of the cervicofacial, collar zones is indicated. Treatment is also recommended in sanatoriums, local sanatoriums, as well as in the resorts of the southern coast of Crimea (in the non-hot season) and the Baltic states. Bleeding in the menopause can be eliminated by F. only after the exclusion of signs of a malignant process (the methods are the same as during puberty).

Benign and hyperplastic processes usually subject to surgical treatment. In other cases, radon and iodine-bromine baths, galvanization, diadynamic therapy, amplipulse therapy, fluctuorization, an alternating magnetic field, as well as drug electrophoresis are prescribed, excluding. Local effects can be localized both on the upper half of the body (excluding the mammary glands), and in the suprapubic, inguinal, hypogastric, lumbosacral regions or on the thighs. With uterine myoma against the background of prolonged endocrine disorders, iodine-bromine baths or endonasal galvanization are prescribed; with myoma, which was preceded by chronic inflammatory gynecological diseases or intrauterine interventions, radon baths, electrophoresis of iodine or iodine and zinc are indicated. The same F. methods are used for le treatment of endometriosis, as well as after operations for uterine fibroids and endometriosis. With mastopathy, iodine-bromine baths and iodine electrophoresis are prescribed (only for the pelvic organs). With benign hyperplastic processes in the endometrium, F. concomitant gynecological diseases is contraindicated, as well as spa treatment.

Treatment of genital infantilism provides for aerotherapy, heliotherapy, thalassotherapy, hydrotherapy. The more pronounced the morphological (reduction in the size of the uterus) and functional (decrease in the estrogenic activity of the ovaries) inferiority of the reproductive system, the more soft and gentle the F should be. mud, ozocerite, hydrogen sulfide mineral waters; HF therapy (inductothermia) is also possible. If the size of the uterus is slightly reduced, but there is a pronounced ovary, it is advisable to use sodium chloride waters, copper electrophoresis, vibration massage, as well as carbon dioxide and nitrogen waters, high-frequency therapy (inductothermy) using a vaginal applicator, vibration massage of the paravertebral zones in the region of the lower thoracic segments of the spinal brain.

Inflammatory diseases. In case of vulvovaginitis in children, general UV irradiation, irradiation of palatine tonsils, posterior pharyngeal wall and external genital organs with UV rays are sequentially carried out on the same day. At home, warm sitz baths with chamomile infusion are useful. With bartholinitis, the focus is affected by UV radiation, UHF and microwave electric fields. Physiotherapy of inflammatory diseases of the uterus, appendages, pelvic peritoneum and fiber in the acute stage is possible only if the process is limited and stabilized. Conduct UV irradiation of the abdomen and lumbosacral region, low-frequency magnetotherapy, microwave therapy. In the subacute stage of the disease, the same physical factors are used, and in the presence of uterine fibroids or endometriosis, electrophoresis of acetylsalicylic acid, magnesium, zinc, and calcium is used.

In chronic inflammatory diseases, a prerequisite for F. is to determine the initial hormonal function of the ovaries, so that, for example, in case of hyperestrogenism, procedures that increase the estrogen of the ovaries are not prescribed. With endometritis, therapeutic mud is used (in the form of panties, vaginal tampons); hydrogen sulfide baths and vaginal irrigation, microwave therapy, low-frequency alternating magnetic field, electrophoresis of acetylsalicylic acid, magnesium, zinc. With salpingoophoritis (salpingitis), peri- and parametritis during the period of exacerbation, low-frequency magnetotherapy is indicated, and for intense pain, microwave therapy. Patients with uterine myoma, endometriosis, mastopathy undergo electrophoresis of medicinal substances recommended in the subacute stage of these diseases; with pain syndrome, diadynamic or sinusoidal modulated currents are effective, as well as (in patients with neurocirculatory dystonia); transcutaneous electrical nerve stimulation, ultrasound therapy are indicated. Patients of reproductive age with obstruction of the fallopian tubes and peritubar adhesions leading to infertility, as well as adhesions in the pelvis with a fixed retroversion of the uterus, are shown ultrasound therapy, turpentine baths, iodine electrophoresis, after clinically cured tuberculosis of the genitals - interference currents, and after gonorrhea - hydrogen sulfide baths and vaginal irrigation, in addition, patients under 30 years old - HF therapy (inductothermy), therapeutic ozokerite,. With residual (residual) manifestations of chronic salpingo-oophoritis (mainly in the form of chronic pelvic pain), the same F. is carried out as during an exacerbation of the disease, and emotional-neurotic and other secondary functional disorders are eliminated (reduced) with the help of hydrotherapy, iodine-bromine baths, galvanization (endonasal, as well as collar or cervicofacial zones). F. is indicated for functional tubal infertility: patients with hypertonicity of the fallopian tubes are prescribed magnesium electrophoresis or radon baths and irrigation; with discoordination of contractile activity - galvanization of the endonasal or collar zone; in the absence or decrease in the contractile activity of the fallopian tubes - their electrical stimulation or hydrogen sulfide baths and vaginal irrigation.

Early recovery F. after gynecological operations is necessary for all patients (except those operated on for malignant tumors, cystomas). It should be started from the first (but not later than the third) day after the operation, i.e. before adhesion of tissues in the small pelvis, preceding adhesion formation. Low-frequency magnetotherapy is effective, less - UHF-therapy. After reconstructive operations on the fallopian tubes, their electrical stimulation is advisable. In all cases, it is advisable to start F. with extracavitary (cutaneous) procedures, and only after adequate reactions to 3-6 such effects, move on to intracavitary.

Physiotherapy in obstetrics. For preventive purposes, pregnant women are shown aero- and at home, general UV irradiation. After the artificial termination of the first pregnancy, copper electrophoresis is indicated, which begins after 1-2 h after surgery and continue in the outpatient setting. With the threat of miscarriage, endonasal galvanization, transcutaneous electrical nerve stimulation, magnesium electrophoresis and uterine electrorelaxation are used to reduce the contractile activity of the uterus. With early toxicosis of pregnant women (excluding indomitable vomiting), central electroanalgesia is effective, with late toxicosis it is advisable only for nephropathy of the I degree of severity; carry out central electroanalgesia or galvanization of the collar zone; with a pronounced immunoallergic component, microwave therapy is most adequate (impact on), with placental insufficiency, transcutaneous electrical nerve stimulation. Restorative F. after late toxicosis includes central electroanalgesia, galvanization of the collar zone, or endonasal galvanization. With nipple cracks in a puerperal, ultrasound therapy is most effective. Lactostasis can be eliminated by UV radiation of the mammary glands, but F. lactational mastitis is not effective enough. For prophylactic purposes, starting from the 2nd day. after surgery on the perineum in childbirth, the sutures are exposed to UV radiation or a helium-neon laser, and starting from the 3rd day. after caesarean section, local UV radiation is performed. With adequate responses, up to 4 procedures per day can be performed, influencing the same factor on one zone (for example, endonasal galvanization), one factor on different zones (UV irradiation of the mammary glands and perineum), or different factors on different zones; influences by various factors on one zone should be refrained from.

Physiotherapy in urology. Patients with pyelonephritis are prescribed drinking mineral water, sodium chloride and carbon dioxide baths, amplipulse therapy, microwave therapy, ultrasound, UHF therapy, direct current. Most often, the complex of treatment includes drinking mineral water, a mineral bath and one of the named physical factors. After surgery for urinary tract stones and acute pyelonephritis, F. is prescribed at different times - from 10 days or more - depending on the nature of the course of the postoperative period and the activity of inflammation. F. is contraindicated in primary and secondary pyelonephritis in the phase of active inflammation, the terminal stage of chronic pyelonephritis, polycystic kidney disease, decompensated hydronephrosis. Microwave therapy is also contraindicated in coral stones of the kidneys, stones of the pelvis and calices of the kidneys.

Patients with acute cystitis are treated with UHF therapy, irradiation of the bladder area with an infrared lamp, sodium chloride baths or sitz baths from fresh water at a temperature of 37 °, paraffin (ozocerite) applications locally or on the lumbar region. With moderate inflammation, ultrasound is used, acting directly on the neck and anatomical triangle of the bladder vaginally or rectally. With hyperreflexia, detrusor hypertonicity, amplipulse therapy is prescribed both in its pure form and for gangleron electrophoresis. In the stage of remission of cystitis, mud rectal or vaginal tampons, mud "cowards", iodine-bromine, sodium chloride, carbonic baths are used. Contraindications for F. in patients with cystitis are oxalates and precipitate with an acid reaction of urine, drinking alkaline bicarbonate sodium or calcium waters is indicated. With phosphate stones that form in alkaline urine, drinking carbonic-hydrocarbonate calcium-magnesium waters is shown, which lowers the pH of the urine. Drinking mineral water is not indicated in violation of the passage of urine, prostate adenoma, insufficiency of kidney function and the cardiovascular system. When the calculus is located in the ureter at any level, drinking mineral water, high-frequency therapy (inductothermy), and amplipulse therapy are consistently used. After taking mineral water in 30-40 minutes, inductothermia is carried out in the projection of the location of the calculus in the ureter on the back or abdominal wall. Immediately after this, amplipulse therapy is prescribed, placing one electrode in the projection area on the lower back, and the second in the suprapubic region at the projection site of the lower third of the ureter. Instead of inductothermy, microwave therapy and sodium chloride baths can be used. When the calculus is located in the lower third of the ureter, the treatment complex includes drinking mineral water, sodium chloride baths and ultrasound (they act vaginally or rectally at the site of the calculus projection). Complex F. is not indicated for stones larger than 10 mm in diameter, acute pyelonephritis, significant anatomical and functional changes in the kidneys and ureter on the side of the lesion, cicatricial narrowing of the ureter below the location of the stone.

In the treatment of patients with chronic prostatitis, mud therapy in the form of panties and tampons, hydrogen sulfide baths and microclysters are used. turpentine baths, ultrasound, amplipulse therapy, laser, low-frequency magnetic field, UHF and microwave electric fields. Contraindications for F. in these patients are acute inflammatory diseases of the rectum and prostate, rectum, anal fissures, acute hemorrhoids, and prostate. For the use of ultrasound prostate adenoma is not a contraindication.

Physiotherapy in pediatrics. Even in the presence of irreversible changes, the early use of F. in combination with educational and other measures helps the child adapt to life due to the large compensatory capabilities of the growing organism. In connection with the anatomical and physiological characteristics of the child's body (increased nervous system, delicate, richly vascularized, with a large resorptive capacity; high water content in the tissues and the resulting large deep-seated organs exposed to electric current, etc.), the dosage of F. methods and the duration course of treatment should be less, the younger the child. Thus, the biodose should be determined at intervals of 15 With and check in 6-8 h; current density for young children should not exceed 0.02 mA/cm2, for preschoolers - 0.03 mA/cm2; electric field can be applied with an output power of up to 30 Tue; number of procedures per course up to 10, etc. In pediatrics, UV radiation, water and heat treatment are most widely used as the most biologically adequate, as well as impulse effects that reduce the energy load on the body.

Most often F.'s methods apply at the following diseases of children. Newborns with diseases of the skin, navel (diaper rash, omphalitis) are prescribed short air baths in combination with local irradiation with a Minin lamp, warm fresh baths with potassium permanganate, UV radiation, UHF electric field (3-4 procedures); with purulent omphalitis - a combination of an electric UHF field and UV radiation (5-6 procedures) in combination with antibiotics. For the treatment of phlegmon of newborns, acute hematogenous osteomyelitis, immediately after surgery, UV irradiation, UHF electric field, laser radiation, hemolytic disease - phototherapy (irradiation with blue light for 6-8 h per day with a break every hour, the course is 3-5 days). With the consequences of a birth injury (brachial plexus, clavicle,) an UHF electric field, irradiation with a Minin lamp, warm baths (for plexitis), then ozocerite applications, amplipulse therapy, iodine electrophoresis are used.

In order to prevent and treat rickets, general long-wave UV irradiation or UV irradiation is carried out, starting from 1/6 - 1/4 of the biodose, gradually increasing to 1 1/2 -2 biodose by the end of the course of 15-20 exposures. It is impossible to combine UV irradiation with taking vitamin D preparations. Sodium chloride baths, massage are also recommended, and for skeletal deformities and muscle hypotension, ozocerite applications, HF therapy (inductothermia), calcium electrophoresis, sand baths.

F.'s role at allergic diseases is especially great. diathesis, children's, neurodermatitis are often associated with food allergies. In the period of subsiding inflammatory manifestations, an alternating magnetic field is used segmentally and on lesions (12-15 procedures), warm medicinal baths (, series, etc.), in the presence of infiltration, skin itching - ozokerite applications, darsonvalization, ultrasound (oscillation frequency 2640 kHz), electrosleep, calcium electrophoresis. In the period of remission, general UV irradiation, radon, hydrogen sulfide, sodium chloride baths, mud therapy, drinking mineral waters, and thalassotherapy are used.

For the treatment of bronchial asthma, asthmatic bronchitis and other respiratory allergies in infectious-allergic forms in the period of subsidence and out of attacks in combination with hyposensitization, electroaerosol inhalations of antispasmodics, amplipulse therapy, ultrasound, an alternating magnetic field, drug electrophoresis (eufillin, etc.) are prescribed for chest, electrosleep; with current endobronchitis - UHF electric field, microwave and high-frequency therapy, then electrophoresis: UV erythema, massage, therapeutic exercises. In the period of remission - baths (carbon dioxide, radon, chloride, sodium), electrosleep, histamine electrophoresis, exercise therapy, swimming. With pollinosis - endonasal intal electrophoresis, diphenhydramine, in the period preceding the flowering of plants, which reduces the severity of allergic manifestations. Acute respiratory diseases (, bronchitis,) in young children occur with significant violations of the general condition and external respiration. In the initial stage, they are pumped with heat-moist (oxygen, medicinal) inhalations, ozocerite "boots", UV irradiation of the feet, mustard wraps, and if the child is worried - warm baths. In older children - UV irradiation of the mucous membrane of the nasopharynx, UHF on the area of ​​the paranasal sinuses. In the period of resolution of bronchopulmonary changes - inductothermia, UHF therapy, UV erythema, microwave therapy, ozocerite applications, drug electrophoresis (ascorbic acid, magnesium, calcium, mud solution, etc.), massage, therapeutic exercises. In remission and in the presence of residual effects - aerosol therapy, mineral baths, mud therapy, massage, hardening procedures, general UV irradiation. In chronic bronchopulmonary diseases in the period of exacerbation, the same F. methods as in acute ones; in the period of remission - sanatorium treatment.

Diseases of the organs of support and movement (congenital hip, congenital, osteochondropathy, scoliosis, rheumatoid arthritis, trauma, etc. . ) require the widespread use of F. methods for the treatment and rehabilitation. In the period of subsiding inflammatory, dystrophic changes, subacute course, UV erythema, UHF electric field, amplipulse therapy, diadynamic therapy, microwave therapy, ultrasound, drug electrophoresis are used (in combination with orthopedic measures) , electrical stimulation, mineral baths, massage, hydrotherapy; in the period of remission, after corrective operations in the stages of recovery - sanatorium treatment, mud therapy, sea bathing,.

In diseases of the nervous system (children's cerebral, consequences of neuroinfections, craniocerebral injuries, peripheral nerves, neuromuscular dystrophies, etc.), physiotherapy methods are of primary importance in rehabilitation treatment. In the period of subsiding inflammatory changes and with residual phenomena, warm baths, amplipulse therapy, UHF electric field, HF therapy (inductothermy), wool wraps, drug electrophoresis, electrical stimulation, mineral baths, UV irradiation, massage, exercise therapy are widely used; Spa treatment. With neurotic reactions, neuroses (, tics, etc.), therapeutic baths, electrosleep, endonasal galvanization, drug electrophoresis, and general UV irradiation are very effective.

For the treatment of diseases of the ENT organs (otitis media, tonsillitis, rhinosinusitis, etc.), in the stage of subsiding acute inflammation or exacerbation of a chronic process, irradiation with a Minin lamp, UHF electric field, UV irradiation, inhalation, drug electrophoresis, ultraphonophoresis, then ozocerite applications are applied locally; in the period of remission - general UV irradiation, baths, mud therapy, climatotherapy.

In diseases of the digestive system (, dyskinesia, gastroduodenitis, duodenal ulcer, colitis, etc.), liver and biliary tract (dyskinesia, cholecystitis, etc.), high-frequency therapy (inductothermy), drug electrophoresis, amplipulse therapy, diadynamic therapy, alternating magnetic field, ozocerite and mud applications, mineral water drinking, massage, exercise therapy; in the period of remission - sanatorium treatment.

F. is also important in the prevention of diseases and the correction of risk factors. For example, in diseases of the cardiovascular system (myocarditis, arrhythmia, arterial cardiopathy, etc.), in order to prevent relapses and progression of the disease, mineral (carbon dioxide, hydrogen sulfide, bromine) baths, mud therapy, UV irradiation, electrosleep, drug electrophoresis are prescribed. For diseases of the urinary organs (chronic, cystitis,), metabolic diseases, balneotherapy methods are widely used - drinking mineral waters, mineral baths, applications of therapeutic mud in the period of remission, in the subacute stage - UHF electric field, microwave therapy on the projection area of ​​the kidneys, amplipulse therapy , electrical stimulation - with hypotension of the ureters, megaureter.

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984. - PHYSIOTHERAPY, physiatry, physical therapy, physical. methods of treatment, is a scientifically practical discipline that has the task of studying the influence of various physical. agents on healthy and diseased organisms and their use with preventive and therapeutic ... ... Big Medical Encyclopedia

Physiotherapy is a field of medicine that studies the therapeutic and physiological effects of natural or artificially created factors on the human body. Physiotherapy also helps in recovery after surgery or illness, and as preventive procedures. The main feature of physiotherapy is that the treatment is carried out without the use of chemical drugs. Let us consider in more detail what physiotherapy procedures are.

Benefits of Physical Therapy

The main advantage of physiotherapy over other methods of therapy lies in its high efficiency and security. It does not require the use of drugs and, in addition, allows you to reduce the use of drugs by several times. Thanks to physiotherapy, the likely side effects of both the disease itself and its treatment, which can adversely affect the body's defenses, are minimized.

Physiotherapy activates the internal reserves of the body, helps to strengthen the immune system, resulting in a shorter treatment time, accelerates wound healing, and stimulates important biochemical processes in the body. This helps the body's natural forces to tune in to recovery. Physiotherapy with success used to treat various diseases and systems of the human body. As an independent method of treatment, it is effective at the initial stage of the development of the disease.

Physiotherapy is divided to natural and artificially created. In the first case it is:

• climatotherapy (rest in the mountains, by the sea);
• hydrotherapy;
• balneotherapy (treatment with mineral waters);
• thermotherapy (treatment with cold and heat);
• pelotherapy (treatment with mud).

Hydrotherapy is considered the most familiar and accessible direction. These are lotions, compresses, contrast showers, wrappings, taking foamy, salt, steam baths and aromatic oils, as well as visiting a bath. A popular method of treatment and prevention of various diseases is climatotherapy, rest by the sea in a sanatorium.

Artificial physiotherapy includes:

Let's take a closer look at the most popular of them.

Galvanization

This physiotherapy is use of direct electric current slight tension and strength for medicinal purposes. It is indicated in the following cases: damage to the peripheral nervous system of traumatic, toxic and infectious origin, neurotic conditions, consequences of traumatic and infectious lesions of the central nervous system, peptic ulcer and hypertension in the initial stage, vasomotor disorders, migraine, trophic disorders, sexual and gastrointestinal disorders, chronic arthritis and polyarthritis, myositis, etc.

Medicinal electrophoresis

Such a physiotherapy combines the effect on the body of direct current and the medicinal substance administered with its help. The intake of such drugs into the body is carried out through sweat and sebaceous glands, as well as intercellular spaces in the form of negative or positive particles (ions). If biological tissues meet on their way, then the ions will penetrate into the depths of the tissues, providing a therapeutic effect.

The indications for the use of drug electrophoresis are quite wide and they are determined by the pharmacotherapeutic properties of the administered agent, while the indications for the use of direct current must be taken into account. It should be noted that it is rather difficult to find a disease in which this physiotherapy would not be beneficial.

Galvanized mud

Galvanic mud is a procedure using electric current and therapeutic mud. It resembles electrophoresis in many ways, only a mud cake is applied to a diseased organ or joint and a direct galvanic current is connected, having a force of not more than 1 mA. Healing components of silt-sulfide mud under the influence of electric current begin to actively penetrate into the tissues, enriching the body with important components necessary for recovery.

Thanks to this physiotherapy, the trophic and regulatory functions of the nervous system are enhanced, brain metabolism and blood circulation are improved, the regeneration of damaged nerve trunks is accelerated, lymph circulation is stimulated, and the secretory function of the liver is enhanced. Galvanic mud has a beneficial effect on internal organs.

UHF therapy

Ultra-high frequency therapy is that the body is exposed to ultrahigh frequency electric field, which is brought to the patient with the help of capacitor plates. In them, the ions oscillate under the influence of current and a thermal effect is created. This procedure is called warming up.

UHF therapy favorably affects the functional state of the endocrine glands, the nervous system, blood and lymph circulation, and improves metabolism. This physiotherapy has an antispastic, desensitizing, analgesic and anti-inflammatory effect, improves tissue trophism and stimulates the body's defenses.

Indications for its implementation are: acute and subacute inflammatory diseases, obliterating endarteritis, some diseases of the peripheral nervous system, progressive muscular dystrophy, poliomyelitis, causalgia, sciatica, long-term non-healing ulcers and wounds. Contraindications: pronounced thyrotoxicosis and atherosclerosis, heart failure with symptoms of decompensation, neoplasms, pregnancy, bleeding tendency, tuberculosis.

EHF-therapy

This procedure consists in the fact that the body is affected millimeter wave very high frequency. It is used to treat various diseases that occur as a result of a decrease in the protective functions of the body. Thanks to EHF-therapy, immunity increases, blood picture improves, tissues are restored, wounds, erosions, and ulcers heal quickly. Relapses of chronic diseases are becoming less and less frequent. In addition, the body becomes much more resistant to other ailments.

Magnetotherapy

Magnetotherapy is a procedure in which an alternating low-frequency magnetic field is used for therapeutic purposes. Under its action, low-frequency eddy currents arise in the tissues, because movement of charged particles. Such eddy currents lead to a change in the biochemical and physico-chemical processes of the body.

Scientists have not fully studied the mechanism of the effect of magnetic fields on human tissues and organs, but it was found that this improves metabolism and blood circulation. In addition, they have anti-inflammatory and analgesic effects.

As a result of the action of an alternating magnetic field in the mucous membranes, tissue permeability begins to decrease, microcirculation accelerates, and peripheral capillary tone increases, which indicates the elimination of venous stasis and an increase in the level of oxygen saturation in the blood.

Ultraviolet irradiation (UVI)

Ultraviolet rays are necessary for the human body for its normal functioning, and when used in therapeutic doses, they help dilate blood vessels in the skin, dissolve and reduce the activity of the inflammatory process, increase blood flow, have a beneficial effect on the immune and nervous systems, have a bactericidal effect, and normalize metabolism.

UVR is used to treat neurological, gynecological, surgical, dermatological, ENT diseases. Contraindications: tendency to bleeding, exacerbation of peptic ulcer of the stomach and duodenum, atherosclerosis of the coronary vessels and arteries of the brain, malignant neoplasms, thyrotoxicosis, hypertension, active tuberculosis, systemic blood diseases.

Thus, physiotherapy has only beneficial effect on the human body, helping in the treatment of various diseases of systems and organs. In addition, physiotherapy is an excellent means of preventing many ailments. Typically, this procedure is used as an additional method in the general course of treatment.

Physiotherapy is a field of medicine that studies the effects of artificial and natural physiological factors on the body. For any type of therapeutic effect on the human body, there are both indications and contraindications. What is a contraindication? This is a certain condition under which it is highly undesirable to use any particular method of treatment. is no exception and physiotherapy, contraindications are also present in it. Among the contraindications in physiotherapy, there are diseases that have not been sufficiently studied to date.

What is physiotherapy?

Physiotherapy is a very ancient science. Therefore, we can say with confidence that its methods of influencing the human body are almost perfect. It is engaged not only in the treatment of various diseases, but is also successfully used as a prevention of various diseases.

For all the time of its existence, physiotherapy has improved every day, as a result, today it includes a huge amount of medical knowledge in various fields. In general, physiotherapy itself is not a unidirectional medicine and has many highly specialized sections, including, such as:

treatment by means of the influence of electric current on the human body - diadynamic therapy;
treatment with low-frequency laser beams - laser therapy;
treatment of eye diseases - ophthalmology;
electricity treatment - amplipulse therapy;
restorative treatment of muscles and nerves, by means of electricity - myostimulation;
thermal radiation treatment;
cold treatment - cryotherapy.

All these sections are an integral part of physiotherapy. And each of them has its own contraindications, among them there are those that are completely incompatible with physiotherapy, and those that are permissible under certain conditions. Let's dwell in more detail on the permissible contraindications.

Contraindications for which physiotherapy is acceptable

Modern methods of physiotherapeutic effects on the body are constantly being improved. This has reduced the number of contraindications. For example, until recently, it was not desirable to use physiotherapy for any manifestations of impaired cerebral circulation or chronic coronary insufficiency. But today, with such symptoms, it is permissible to use treatment with the help of drug electrophoresis and other methods of physiotherapy.

Nevertheless, at the moment, most of the methods of physiotherapy used have contraindications, for example, such as bleeding. However, with such a symptom, electrophoresis with aminocaproic acid is quite acceptable, which helps to stop bleeding. You can also apply an integrated approach - homeostatic remedies and treatment with ultra-high frequencies. The use of such an integrated approach is safe for children's health and has a beneficial effect on the child's body, helps to reduce the frequency of hemorrhages.

Physiotherapy does not stand still, new treatment methods are constantly being developed, due to this, the list of contraindications is regularly reduced. Of the latest innovations in this medical science, one cannot fail to mention such a wonderful method as a carbon dioxide bath. In the process of applying this technology, hydrostatic water pressure is not exerted on the human body, so this bath can be used even when serious diseases occur, for example, with a stable course of angina pectoris, as well as in a number of other diseases in which water is contraindicated.

Now let's go directly to the contraindications, in which the use of therapeutic methods of physiotherapy is not recommended.

The main contraindications for physiotherapy

So, let's look at the general contraindications, in which it is not recommended to resort to treatment with physiotherapeutic methods:

A sharp exacerbation of various inflammatory processes.
Feverish state, high temperature.
Acute infectious diseases.
Cachexia is a critical lack of weight.
Tuberculosis, active.
Bleeding or manifestation of inclinations to this disease.
Malignant tumors or suspicion of their formation.
Diseases of the cardiovascular system.
Blood diseases.
Aortic aneurysm.
Diseases of the central nervous system, especially in pronounced forms.
Increased blood pressure.
Atherosclerosis of cerebral vessels, in pronounced forms.
Extrasystole and atrial fibrillation - violation of the heart rhythm.
Epilepsy, especially in a pronounced form, accompanied by seizures.
Psychosis and hysteria.
With a pacemaker.
Acute infectious diseases.

Private contraindications

What are private contraindications? This is an individual intolerance to one or another type of physiotherapeutic method of treatment. Below is a list of such particular contraindications:

DC intolerance.
Violated integrity of the skin - cracks, abrasions, rash.
Allergy to the applied pharmaceutical preparation.
The presence of metal objects implanted in the body, such as a pacemaker.

Contraindications to the use of phonophoresis and ultrasound

If you decide to resort to physiotherapy, contraindications that are applicable to phonoresis treatment and ultrasound therapy methods, you should know:

Pregnancy in the early stages. It is especially not recommended to radiate the lower abdomen.
Diseases of the cardiovascular system - hypotension, angina pectoris, thrombophlebitis, vegetative vascular dysfunction, arrhythmia.
Severe suppuration, especially in the irradiated area.
Nevus eczema.
Myopia of the retina, in case there is a therapeutic effect on the eyes.
Cholelithiasis and urolithiasis if the lower back or abdomen radiates.
Acute pneumonia or bronchitis.
Ulcer, especially during complications.
Chronic skeletal disease - osteoporosis.

There are also contraindications to the use of magnetic and laser therapy, we will consider them.

Contraindications to the use of magnetic laser therapy

Magnetic laser therapy is a powerful and effective treatment system. This important section of physiotherapy also contains a number of contraindications, among them the following should be noted:

the formation of a blood clot on the walls of the veins - thrombophlebitis;
pronounced hypotension, that is, a regular, sharp drop in blood pressure;
aortic aneurysm;
thyroid nodules;
pregnancy.

Here, in principle, the entire list of contraindications in the treatment of physiotherapy methods.

Physiotherapy (physiotherapy treatment, physiotherapy, physical or physical therapy, physiatry) is a specialized field of clinical medicine, the purpose of which is to study and use natural and artificially obtained physical factors for therapeutic and prophylactic purposes without destroying tissues. Natural (or natural) factors are water, air, sunlight and heat. Artificial include ultrasound, laser, electric current, magnetic field, various kinds of radiation (infrared, ultraviolet, etc.). Physiotherapy treatment is one of the oldest methods in medicine, a large number of physiotherapeutic methods of influencing a person were known many centuries ago. The term "physiotherapy" itself comes from the Greek words "physis" (nature) and "therapeia" (treatment, therapy).

Physiotherapy has long been used to treat a wide range of various diseases, because. provides a good therapeutic effect, minimal burden on the patient's body and the absence of unforeseen negative side effects that may result from taking medications. At the same time, physiotherapy treatment can be used both independently and as one of the components of complex therapy. The effectiveness of physiotherapy as part of complex therapy is especially high, since, in combination with drug treatment and surgical intervention, it greatly accelerates the processes of treatment and recovery in cases where the patient is diagnosed with several infectious diseases that occur with complications and are not always amenable to the influence of traditional medicine. medicine.

Physiotherapy treatment involves the use of a truly huge number of various methods: therapeutic, rehabilitation, as well as preventive. Among them:

• Cryotherapy;
• Balneotherapy;
• Laser magnetic therapy;
• Light chromotherapy;
• transcranial electrical stimulation;
• Electrosleep;
• Infrared sauna;
• Electrophoresis of therapeutic mud;
• Heat and mud therapy;
• Cryotherapy;
• Ozone therapy;
• Various types of massage: acupressure, classical, etc.;
• Vibrotherapy;
• Water treatments: Charcot shower, underwater massage shower, etc.;
• Climatotherapy;
• Foot baths;
• Dry carbonic baths;
• Hardware methods of figure correction;
• Physiotherapy;
• Treatment with mineral waters, etc.

Physiotherapy treatment is prescribed to the patient individually based on the characteristics of the course of the disease, its stage and severity, medical history, lifestyle, general health (both physical and mental), geography of residence. As an independent method, it is suitable only for the treatment of a number of individual diseases. In other cases, physiotherapy is used in the initial stages of the development of the disease or as an adjuvant.

Physiotherapy treatment: the effects of procedures on the body

Physiotherapeutic procedures are able to target directly the systems and organs that require treatment. Wherein:

• blood circulation improves (both central and peripheral and regional);
• the processes of cellular nutrition are activated, due to which the normal vital activity of tissues and organs is ensured;
• pain syndrome is removed;
• neurohumolar regulation is normalized, in case of its violation, the function of the immune system is restored.

However, physiotherapy also has a number of contraindications. This method is not used when

• the patient's condition is accompanied by fever, his body is exhausted;
• diagnosed with an acute form of an infectious disease;
• the patient has a malignant tumor (or there is a suspicion of an oncological disease).

Also, physiotherapy treatment is contraindicated in such conditions as:

• Active course of the tuberculous process;
• Systemic diseases of the circulatory system;
• Cardiovascular diseases (in which the stage of circulatory failure is higher than the 2nd);
• Aneurysm of large vessels;
• Diseases of the central nervous system, characterized by increased excitability of the patient.

The appointment of physiotherapy treatment is advisable for children, even in cases where they have irreversible disorders. And, the earlier it is appointed, the better results can be achieved upon its completion. This is due to the fact that the child's body has very large compensatory capabilities. Here, however, one should remember such features of the anatomy and physiology of young children as an increased susceptibility of the nervous system, high resorptive abilities of the skin, a high water content in the tissues and, as a result, a higher indicator of the accessibility of deep-lying internal organs to the impact compared to adults. electric current. It is these features that determine the need to prescribe a reduced dose of physiotherapeutic factors to children, as well as a shorter course of physiotherapy treatment (the earlier the child's age, the shorter the course and the lower the dosage should be).

Most often, children are treated with physiotherapy in the following cases:

• In the presence of skin diseases and diseases of the navel in newborns (short air baths and irradiation with a Minin lamp);
• With purulent omphalitis (a combination of ultra-high-frequency therapy, ultraviolet radiation and antibiotics);
• With phlegmon in newborns (UHF, exposure to ultraviolet rays, laser exposure);
• In the acute form of hematogenous osteomyelitis (UHF, irradiation with ultraviolet rays, laser exposure);
• With hemolytic disease (phototherapy);
• With atopic and infectious-allergic forms of respiratory allergies (inhalation, ultrasound, exposure to an alternating magnetic field, massage, physiotherapy exercises, baths, swimming, etc.);
• With broncho-pulmonary diseases (UHF and microwave therapy, ozocerite applications, electrophoresis, massage, physiotherapy exercises);
• In diseases of the musculoskeletal system, including congenital ones (diadynamic therapy, ultrasound, electrophoresis, physiotherapy exercises, spa treatment);
• In diseases affecting the nervous system (amplipulse therapy, electrical stimulation, mineral baths, inductothermy, electrosleep, therapeutic baths, etc.);
• With ENT diseases (irradiation with a Minin lamp, UHF, inhalations, ozocerite applications, etc.);
• For diseases of the digestive system (amplipulse therapy, electrophoresis, massage, mineral water treatment, spa treatment).

Physiotherapy treatment is also an effective preventive measure that can significantly reduce the risk of developing certain diseases, slow their progression and reduce the likelihood of relapses.

This was how they treated when medicine was in its infancy, and even then it helped. Now physiotherapy has many possibilities and few contraindications, so it is one of the most interesting branches in medicine.

Why is she needed?

Physiotherapy is needed when drugs and operations do not bring the desired effect or help not completely. Some diseases, especially injuries, are generally difficult to treat. But gradual rehabilitation gives results.

If you want to quickly forget about the consequences of the disease, go to the physical room.

How do the procedures work?

Procedures improve blood circulation and enhance metabolic processes. Along with them, regeneration is also enhanced, that is, independent tissue repair, so physiotherapy helps with ulcers, skin diseases, and so on. These are galvanization methods, impulse currents, high frequency currents, ultrasound.

With the help of popular electrophoresis, it is generally possible to drive the medicine into the tissues near the sore spot so that the drugs enter exactly the focus of pain and do not pass through the stomach and intestines.

The current stimulates the nervous system, helps the muscles to relax and contract (electrical stimulation method).

The effects of heat and light work in a similar way: make blood move faster and speed up recovery from injury or illness. This is laser therapy, ultra-high frequency electromagnetic oscillations.

Procedures increase phagocytic activity - when the cells of the body themselves destroy bacteria, viruses and other infections. It can be said that they have an increased appetite, so it is useful after an infection. To do this, use infrared rays, ultraviolet.

Physiotherapy relaxes the smooth muscles that make up the internal organs and blood vessels, improves tissue nutrition. Therefore, it is used for cardiovascular diseases and any problems with internal organs.

When is physical therapy prescribed?

Physiotherapy can be prescribed in almost all cases when the disease is more serious than a banal ARVI, after injuries, or when the disease has become chronic. Restoration and strengthening of the body are not superfluous.

Who should not have procedures?

• oncological diseases;
• blood diseases;
• heat;
• severe pain;
• bleeding.

There are contraindications to certain procedures, they are associated with intolerance to a certain type of treatment.

Are there side effects?

Is it possible somehow without procedures?

And if you are in pain and feel bad, then follow all the doctor's orders and get to the physiotherapist's office.

It hurts?

Most of the procedures are even pleasant. For example, breathing in moist sea air is also physiotherapy. Long walks in the mountains and running are physiotherapy. Regular exercise, exercise and warm-up, baths, electrosleep and massage are physiotherapy.

Is it true that some devices help from everything in the world?

No one method can fight all diseases. Physiotherapy only helps to feel better.

One device can be used for different diseases. But one device cannot cure them.

Is all physical therapy effective?

There are also clearly anti-scientific methods that have nothing to do with physiotherapy and medicine in general, for example