1

• Paraffin wax bath therapy is an

application of the molten paraffin
wax on the body part.
• The temperature of the paraffin wax

is maintaining at 40-44°c, where as

its melting point is 51-55°c.
• If the molten wax at 51-55°c is

poured on the body part, it may

cause burn over the body tissue,
which is why some impurity is added
to lower down its melting point such
as liquid paraffin or mineral oil.
• The wax is maintained molted in
stainless steel or enamel bath which
are electrically heated; temperature
is kept constant by a thermostat.
• There may be a fixed thermometer

to check the temperature and a

means of adjusting the thermostat
setting to the temperature.
• Paraffin wax bath therapy provide

about the 6 times the amount of

heat available in water because the
mineral oil in the paraffin lowers its
melting point.
 2

• The combination of the paraffin and

the mineral oil has low specific heat
which enhances the patient’s ability
to tolerate heat from the paraffin
better then from the water of the
same temperature.
• The composition of the wax: paraffin:
petroleum jelly is 7:3:1 or wax:
paraffin: or mineral oil is 7:1.
• The mode of the transmission of heat
from paraffin to the patient skin is by
means conduction.

Parts of a typical paraffin wax bath

unit are container, mains, thermostat,
thermostat pilot lamp, power pilot
lamp, lid, and caster.

• Container is made-up of enamelled

baths or stainless steel bowl and
outer fiberglass shell.
• Initially heating is quicker with this

type because there is no water jacket

to be heated.
 3

• Container contains wax and paraffin

oil. Main function is to switch on or
off the heating element, which is
located in the casing of paraffin wax
bath unit.
• Thermostat keeps the temperature
fix or static in the range which is
adjusted with knob thermostat pilot’s
lamp indicates whether thermostat is
on or off.
• Power pilot’s lamp function is to
show whether power is on or off.
• Lid cover container and caster allow

the paraffin wax bath container to be

move from 1 place to another.

• The nature of wax treatment is

explained and the area to be
treated is inspected for
contraindication.
 4

• Look for any wound, skin infection,

rashes etc. on the part to be
treated.
• Cleaned the skin using tissue paper
or cotton.
• Tell the patient in brief about
temperature of the wax and
benefits
• Drip down few drops of molten wax
on the dorsal surface of your hand
to check the temperature.
• This is done before; the patient so
that he/she can prepare
psychologically and fear of heat is
minimized.
• After the above step the patient is
always found to cooperate and fear
of molten wax and heat is remove
from the mind.

• The part is immersed for a second

or so in the wax, withdraw and
 5

allow to cool for 2 to 3 sec. and

then re-immersed
• It is important to immerse the part
briefly other wise the outer most
coating is melted off and the
thickness of wax does not build.
• The procedure is repeated 6-12
times to produce a coating of wax 2
or 3 mm thick over the body part.
• The part is then put into a plastic
bag or paper cover and raped in a
blanket or towel to limit the rate of
heat loss to the air.
• For any condition in which there is
a proclivity for edema the part
should be elevated.
• Adequate elevation in which the
part is kept above the level of the
heart is of almost importance since
other wise the heating effect will
tend to exacerbate swelling of the
extremities.
 6

• The glove of wax is normally left in

a place for some 15 minute by
which time the wax is completely
solid although still malleable, so
that it can be remove in a 1 piece.
• After use the wax is cleaned in a
purified and reuse.

• Despite of the fact that skin

temperature above 45°c can lead
to damage, it is possible to put the
hand comfortably in bath of wax at
some 50°c.
• Water at the same temperature
would be uncomfortably hot and
ultimately cause damage.
• This is bcozs the specific heat of

paraffin wax is about 2.72 kj/kg/°c

or less with added mineral oil and
therefore much lower than that of
water at 4.2 kj/kg/°c.
 7

• Thus, the amount of energy

released by the wax cooling 1°c is
less than that of water. kj/kg/°c
• Perhaps more importantly, when
the part is immersed in wax the
cool skin causes a thin layer of wax
to solidify on the surface.
• Due to the relatively low thermal
conductivity of the wax this static
layer act as to insulate the skin
from the hotter surrounding the
wax: some air may be trapped
between this solidify layer and the
skin, adding to the insulating
effects.
• The wax transmits the heat energy
to the tissue by giving up energy as
it solidifies the latent heat of the
fusion without any temperature
changes.
• This amount of energy is quite
small therefore about 35 kj/kg.
• Although the temperature of a thin
layer of wax on the tissue falls
quite quickly on its outside surface
the low thermal conductivity
 8

prevents much heat loss from the

skin surface.
• The net effect is to provide
remarkably effective low
temperature heating of the part.
• Certainly there is widespread
approbation amongst patient who
suffers with painful and stiff joints
for this form of heat.
• As a consequence of preventing
water loss from the surface of skin
the wax treatment tends to leave
the skin with more moisture hence
feeling soft and pliable.
• This may be therapeutically
valuable if the skin is dry.
• It is also claimed to soften adhesion
and scar in the skin.
 9

• The part to be treated must be

cleaned by soap and moisture to
be soaked by towel.
• Position of the patient should be
such that the part to be treated
comes closer to the wax bath
container.
• Before application one must
ensure that there should be no
moisture on the body tissues
otherwise burn could occur.
• The warm wax is placed on the
body tissues by various
techniques and the treatment is
given for about 10-20 minutes.

Various techniques used for the

application of paraffin wax are as
fallows:

1. Direct pouring method:

 10

• The molten Wax is directly

poured by a mug or utensil on
the part to be treated and then
wrapped around by a towel.
• The wax is allowed to solidify for
about 10-20 minutes. Several (4-
6) layers can be made over the
body tissues.

2. Brushing method:
• It is a less commonly used
method of paraffin wax
application.
• in this method, 8-10 coats of
wax are applied to the area
with a paint brush using even
and rapid strokes
• The area is then wrapped with
towel for 10-20 minutes and
after this time, paraffin wax is
removed and discarded

3. Immersion method:
• This method of application
provides some what vigorous
heating.
 11

• The body part to be treated dipped

3-4 time to form a thin coat and
then left immersed in paraffin wax
for 20-30 minutes
• A thin glove of solid paraffin wax

formed slows the heat conduction

• Use of immersion method required
co-operation and tolerance by the
patient in a dependent position
• Care should be taken to ensure
that the patient is in comfortable
position during the treatment
• With immersion method, the
temperature elevation of body
tissue is 2°c higher then dipping
method

4. Dipping method:
• It provides mild heating.
• The patient should wash and dry
the part to be treated.
• The therapists instruct the patient
to dip the body part in a bath and
then removed it until the paraffin
solidifies and thin layer of adherent
 12

solid paraffin is formed which

covers the skin.
• Dipping is repeated until a thick
coat is formed.
• In other words, at least 8-12 times
until thick glow on a part.
• Once thick glow of wax is formed
the treated area should be wrapped
1st in a plastic and then wrapped
with a towel.
• If edema is concerned then area
may be elevated.
• The effective duration of this
treatment is 10-15 minutes.
• At the end of this treatment time
the glow of solid of peeled off or
removed by slipping the finger
beneath the glow and sliding the
wax off and into the plastic sack,
which cover it during the treatment
• The sack is then discarded or the
wax is emptied in the bath unit.

5. Toweling or bandaging
method:
 13

• A towel or a roll of bandage is

immersed in molten paraffin wax
and then wrapped around the
body part.
• Several layers can be made over

the body part.

• This method is preferably used
for treating proximal parts of the
body.

Once the treatment is given by

paraffin wax, it can be reused for the
next session. Regular cleaning or
changing of the wax is necessary to
ensure good hygiene.

1. Heat production:
• There is a marked increase in
skin temperature in the 1st two
minute, up to 12-13°c.
• This drop, while in the wax
wrapping to an increase of
 14

about 8°c at the end of 30

minutes.
• In the subcutaneous fascia,
there is an increase of 5°c at
the end of the treatment.
• In the superficial muscles, then
in only about 2-3°c rise in
temperature at the end of the
treatment

2.Circulating effect:
• Stimulation of superficial
capillaries an arterioles cause
local hyperemia and reflex
vasodilatation.
• This is marked only in the region
of the skin.
• The hyperemia is due to
response of the skin to its
function of heat regulation.
• The effects of vasodilatation in
the muscle are negligible, but
then may be some reflex
heating in the joints.
• Skin and subcutaneous tissue
temperature drop after 15-20
 15

minute, reducing the

vasodilatation
• Exercise after the wax is
essential to increase the muscle
circulation and sedative effect
of heat to obtain more range of
movement and muscle strength.

3.Analgesic effect:
• The most important effect of
wax its marked sedative effect
on the tissue.
• The moist heat is remarkable
soothing to the patient.
• It is this effect that is used prior
to the exercise, in the treatment
of superficially placed joints.
• It is very comfortable to the
patient.

4.Stretching effect:
• Wax leaves the skin moist, soft
and pliable.
 16

• This is useful for stretching scar

and adhesion before applying
mobilization techniques.

1. Pain and Muscle Spasm: Wax

reduces the pain and muscle spasm
seen in hands and feet, as the moist
heat encircles each finger and toe,
and relieves pain.

2. Edema and Inflammation:

The gentle heat reduces post-
traumatic swelling of the hands and
feet and also swelling in hands
affected by rheumatoid arthritis or
degenerative joint disease,
particularly in the sub-acute and
early chronic stages of
inflammation.

3. Adhesions and Scars: Wax

softens the adhesion and scar in the
skin and thus facilitates the
 17

mobilization and stretching

procedures.

1.Impaired skin sensation: This

will be determined by a hot/cold
skin test.

2.Some Dermatological
conditions are exacerbated by
moist heat, such as eczema,
athlete’s foot and dermatitis. Any
dermatological condition, which
appears after treatment, must be
reported.

3.Circulatory Dysfunction:
Patients with varicose veins, deep
vein thrombosis and arterial disease
must not have any heat applied
directly over the affected part.

4.Analgesic Drugs: If patients are

taking strong narcotics for pain, the
 18

time and dosage of the drugs must

be ascertained. Heat is not
administered immediately after
intake of drugs, since pain tolerance
to heat is impaired.

5.Infections and open

wounds: Heat will increase the
infective activity.

6.Cancer or tuberculosis: In the

area to be treated, heat, by
increasing the metabolic rate, may
increase the rate of growth and
spread the disease.

7.Gross edema: With a very thin

and delicate skin covering the area,
the skin may be damaged and the
heat may tend to increase the
edema.

8.Lack of comprehension:
patients who cannot understand the
nature of the treatment and
comprehend the potential danger,
 19

for example, children, very old

patients, other nationalities.

9.Deep X-ray Therapy: Within

three months prior to treatment
decrease blood flow in the area and
may cause impaired skin sensation.

1.Low specific heat allows for

application at a higher temperature
than water without the risk of a
burn.
2.Low thermal conductivity allows for
heating of tissues to occur more
 20

slowly, thus reducing the risk of

overheating the tissues.
3.Molten state allows for even
distribution of heat to areas like
finger and toes.
4.First dip traps air and moisture to
create more even heat distribution.
5.Oils used in the wax add moisture to
the skin.
6.Wax remains malleable, after
removal, allowing for use as an
exercise tools.
7.Comfortable, moist heat.
8.Relative inexpensive to replace wax.
 21

1. Effective only for distal extremities

in the terms of ease of application.
2. Most effective method of application
is the bath method, which limit
accessibility for other body part to
be treated effectively.
3. No method of temperature controls
once applied.
4. Heating last only about 20 minutes.
5. It is a passive treatment: exercise
may not be performed
simultaneously.

Sterile the paraffin wax bath by heating

it to 212° Fahrenheit. For reuse
sterilization should be done frequently.
Drain the melted paraffin wax, filter it
out and replace it back for reuse.
Change the wax at least once in 6
month.