-Subacute or chronic pain

- Decreased ROM

-Facilitate healing

-Muscle guarding

-Muscle spasm

-Myofascial trigger points

-Subacute muscle strain

-Subacute ligament strain

-Recent or potential hemorrhage

-Thrombosis

-Impaired sensation

Impaired mentation

-Malignant tumor

-Infrared irradiation of the eyes

-Over an open wound

-Cardiac insufficiency

-Impaired circulation

-Poor thermal regulation

-Edema

• Decrease pain

• Decrease neuromuscular excitability

• Stimulation circulation

• Facilitate healing

• Restore joint mobility

• Remove lactic acid

• Alleviate muscle cramps

• Increase blood flow

• Increase venous return

• Retard muscle atrophy

• Increase ROM

• Edema

Thrombosis

Embolism

Severe varicose veins

Acute phlebitis

Cellulitis

Synovitis

Abcesses

Skin infections

Cancers

Acute inflammatory conditions

-Paraffin Bath

-Warm/Hot Whirlpool

-Fluidotherapy

-Infrared Lamps

-Contrast Bath

-Improvement of ROM

-Accelerated Healing

C3- Supraclavicular fossa

C4- acromioclavicular joint

C5- lateral aspect of shoulder

C6- palmar side of thumb

C7- palmar side of middle finger

C8- palmar side of little finger

T1- medial aspect of antecubital fossa

T2- apex of the axilla

T3-T12- Abdominal/ intercostal spaces

L1- inguinal region and top of medial thigh

L2- middle and lateral aspect of anterior thigh

L3- medial epicondyle of the femur

L4- medial malleolus

L5- dorsum of the foot

S1- lateral aspect of the calcaneus

S2- midpoint of popliteal fossa

S3- horizontal gluteal crease

S4/5- perianal area

C5-shoulder abduction and external rotation, elbow flexion

C6- wrist extension

C7- Elbow extension and wrist flexion

C8- thumb extension and finger flexion

T1-finger abduction

L2- Hip flexion

L3- knee extension

L4- ankle dorsiflexion

L5- big toe extension

S1- ankle plantarflexion

S4- bladder and rectum motor supply

Ice bath

Cold pack

Ice massage

Cold whirlpool

Vapocoolant Sprays

Cold/Compression Units

Hypertension

Impaired sensation or mentations

Patients who are very young or very old

Over an open wound

Over an area with circulatory compromise

Peripheral vascular disease

Hypersensitivity to cold

Cold intolerance

Cryoglobulinemia

Paroxysmal cold hemoglobinuria

Over a regenerating peripheral nerve

Chronic pain

Acute swelling

Myofascial trigger points

Muscle guarding

Muscle spasm

Acute muscle strain

Acute ligament sprain

Acute contusion

Bursitis

Tenosynovitis

Tendinitis

Delayed onset muscle soreness

Reducing temperature

Pain control

Inflammation control

Spasticity modification

Muscle facilitation

Thrombophlebitis

Eyes

Reproductive organs

Pregnancy

Pacemaker or implanted cardiac rhythm device

Malignancy

Epiphyseal areas in young children

Total joint replacements

Central Nervous System Tissue

Soft tissue healing and repair

Scar tissue

Joint contacture

Chronic inflammation

Increase extensibility of collagen

Reduction of muscle spasm

Pain modulation

Increase blood flow

Soft tissue repair

Increase in protein synthesis

Tissue regeneration

Bone healing

Inflammtion associated with Myositis Ossificans

Plantar warts

Myofascial trigger points

Areas with ischemia

Impaired sensation

Impaired mentation

Thrombosis

Fluid filled areas or organs

Joint effusion

Eyes

Contact lenses if treating near head

Over moist clothing or wound dressings

Malignancies

Testes

Pregnancy

Epiphyseal plates in children

Cardiac pacemakers and other implanted electronic medical devices

Intrauterine devices

Watches or jewelry on the patient

Metal implants

Infection

Poor thermal regulation

Pelvic area during menstruation

Obesity

Muscle guarding

Joint contractions

Myofascial trigger points

Pain management

Soft tissue healing

Nerve healing

Bone healing

Malignancy

Low back or abdomen during pregnancy

Within 4-6 months of radiation therapy

Over hemorrhaging area

Over the thyroid glands

Epiphyseal plates in children

Light sensitivity

Tattoos

Pain reduction

Increasing the tensile strength of a scar

Decreasing scar tissue

Decreasing inflammation

Bone healing and fracture consolidation

Peripheral vascular disease

Presence of DVT or thombophlebitis

Local superficial infection

Congestive heart failure

Acute pulmonary edema

Displaced fracture

Uncontrolled hypertension

Cancer

Superficial peripheral nerves

Traumatic edema

Chronic edema

Venous stasis ulcers

Wound healing following surgery

Prevention of Deep Vein Thrombosis

Malignancy

Pregnancy

Placement of electrodes over the carotid sinus

Thrombosis or thrombophlebitis

MSK problems where muscle contractions would exacerbate the condition

Impaired mentation

Cardiac disease

Areas of skin irritation or open wounds

May cause delayed muscle soreness

Low-Frequency or Burst Mode may cause delayed-onset muscle soreness if used for more than 30 minutes

Stimulation of denervated muscle

Retarding muscle atrophy

Muscle strengthening

Muscle reeducation

Stimulation of venous and lymphatic circulation

Management of edema

Muscle spasms

Muscle guarding

Wound, fracture, tendon, ligament healing

Regaining neuromuscular control

Increasing isometric and isotonic strength of a muscle

Relaxation of muscle spasm

Decreasing muscle guarding

Pain reduction

Psychological relaxation

Fractures

Where motion is contraindicated

Acute injury or inflammation

Joint hypermobility or instability 

Peripheralization of symptoms with traction

Uncontrolled hypertension 

Pregnancy 

Positive vertebral artery test (for cervical traction)

Infection

Rhematoid arthritis

Prolonged systemic steroid use

Hiatal hernia

Vascular compromise

Medial disc protrusion

Claustrophobia

Inability to tolerate prone or supine position

TMJ problems

Dentures

When severe pain resolves fully with traction

 Spinal nerve root impingement

 Joint hypomobility

 Subacute joint inflammation

 Muscle spasm

Brachioradialis-C6

Triceps-C7

Patella-L4

1: no visible movement but palpitation is felt

2: moves through partial ROM gravity eliminated

2+: moves through partial ROM against gravity

3-: reaches full ROM with gravity, not able to hold

3 :held against gravity

3+: 0-24% force

4-: 25-49% force

4:50-74% force

4+: 75-95% force

5: >95%