Efficacy of Paraffin Wax Bath with and without Joint Mobilization

The post-traumatic stiff hand commonly occurs in post traumatic upper extremity (UE) fractures, and is clinically complex problem. It generally results in common symptoms of edema, immobility and pain. The post-traumatic stiff hand generally leads to disuse of hand function, due to restricted range of motion and loss of muscle strength. The physical therapists rehabilitate the patients with post-traumatic stiff hand by joint mobilization techniques, stretching and strengthening exercises.1 If the patients with post-traumatic stiff hand are not rehabilitated, they will develop contractures in hand muscles and will result in a position of dysfunction. The physical therapy plan of care is based on physical examination, includes evaluation of PROM, muscle strength, edema, gross sensation, bone healing, and adhesions. The common goals of physical therapy management of post-traumatic stiff hand are to manage pain, increase PROM, and muscle strength.

The improvement in joint PROM is the key component of physical therapy management, due to musculotendinous tightness. The joint mobilization techniques are used to improve joint PROM, by producing passive glides with distraction between the articular surfaces of hand joints to manage pain, break adhesions, and improve joint PROM. The grade I and II are used to manage pain and grade-III for improvement in joint PROM.

The paraffin wax bath is commonly used as effective remedy to improve circulation and promotes relaxation.4 Both hands and feet are most common segments to be treated with paraffin wax bath in physical therapy. Paraffin wax bath treatment followed by active hand exercise resulted in significant improvements of range of motion.