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Overview
Small unit that holds hot wax (around 127 degrees Fahrenheit) in which the hand is dipped into at the beginning of a session
Used to increase blood circulation, stiffness, pain, and promote tissue healing
General rule is to have patient dip hand in and out of the wax 5 times, allowing a few seconds before dipping the hand back in each time to build up a layer of the wax
Hand is then wrapped with plastic wrap or plastic bag, followed by a hot pack with towels or mitt to enclose the heat
Can be beneficial to use compared to a hot pack as the wax can conform around the fingers better
The wax provides a moisturizing component which can be good for scar healing
Typical treatment time is 10-15 minutes
Ensure hands are dry before use as water droplets can potentially cause a small fire in the unit
If a patient has limited finger motion, wrapping the hand in Coban before dipping it in paraffin can help stretch tight joints, as the heat relaxes the tissues and allows them to conform to the stretch
Restored Hope Therapy. What Is Paraffin Wax? image on Restored Hope Therapy blog. https://www.restoredhopetherapy.com/blog/what-is-paraffin-wax/
How it Works
Heat transfers from the wax to the tissue through conduction (transfer of heat between objects through direct contact)
Heat causes blood vessels to dilate (vasodilation), increasing blood flow to the area, which brings more oxygen and nutrients to support healing and helps flush out waste products from the local tissues
Heat increases tissue extensibility by raising tissue temperature, which makes muscles and connective tissues temporarily more elastic and easier to bend and stretch
Allows increased effectiveness of PROM
Heat increases local metabolism, which helps the tissues heal faster
Indications
Joint stiffness
Pain
Scar remodeling
Muscle spasms
Contraindications
Open wounds
Impaired sensation
Poor blood circulation or vascular disease
Acute inflamation or edema
Infection
Malignancy - cancer in treatment area
Quiz Questions
Why should a patient’s hand be dry before using a paraffin bath?
A. Wax won’t adhere otherwise
B. Water droplets can cause a fire or splatter hazard
C. Moisture interferes with heat transfer
D. It causes burns more easily
Why might paraffin therapy be chosen over a standard hot pack for treating the hand?
A. It's faster
B. It's less expensive
C. It conforms better to finger contours
D. It produces deeper tissue heating
Which of the following is a contraindication for paraffin use?
A. Muscle spasms
B. Joint stiffness
C. Open wounds
D. Scar remodeling
How does wrapping the hand in Coban before paraffin application help?
A. Makes the wax stick better
B. Provides a stretch as tissues relax from the heat
C. Prevents burns
D. Keeps the wax from dripping
How many times should a patient typically dip their hand into the wax during paraffin application?
A. 2–3 times
B. 5 times
C. 7–10 times
D. 1 time
Quiz Answers
B
C
C
B
B
References
Allen, E. (n.d.). Occupational Therapy—Paraffin Bath. Jacksonville Orthopaedic Institute. https://www.joionline.net/library/paraffin_bath/#:~:text=This%20modality%20uses%20heated%20paraffin,decreased%20sensitivity%2C%20or%20heat%20intolerance
Kim, S.-G., Kang, J. W., Boo, J. H., Jin, D. U., Choi, S. J., Song, G. G., & Jung, J. H. (2023). Effectiveness of paraffin bath therapy for the symptoms and function of hand diseases: A systematic review and meta-analysis of randomized controlled trials. Journal of Hand Therapy, 36(3), 706–712. https://doi.org/10.1016/j.jht.2022.10.005
Lercara, C., Lon, Y. C., Ho, E., Baskaran, S., & Elzayat, A. (2024). Therapeutic Modalities—Thermal. PM&R Knowledge NOW. https://now.aapmr.org/therapeutic-modalities-thermal/
Meydum, J. (n.d.). Physical agent modalities: An overview for beginners. Physical Agent Modalities: An Overview for Beginners. https://www.myotspot.com/physical-agent-modalities/
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