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Contraindications/Precautions for Hot and Cold Therapy

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Superficial Heat Contraindications:
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*Acute inflammatory conditions (i.e. RA) *Recent or potential hemorrhage *Active bleeding *Thrombophlebitis, PVD, DVT *Cancer *Irradiation of the eyes (Avoid with IR–Infrared Radiation) *Recent fever or infection *Skin Infection *Over areas irradiated by x-ray therapy *VERY superficial metal implants *Venous ulcers (warm/hot WP only)
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Superficial Heat Precautions
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*Over areas of impaired sensation *Pregnancy (avoid generalized heating–no HP on abdomen or jacuzzi) *Poor thermal regulation (very young or very old) *Edema *Cardiac insufficiency (avoid generalized heating) *Over open wounds *Impaired cognition *Over areas where topical counterirritants have been recently applied (i.e. Icy Hot)
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Cold/Cryotherapy Contraindications:
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*Hypersensitivity to cold or cold intolerance ***Cryoglobulinemia ***Paroxysmal cold hemoglobinuria ***Raynaud’s Disease ***Syncope/Cold allergy *Over regenerating peripheral nerve *Poor circulation/PVD *Angina pectoris/ cardiac dysfunction/ respiratory complication (avoid generalized cold)
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Cold/Cryotherapy Precautions:
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*Over areas of impaired sensation *Over the superficial main branch of a nerve *Over open wounds *Uncontrolled HTN (avoid generalized cold) *Impaired cognition *Poor thermal regulation (very young or very old)
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Contrast Bath Contraindications:
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Same as Superficial Heat and Cold