Impulse currents in physiotherapy. Basic rules for performing physiotherapy
Among all methods of treating diseases with conservative methods, physiotherapy is especially effective. The procedure is in demand because it is painless, has virtually no contraindications, and can be used even for children over the age of 5 years.
What effect does physical therapy have?
Physiotherapy for osteochondrosis is performed through various physical means. Thanks to physiotherapeutic treatment, the drug enters mainly into the focus of inflammation (on deep-lying tissues). With osteochondrosis of the cervical spine, it is directed to the area of the shoulders and neck, and in case of damage to the lumbar region - to the lower back and buttocks.
The main goals of this treatment include:
- removal of the inflammatory process;
- elimination of spasms, pain;
- stimulation of the process of tissue regeneration;
- increased immunity;
- elimination of pinched nerve endings.
Physical factors have a positive effect on the human body as a whole. The main advantage of this type of physiotherapy is that it does not cause allergic reactions.
The healing process is accelerated by the combination of physiotherapy with the use of medications.
Types of physiotherapy in the treatment of osteochondrosis
Osteochondrosis is the most common pathology of the spinal column, which affects not only adults, but also children. Let us consider in more detail what physiotherapy procedures are used for osteochondrosis. Various physical factors can have an effect on the human body. These include the following types of exposure: ultraviolet rays, vibration, laser radiation and many others.
Physiotherapy has an effective effect with the help of massage for osteochondrosis of the lumbar spine. It is carried out by a chiropractor using manual manipulations and a vibratory massager. After such therapy, patients have a significant improvement in blood circulation and pain relief.
Detensor Therapy
Detensor therapy is a physiotherapy of osteochondrosis using a specific bed, which consists of inclined movable rollers instead of a conventional mattress. With its help, the spinal column is stretched under its own weight, which leads to a decrease in pressure on the intervertebral discs. Detensor therapy is used for osteochondrosis of both the cervical and lumbar regions. It relieves muscle tension, improves posture and reduces pain in the spinal column.
The procedure has a minimum number of contraindications, since it does not injure the muscles and joints and does not exert a strong load on the blood vessels. The duration of treatment is determined by the doctor, it depends on the stage of the disease. In most cases, the result is noticeable after 5 procedures.
Laser therapy
One of the most effective physiotherapy procedures for cervical osteochondrosis is laser therapy. The therapeutic effect is based on the precise action of special lasers through soft tissues on the damaged area of the spinal column. This manipulation promotes the activation of metabolic processes and effectively relieves pain. There is a significant improvement in the functioning of bioelectric impulses.
This is a relatively new method of therapy, but it has already managed to prove itself well in the treatment of damage to the tissues of the spinal column. One procedure lasts about 10-20 minutes and does not cause discomfort to the patient.
Balneotherapy
Physiotherapy for cervical osteochondrosis using the method of balneotherapy is carried out using healthy water saturated with salt, healing mud and minerals. During the procedure, the patient lies in a special bath, which is equipped with a massage function, which has a positive effect on damaged areas, improves metabolic processes in tissues and the absorption of minerals. Healing water has a beneficial effect on the joints and the musculoskeletal system. The therapy can be used at any time, whether it is an exacerbation of the disease or remission. Saline solutions increase the load on the heart muscle and increase blood pressure, so people with hypertension are contraindicated in this treatment.
Magnetotherapy
The essence of magnetotherapy is the use of variable and constant magnetic fields of different frequencies. During the procedure, the patient lies on his stomach, and the doctor places inductors with a magnetic field along his spinal column, which stimulates the process of tissue repair and metabolic processes, saturates damaged tissues with oxygen. The duration of the procedure is about 15 minutes.
Physiotherapy for osteochondrosis of the cervical spine with the help of acupuncture is carried out only during the period of remission of the disease. During an exacerbation of the disease with a pronounced pain syndrome, it is worth refraining from using this method. Acupuncture is an additional method of therapy, the use of which enhances the effect of medications.
Indications for physiotherapy
Before prescribing treatment, a comprehensive examination of the body and the spinal column is carried out in order to determine the stage of the disease, to prescribe the most appropriate physiotherapy program. It is indicated for radicular syndrome (compression of the spinal roots), intervertebral hernia, limited mobility of the spinal column.
In general, physiotherapy has a positive effect on the process of blood circulation and strengthening muscle tone. Physiotherapy is used for osteochondrosis of all departments (cervical, thoracic, lumbar). Procedures of this type speed up the healing process.
Physiotherapy for osteochondrosis complements the main treatment and greatly facilitates the patient's condition. Selectively acting on the painful focus, physiotherapy has practically no undesirable side effects.
This type of therapy does not cause an exacerbation and allows you to reduce the dose of drugs. Due to fewer drugs, the risk of allergies and side effects is reduced.
Physiotherapy procedures:
- Normalize metabolism
- Improve the condition of organs and tissues
- Activate immunity
- Activate neurohumoral functions
- Stop the pain
- Improve microcirculation in the affected area
- Have anti-edematous and anti-inflammatory effect
- Reduce movement disorders.
Physiotherapy for osteochondrosis, depending on the condition of the patient, is used both in combination and independently. The healing effect on the human body is achieved with the help of a modified form of electrical and mechanical energy and natural factors (light, climate, dirt, water).
Types of physiotherapy in the treatment of osteochondrosis
With osteochondrosis, the following types of physiotherapy are used:
- Laser therapy
- Detensor - therapy
- Magnetotherapy
- Balneotherapy
- Vibration exposure (ultrasound therapy, zonal or acupressure vibration massage)
- Ultraviolet irradiation (UVI)
UFO
Under the influence of UV radiation, vitamin D is formed in the skin, which helps calcium to be absorbed. The method is carried out with the help of irradiators, which have a bactericidal, anti-inflammatory and some analgesic effect.
With cervical osteochondrosis, UVR physiotherapy is used on the back of the neck and upper part of the shoulder blades, subclavian region, and the outer surface of the shoulder. With thoracic osteochondrosis, they affect the midline of the spine in the sternum. With lumbar - on the lumbosacral region, buttocks, back of the thigh and lower leg.
Before therapy, be sure to check the sensitivity to ultraviolet rays. At the first procedure, the smallest biodoses are prescribed and they are gradually increased with each subsequent session. Usually appoint 10-15 procedures.
Contraindications:
- Oncological diseases
- Taking drugs whose effect is enhanced by exposure to ultraviolet rays.
- Blood diseases.
vibration impact
The method underlies many effective treatments. Due to its effect, the method relieves pain of various localization.
During ultrasound therapy, the body is exposed to high-frequency sounds (from 20,000 Hz or more). This method is combined with drugs for better penetration into the affected tissues.
Contraindications for carrying out:
- Oncological diseases
- vibration sickness
- Dermatitis or skin lesions in the affected area
- Mental disorders.
Shock wave therapy is used for osteochondrosis
The method consists in transmitting an acoustic wave to a painful area of the body. This kind:
- Eliminates pain
- Improves microcirculation
- Improves metabolism.
Detensor therapy
The method consists in stretching the spine with the help of the patient's body weight.
Laser therapy
The method has a healing effect with the help of helium-neon lasers.
Due to the activation of bioelectrical processes in the tissues of the nervous system, laser therapy has the following properties:
- Wound healing
- Anti-inflammatory
- Painkillers
Laser radiation is carried out along the inflamed spinal roots. In osteochondrosis, the impact on the paravertebral zones (paravertebral) of the affected spine is used. The duration of exposure to each zone (spinal root) is no more than 2 minutes. The total session time does not exceed 14 minutes.
The method acts with the help of an electric field and current. Under the influence of electric current, heat is generated in the tissues, which contributes to increased local blood circulation. Electrotherapy has the following effects on the body:
- Eliminates pain and discomfort
- Speeds up healing.
Current treatment is contraindicated in patients who have metal parts and devices in their bodies, pacemakers.
Impulse currents
Impulse currents have a very effective therapeutic effect. Their mechanism of action on the body is determined by the effect on nerve receptors. Low-frequency pulses contribute to the extinction of pain.
Diadynamic therapy (DDT)
DDT is used in the treatment of osteochondrosis by exposure to double continuous or wave current. The current strength increases until a slight vibration is felt at the site of exposure. Sessions are prescribed daily for up to 10 days. Already after the second procedure, acute pains become aching in nature, muscle tension and symptoms of nerve root tension are relieved. A full course of treatment with DDT leads to normalization of muscle tone and increased mobility of the spine.
interference therapy
The method is used for acute pain. The method consists in a rhythmic change in the frequencies of the electric current. The current strength increases until vibration appears in the affected tissues. The procedure lasts up to 15 minutes.
Exposure to sinusoidal modulated currents (SMT)
The frequency of the current and the depth of modulations with this method of physiotherapy is selected depending on the pain syndrome. With each subsequent procedure (as pain decreases), the frequency of modulations is reduced, and the depth is increased.
Electrotherapy relieves pain and speeds up healing
Transcutaneous electrical neurostimulation (TENS)
TENS uses plate electrodes with hydrophilic pads. Stimulation is achieved by activating the nerves without direct action on the motor structures. Electrodes are applied to the entire area of the paravertebral affected area, to the projection area of the spinal roots. The current strength increases until vibration appears in the affected area. The method is effective in the acute period.
UHF electric field
Electrodes for UHF therapy are installed on the paravertebral zones along the roots. The duration of the procedure is up to 14 minutes, first daily, then every other day and combined with other physiotherapy. Course up to 15 procedures.
Magnetotherapy
Physiotherapy for osteochondrosis includes the use of magnetic therapy. Inductors are located on the affected spine and limb. Magnetic therapy uses continuous mode with magnetic field induction from 28 to 35 mT. The procedure lasts up to 20 minutes, the course is up to 20 procedures daily.
Balneotherapy
Balneotherapy for osteochondrosis consists in the use of mud and mineral waters (local and general baths, pools, showers) for the purpose of treatment and rehabilitation. Mineral substances during the procedure penetrate the skin and act on receptors and nerve centers.
When treating with mud (peloidothermia), the effect on the body occurs under the influence of temperature and the chemical composition of the healing mud. Mud is used in the form of applications. Balneotherapy stimulates metabolism, improves blood circulation and relieves inflammation.
Combined methods of physiotherapy
The most commonly prescribed combined methods of physiotherapy of osteochondrosis. For example, with severe pain, diadynamic therapy and electrophoresis (diadynamophoresis) using novocaine are used.
For simultaneous impact on biologically active points, the method of acupuncture is used. Its action is to activate points with acupuncture needles and laser radiation. Mud therapy is often used with electrotherapy (electrophoresis with mud solution, inductothermy with mud, galvanic mud therapy).
Physiotherapy is a complex of procedures that consists in exposing diseased parts of the body to various physical factors and methods: electric current, light, ultrasound, radiation, as well as natural ones: sun, air, water and mud.
Such procedures are usually prescribed by a physiotherapist and are held in courses several times a year. For arthritis and other joint problems, physical therapy is used to relieve pain, keep the inflamed joint functioning, and strengthen the muscles around it. Most often, the procedures are prescribed in combination with anti-inflammatory and painkillers, however, in cases where the patient for some reason cannot take medications, physiotherapy is used as an independent method of treatment.
Types of physiotherapy
Physiotherapy procedures are divided into several types, in accordance with the methods of their implementation and certain methods of influencing the joints affected by the disease.
electrophoresis
Electrophoresis - the introduction of drugs is localized, through the skin, using a constant electric current. Electrophoresis is performed using drugs that help to quickly relieve pain and block the inflammatory process (heparin, novocaine, salicylate). This is one of the few procedures that can be performed in the stage of exacerbation of diseases. This method is also good for its cumulative effect - after a course of procedures, a certain amount of drugs that have a therapeutic effect accumulate under the skin.
Phototherapy
Phototherapy called dosed effect on the body of infrared, visible and ultraviolet radiation. This includes chromotherapy and quantum therapy. Light treatment helps relieve swelling, improve blood circulation and lymph outflow, and relieve pain in an inflamed joint.
laser therapy
Laser therapy - a therapeutic effect on the joints is provided with the help of low-frequency laser irradiation. It has a sedative effect, anesthetizes, softens inflammation and relieves spasms, improves lymph circulation, eliminates blood circulation disorders, stimulates metabolic processes in cells and tissues. Laser therapy can be prescribed during an exacerbation.
Magnetic Therapy
Magnetic therapy - the impact on the affected joints with a magnetic field. Relieves inflammation, improves lymph flow and blood flow, normalizes vascular tone, stimulates metabolic processes in the joints. For arthritis, local magnetic therapy is usually prescribed.
Ultraviolet
Ultraviolet - irradiation of diseased joints with ultraviolet waves of medium length. It helps to reduce the sensitivity of nerve fibers, due to which it has a quick analgesic effect. Accelerates the synthesis of vitamin D3, necessary for strengthening joints. UHF-therapy - impact on the joint with electronic waves of the decimeter range. Warms up muscles, relieves spasm, reduces pain. Suitable for the subacute phase of the disease.
UHF therapy
UHF-therapy - treatment with electromagnetic fields of ultra-high frequency. UHF therapy is also called "heat treatment", because. in the process, the body tissues absorb the energy of magnetic fields and release heat. Effectively relaxes, anesthetizes, relieves swelling and inflammation.
Ultrasound
Ultrasound - exposure to the affected areas with high-frequency sound, sometimes carried out with hydrocortisone ointment. Ultrasonic exposure helps to speed up the metabolic process in tissues, improves blood flow, and gives a massage effect. Due to this, edema dissolves, inflammation goes away.
Massage
Massage - relieves swelling, minimizes pain, improves blood circulation, increases the mobility of affected joints, strengthens muscles. One of the few types of physiotherapy that can be carried out at home by the patients themselves.
Cryotherapy
Cryotherapy is a short exposure to low temperatures on a sore spot. Stimulates blood flow, reduces swelling and pain, promotes partial tissue regeneration.
Acupuncture
Acupuncture (acupuncture) is a treatment with injections of special and acupuncture needles, which are injected to a certain depth and left in the patient's body for a while. Relieves pain, improves blood circulation.
Balneotherapy
Balneotherapy - water procedures (therapeutic baths, showers) using different types of mineral waters. In particular, for arthritis, hydrogen sulfide, radon or iodine-bromine baths are recommended. Helps to strengthen blood vessels, accelerate blood flow.
exercise therapy
Exercise therapy is physiotherapy exercises, a complex set of exercises aimed at improving blood circulation, strengthening muscles, at least partial restoration of the mobility of diseased joints. This type of physiotherapy is of particular benefit in the treatment of rheumatoid arthritis in patients over 50 years of age, because. it prevents the formation of ankylosis and adhesions in the connective tissues.
Mud therapy
Mud therapy is the application of therapeutic mud containing salts and acids of natural origin to diseased areas. Improves blood circulation, accelerates the delivery of drugs and nutrients to the joints.
The number of sessions for all types of procedures from the list above, as well as the duration of one session, is set by the physiotherapist. You can not self-medicate or independently prescribe physiotherapy for yourself without first consulting a doctor. Also, do not combine several types of procedures at once in a short period of time.
Important: the effect of the technique will increase significantly if the patient adheres to a special diet (reduces the consumption of prepared food), limits the load and gives up bad habits.
Like any other medical manipulation, physiotherapy for arthritis has certain indications and contraindications.
Indications
- Severe discomfort in the joints.
- Arthritic pain syndrome, which becomes stronger with exertion, weather changes, at night.
- Heaviness, stiffness in a joint, limb or whole body, limited movement.
- Spasms, convulsions in the diseased limb.
- Swelling, swelling in the affected area.
Contraindications
- High (from 38 °) body temperature, fever.
- General serious condition of the patient.
- Cachexia.
- The presence of neoplasms, both malignant and benign.
- Recent (less than 3 months ago) acute myocardial infarction.
- Pulmonary tuberculosis.
- Systemic blood diseases (including severe anemia), poor blood clotting, a tendency to bleed.
- Wounds, inflammation of the skin, purulent processes at the site of the physiotherapy.
- Epilepsy.
- Mental diseases and disorders of mental activity (psychosis) in the acute stage.
Individual contraindications for certain types of procedures:
- Intolerance to the therapeutic factor.
- Pregnancy, postpartum period, lactation.
- Neoplastic processes on the skin.
- Urolithiasis and / or gallstone disease.
Physiotherapy, carried out under the supervision of a specialist, usually helps to achieve remission after the first course, however, to maintain the effect, it is recommended to take courses of procedures 2-3 times a year, in accordance with the doctor's prescription. Do not underestimate physical therapy, this part of a comprehensive approach to the treatment of arthritis is no less important than drug therapy. The procedures will help not only relieve symptoms, but also improve blood circulation and metabolism (and hence the nutrition of the affected areas), strengthen the muscle corset, thereby reducing the load on the joints.
Physiotherapy (physiotherapy, physiotherapy, physical or physical therapy, physiatry) is a specialized field of clinical medicine, the purpose of which is to study and use natural and artificially obtained physical factors for therapeutic and prophylactic purposes without destroying tissues. Natural (or natural) factors are water, air, sunlight and heat. Artificial include ultrasound, laser, electric current, magnetic field, various kinds of radiation (infrared, ultraviolet, etc.). Physiotherapy treatment is one of the oldest methods in medicine, a large number of physiotherapeutic methods of influencing a person were known many centuries ago. The term "physiotherapy" itself comes from the Greek words "physis" (nature) and "therapeia" (treatment, therapy).
Physiotherapy has long been used to treat a wide range of various diseases, because. provides a good therapeutic effect, minimal burden on the patient's body and the absence of unforeseen negative side effects that may result from taking medications. At the same time, physiotherapy treatment can be used both independently and as one of the components of complex therapy. The effectiveness of physiotherapy as part of complex therapy is especially high, since, in combination with drug treatment and surgical intervention, it greatly accelerates the processes of treatment and recovery in cases where the patient is diagnosed with several infectious diseases that occur with complications and are not always amenable to the influence of traditional medicine. medicine.
Physiotherapy treatment involves the use of a truly huge number of various methods: therapeutic, rehabilitation, as well as preventive. Among them:
- Cryotherapy;
- Balneotherapy;
- Laser magnetic therapy;
- Light chromotherapy;
- transcranial electrical stimulation;
- Electrosleep;
- Infrared sauna;
- Electrophoresis of therapeutic mud;
- Heat and mud therapy;
- Cryotherapy;
- Ozone therapy;
- Various types of massage: acupressure, classical, etc.;
- Vibrotherapy;
- Water treatments: Charcot shower, underwater massage shower, etc.;
- Climatotherapy;
- Foot baths;
- Dry carbonic baths;
- Hardware methods of figure correction;
- Physiotherapy;
- Treatment with mineral waters, etc.
Physiotherapy treatment is prescribed to the patient individually based on the characteristics of the course of the disease, its stage and severity, medical history, lifestyle, general health (both physical and mental), geography of residence. As an independent method, it is suitable only for the treatment of a number of individual diseases. In other cases, physiotherapy is used in the initial stages of the development of the disease or as an adjuvant.
Physiotherapy treatment: the effects of procedures on the body
Physiotherapeutic procedures are able to target directly the systems and organs that require treatment. Wherein:
- blood circulation improves (both central and peripheral and regional);
- cellular nutrition processes are activated, due to which the normal vital activity of tissues and organs is ensured;
- pain syndrome is removed;
- neurohumolar regulation is normalized, in case of its violation, the function of the immune system is restored.
However, physiotherapy also has a number of contraindications. This method is not used when
- the patient's condition is accompanied by fever, his body is exhausted;
- diagnosed with an acute form of an infectious disease;
- the patient has a malignant tumor (or there is a suspicion of an oncological disease).
Also, physiotherapy treatment is contraindicated in such conditions as:
- Active course of the tuberculous process;
- Systemic diseases of the circulatory system;
- Cardiovascular diseases (in which the stage of circulatory failure is higher than the 2nd);
- Aneurysm of large vessels;
- Diseases of the central nervous system, characterized by increased excitability of the patient.
The appointment of physiotherapy treatment is advisable for children, even in cases where they have irreversible disorders. And, the earlier it is appointed, the better results can be achieved upon its completion. This is due to the fact that the child's body has very large compensatory capabilities. Here, however, one should keep in mind such features of the anatomy and physiology of young children as increased susceptibility of the nervous system, high resorptive abilities of the skin, high water content in the tissues and, as a result, a higher indicator of the accessibility of deep-lying internal organs to exposure compared to adults. electric current. It is these features that determine the need to prescribe a reduced dose of physiotherapeutic factors to children, as well as a shorter course of physiotherapy treatment (the earlier the child's age, the shorter the course and the lower the dosage should be).
Most often, children are treated with physiotherapy in the following cases:
- In the presence of skin diseases and diseases of the navel in newborns (short air baths and irradiation with a Minin lamp);
- With purulent omphalitis (a combination of ultra-high-frequency therapy, ultraviolet radiation and antibiotics);
- With phlegmon in newborns (UHF, exposure to ultraviolet rays, laser exposure);
- In the acute form of hematogenous osteomyelitis (UHF, irradiation with ultraviolet rays, laser exposure);
- With hemolytic disease (phototherapy);
- With atopic and infectious-allergic forms of respiratory allergies (inhalation, ultrasound, exposure to an alternating magnetic field, massage, physiotherapy exercises, baths, swimming, etc.);
- With broncho-pulmonary diseases (UHF and microwave therapy, ozocerite applications, electrophoresis, massage, physiotherapy exercises);
- In diseases of the musculoskeletal system, including congenital ones (diadynamic therapy, ultrasound, electrophoresis, exercise therapy, spa treatment);
- In diseases affecting the nervous system (amplipulse therapy, electrical stimulation, mineral baths, inductothermy, electrosleep, therapeutic baths, etc.);
- With ENT diseases (irradiation with a Minin lamp, UHF, inhalations, ozocerite applications, etc.);
- For diseases of the digestive system (amplipulse therapy, electrophoresis, massage, mineral water treatment, spa treatment).
Physiotherapy treatment is also an effective preventive measure that can significantly reduce the risk of developing certain diseases, slow down their progression and reduce the likelihood of relapses.
Physiotherapy is one of the most effective, safe and affordable ways to treat plantar fasciitis. Orthopedic doctors without fail prescribe physiotherapy if the patient has no contraindications.
If a heel spur is diagnosed, physiotherapy helps to get rid of pain, reduce the level of inflammation, and restore the motor functions of the feet.
Some procedures can completely eliminate the heel spike, replacing the painful one.
Heel spur: physiotherapy treatment
For physiotherapy, special devices installed in physiotherapy rooms are used. Treatment of heel spurs with physiotherapy can be done on an outpatient basis when the patient visits the clinic, or inpatient.Physiotherapy devices emit various types of energy: quantum, ultrasonic, magnetic, electrical, which has a positive effect on inflamed fascia and bone spike. The goal of physiotherapy is to improve the patient's quality of life.
The attending physician may prescribe:
- ultra-high frequency exposure (UHF);
- electrophoresis;
- ultraphonophoresis (phonophoresis);
- quantum therapy (laser treatment);
- shock-wave impact;
- radiotherapy, etc.
In the process of treatment and after it, it is necessary to use either orthopedic insoles that unload the foot at peak points of stress.Attention! Physiotherapy cannot eliminate the cause of plantar fasciitis! Therefore, during and after the course of treatment, in order to avoid relapse, it is necessary to eliminate the factors that provoke the appearance of spurs.
Laser therapy (quantum therapy) is of two types:
- low-frequency laser exposure, aimed at reducing pain, swelling and improving tissue regeneration;
- high-frequency quantum radiation, with the help of which the spur is crushed.
Shock wave therapy removes the spur by breaking it up with sonic shock waves. In the process, the growth gradually loosens and dissolves.
Additional physiotherapy for heel spurs
When prescribing treatment for heel spurs, physiotherapy should solve specific problems, doctors often recommend additional methods of physiotherapy.
These methods are not universally recognized, but their effectiveness in combination with traditional procedures is beyond doubt.
These additional physiotherapy procedures include:
- Magnetotherapy for heel spurs. Exposure to magnetic fields stimulates blood circulation, speeds up metabolism, and eliminates edema.
- Ultraviolet irradiation. Promotes tissue renewal, has a beneficial effect on nerve endings.
- Mud cure. Mud wrap helps relieve acute pain, reduce inflammation, has a warming effect
- Paraffin treatment. "Paraffin boots" have a resolving effect, stop pain symptoms.
- Hydrotherapy: baths, mineral waters, circulation showers. Improve metabolic processes, have a strengthening effect.
- . It helps to relax and release the fascia clamped by the spur, improves lymph and blood flow in the extremities.
Contraindications to physiotherapy
Despite the high efficiency, each physiotherapy has its own list of contraindications. When prescribing a treatment course, the doctor will necessarily take into account the characteristics of the body and the state of health of the patient.
Absolute contraindications for most physiotherapy procedures are:
- hypertension in the acute phase;
- oncology;
- acute infectious diseases;
- bronchial asthma in the acute stage;
- foot injuries;
- violation of blood coagulation;
- some forms of diabetes;
- foot wounds.
