[Physio and balneotherapy of acral circulatory disorders and cutaneous microangiopathies].

The peripheral circulation and the receptive function of the skin are constituents of the thermoregulation. When physiotherapy is first of all understood as regulation therapy, then the thermotherapy is a nearly causal element in the total therapy concept of disturbances of the acral blood supply and of cutaneous microangiopathies. Among the thermotherapy the hydrotherapy occupies the first place in efficacy, universal practicability and irritation dosage of physiotherapeutic measures. It should be a constituent of every information for vascular training. Under this aspect also the therapeutic classification of the sauna bath is to be performed. On principle the intensity of irritation of the individual treatment and the series of treatment should stand in the reverse relation to the degree of severity of the disease. The apparative-bound physiotherapy is performed in series in policlinical departments. Particular attention is paid in this case to electrotherapy, last not least also on account of favourable conditions as to working economy. The spa-therapy connects the various therapy disciplines in the framework of an indication-orientated complex therapy, in which dominate the balneo-climatotherapy and the physiotherapy. While nearly all peripheral functional disturbances of the blood supply react favourably to measures providing warmth supply, in the erythromelalgy pathological warmth sensitiveness is existing, which renders necessary a removal of heat. The heat desensitisation demands particular caution in temperature-increasing therapies. All organic manifestations (Raynaud's disease stage II, diabetic microangiopathy among others) restrict the reactivity to temperature irritations, so that the warmth supply must be performed particularly protractedly, or only still segmentally effective physiotherapeutic techniques are used.