Physical Therapy Modalities
Modalities may be used in conjunction with exercise and hands-on techniques to augment treatment by decreasing inflammation and/or pain, improving circulation, and promoting tissue healing.
LOW LEVEL LASER THERAPY
Laser therapy utilizes light from a laser to stimulate cell or tissue function. Since the intensity level of the light is low, there is virtually no thermal (heat) effect. The reaction it produces at the cellular level is photochemical or photobiologic, which is similar to the effect of the sun to plants. The light photons are absorbed by the cells and stimulate the production of ATP, which improves cell function & tissue regeneration, increases cell proliferation, stimulates blood circulation, increases lymphocyte activities. All of these effects assist in the healing process.
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Various forms of electrical current have been used in the clinical setting for pain control, edema/inflammation, and muscle strengthening, as well as other conditions.
Electrical stimulation uses the gate theory to control pain. Simply, it sends messages through the pathways and triggers the receptors to "close the gate" on the pain messages to the brain. Since less pain messages are getting through, your pain threshold increases and you feel less pain. There are different types of electrical stimulation which control pain, but the one that has been found to be the most comfortable is interferential current, which is the one that we use predominantly to control pain at our facility.
Another use for electrical stimulation is to reduce edema or inflammation. The current, settings, and electrode placement are specific in order to achieve muscle contractions around the affected region to create a "pumping" action. This "pumping" action decreases the pooling of fluid and allows it to flow better.
Electrical stimulation can also be used to help strengthen muscles. It activates a muscle contraction and facilitates movement in weak muscles.
Iontophoresis is a procedure in which medication is transmitted through the skin via a low voltage current. It is a non-invasive and painless method to treat a joint or small body part for conditions such as tendinitis, bursitis, carpal tunnel syndrome, etc.
The use of heat is generally more comfortable than ice, and it has been shown to decrease pain and muscle spasms, as well as joint stiffness. Because heat increases the blood circulation and helps relax muscle spasms, it decreases the pain sensation. Patients often ask what the difference is between dry and moist heat. At our facility, we recommend the use of moist heat as it is safer and more effective. There are higher incidences of burns with dry heat. Moist heat penetrates to deeper tissues thereby providing longer-lasting relief of symptoms.
Another method of delivering heat is through the use of paraffin. It is generally used for the extremities (i.e., hands and wrists) where the use of moist heating pads is too cumbersome and cannot maintain contact with these areas.
Cold therapy has been shown to be effective in controlling/reducing inflammation, pain, muscle spasms, even in chronic conditions. Applying ice for approximately 10-15 minutes can control pain by interrupting the pain cycle and reducing inflammation/edema. Some patients are reluctant to try ice, but once persuaded, most find that they receive more relief with the use of ice than that with heat.
Ultrasound uses sound waves which travel through tissue and depending on the settings used, has a variety of effects on the body. Ultrasound reaches the deeper tissues and is used to decrease pain and muscle spasms, to increase joint motion when done with stretching, to accelerate tissue healing, and to facilitate transdermal drug delivery.
Phonophoresis is a method in which anti-inflammatory drugs are delivered via ultrasound into a small area that is painful or inflamed. It is a non-invasive and painless way to treat certain conditions (e.g., tendinitis, bursitis). With phonophoresis, the drug is more concentrated in a specific area without stomach upsets, pain, and risk of infection which are associated with taking medications orally or by injection.