When you think about physical therapy or physical therapy modalities, what comes to mind? Torture chambers? People screaming in pain? Severely injured persons being worked over by a hulking, muscle bound figure?
Don’t worry, you aren’t alone in those thoughts. Cartoons and films have gone a long way toward forming those types of images, but this is all about to change.
Believe it or not, modalities have been used since the dawn of time. While our ancestors did not have access to such things as ultrasound, they quickly discovered that sunlight, thermal hot spring, snow, or mud baths brought pain relief and helped wounds or injuries to heal more quickly.
After WWI, a more modern form of physical therapy and modalities began to take shape. The Polio epidemic in the 1950’s and WWII brought physical therapy modalities to the forefront, when iron lungs were used to help people breathe until they could recover.
Today, modern methods allow the medical profession to use a variety of devices powered by computers, lights, electricity, and more to restore strength, improve healing, reduce pain and give more flexibility that go beyond heating pads and simple calisthenics.
Some of the following are common myths or misconceptions about what physical therapists do and what physical therapy modalities are:
Let’s not forget that diet and exercise are also important to your rehabilitation efforts, although most people don’t realize it!
Contrary to what many people believe, physical therapy does not or cannot:
A modality is a mechanical, electrical, or thermal energy that causes physiological changes, such as pain relief, a reduction in swelling, reducing muscle spasms, improving circulation, etc.
Since manual therapy only involves hands on methods, such as soft tissue manipulation or Canalith repositioning procedures, manual therapies are extremely helpful in a variety of ways, but they aren’t necessarily a modality, but they are still therapy.
A typical physical therapy modalities list can be rather lengthy, but the modalities most often used include:
Some injuries are caused by incorrect body mechanics, stress that is unique to a particular job, or from overuse. Chiropractors often employ patient education in proper body mechanics, occupational ergonomics, and posture correction or training to help prevent future injuries.
The American Occupational Therapy Association describes PAMs (Physical Agent Modalities) as equipment that includes both superficial, thermal, electrotherapeutic agents and mechanical devices. So, while PAMs and physical therapy modalities use different names, they are almost identical in nature.
Technically, no they aren’t. Modalities are considered physical agents, such as electric, light, or mechanical means.
Therapy or therapeutic often refers to manual therapies or by effecting change through skills or services, such as massage or yoga.
Most people will simply refer to the word “therapy” or “therapies” to describe all types of healing means, including chiropractic, electrical stimulation, even acupuncture.
Chiropractors use a variety of treatment modalities, whether they are physical therapy modalities or manual therapies, to help their patients heal. Most chiropractors offer multiple physical therapy modalities, including TENS devices, cold lasers, spinal decompression, and ultrasound in addition to their manual therapies, such as adjustments and chiropractic massage.
While these two types of therapy might sound the same, they aren’t. You might think of them as cousins; closely related, but not the same.
Occupational therapy’s main focus is on helping clients improve their ability to perform daily living activities. Physical therapy focuses on improving the movements of a client’s body.
An occupational therapist will work with the entire body, helping people re-learn how to walk or speak, how to get out of bed without causing injury, or how to hold everyday items when hands or fingers have become permanently disabled.
Physical therapy addresses certain body parts, such as backs, arms, or legs, so that the patient has improved mobility, range of motion, and reduced pain levels.
As you can see from the above list, there are a variety of therapeutic modalities available to help reduce pain, speed healing, and restore function and strength. However, there are a few secrets in this area that most people are not aware of.
For the majority of patients, using a combination of both thermotherapy (heat) and cryotherapy (ice) will work better than either one by themselves. While there
While some studies have shown that heat is actually better at stopping pain, there is no doubt that ice will reduce swelling and inflammation. Contrast hydrotherapy, which uses heat, then cold, then return to heat (or the reverse) has long been used by ancient cultures and it appears to be more effective than relying on any one therapy alone.
While there are no real studies to back up claims of effectiveness, you will find most health care professionals, including physical therapists, recommend this procedure due to its known benefits and effectiveness.
Electrical stimulation is something many people shy away from due to some fear of receiving a strong shock or even electrocution, although this isn’t really possible. Electrical stimulating devices, such as a TENS until, not only stimulates healing, but greatly reduces pain. One study found that those who used a TENS device for their back pain used fewer opioid pain killers and avoided future opioid use, opting to use the TENS device instead.
Electric stimulation therapy reduces muscles spasms and blocks pain right at the nerve gateway. These devices work whether they are used pre or post treatment. When used in combination with chiropractic care, electrical stimulation devices are perfect for those with musculoskeletal issues, such as tendonitis or acute back pain.
While back pain continues to haunt more than 80% of all Americans, getting doctors to agree on any one therapy has proven to be difficult. When you consider that a Consumer Reports survey in 2016 found that nearly 90% of respondents said that they were highly satisfied with the chiropractic treatment they received for low back pain, you can easily see why chiropractic is often recommended by most physicians.
Chiropractic care is manual manipulation of the spine. Used in combination with other types of physical therapy modalities, it is one of the most effective means of stopping and preventing almost all types of musculoskeletal problems or injuries.
You will find that nearly all chiropractic clinics offer a variety of rehabilitative modalities, such as chiropractic care, electrical stimulation, heat/ice therapy, and more.
When you think of ultrasound, most people think of those cute baby pictures in the womb, but ultrasound also has powerful healing and pain-relieving effects.
Ultrasound uses vibration to deliver heat deep into tissues, such as ligaments, tendons, and muscles. This is an ultra-safe method that works very well, especially when combined with other therapies, such as chiropractic.
Studies show that ultrasound improves range of motion, improves scar tissue, and reduces painful muscle spasms. For those who suffer from health issues such as osteoarthritis, ultrasound reduces pain and improves range of motion, such as this study from 2009 demonstrated.
Some injuries are so painful, especially back injuries, that walking, standing or even sitting can bring on such intense pain that patients cannot gain strength or improve range of motion due to the pain.
This is where aquatic physical therapy can work wonders. By reducing gravity and weight, individuals can perform stretching and exercises minus the pain caused by their own body weight. This is obviously a type of manual modality, but for some patients, such as the ones in this study, it can mean the difference between healing in a few weeks or healing over several months.
Cold laser therapy, sometimes called low-level-laser, magnifies the energy from light that is invisible to the human eye. While this isn’t a new physical therapy modality, therapeutic lasers speed up the process of healing by reaching tissue that lies up to 2 inches below the surface.
Cold laser therapy has been used for at least 2 decades and is very safe and effective. Treatments can last between 5 and 20 minutes, although it generally takes several sessions for complete healing to occur since it cumulative over time. Almost all patients feel relief an hour or two after the session has ended.
Because laser therapy interacts within the cells themselves, the results are often dramatic and long lasting. There is no need to fear laser therapy, it’s not Star Wars, but you will feel warmth and tingling sensations that let you know that this modality is doing its job!
Non-surgical spinal decompression sounds like a scary new movie, but it’s actually a modality that can prevent back surgery.
Chiropractors play a vital role when it comes to bulging or herniated discs, disc degeneration, or other types of musculoskeletal issues. While adjustments will go a long way towards repositioning the vertebrae, a spinal decompression unit offers immediate pain relief while creating more space between the vertebrae of the spine, which relieves pressure.
Spinal decompression creates a vacuum that reduce negative pressure within the disc. This cannot be achieved by a mechanical or physical manipulative force alone. This procedure is painless, and many patients find that they relax completely, sometimes even falling asleep while the decompression is being performed.
One of the new physical therapy modalities is shockwave therapy. This type of modality uses very focused sound waves to breakdown scar tissue or adhesions that can form within the joints, tendons, and/or ligaments.
A 2018 study found that a single dose of shockwave therapy lasted for as long as 24 weeks for those who suffered from mild to moderate carpal tunnel syndrome when compared to the placebo group.
This type of therapy is helpful for those with tendonitis of the elbow or Achilles tendon, and sacroiliac joint problems. This new type of modality isn’t common at this time, but you might expect to see this in the near future.
If you think yoga is only for granola loving New Agers, think again! Yoga has a growing field of scientific evidence that shows it not only treats mental health issues, but it is a terrific therapy for many health problems and can be used as a self-care program for injury prevention and maintenance.
It’s been known for years that yoga helps with feelings of depression and anxiety, but because of the concentration between mind and body that occurs with yoga, it can also be used to address health issues, such as back pain and injury recovery, without the need for prescription pain killers. Many chiropractors, massage therapists, and physical therapists employ yoga techniques in their daily work.
The breathing techniques used in this ancient practice can be used to control pain, while the poses are beneficial for stretching and improving range of motion. Yoga poses stimulate the fascia and improve muscle response. In a 2012 study, yoga was found to reduce pain and stiffness, as well as shorter recovery times, for post-surgery patients.
Combined with physical therapy modalities, manual modalities, such as chiropractic and massage therapy, yoga can improve both body and mind, offering patients far more benefits than simply stretching and increased flexibility.
While nearly everyone would agree that massage therapy is a delight, not nearly as many are aware that massage therapy, especially chiropractic massage therapy, has multiple benefits that go beyond feeling good.
Chiropractic massage offers superior pain relief, especially when dealing with any type of musculoskeletal injury or pain. Those who suffer from chronic neck, back, knee, or joint pain are surprised at how well weekly massage sessions can reduce or eliminate their pain. Less pain leads to an improved quality of life.
Whenever the body is dealing with injury, improved circulation is a must for faster healing. Chiropractic massage improves circulation, which allows fresh blood to bring much needed nutrients to damaged areas and remove damaged tissue. It can even improve your cognitive function since more oxygen via improved circulation means improved thinking and memory skills, as shown in this 2012 study.
You can also find relief from depression and anxiety, since studies also show that regular massage therapy lowers the stress hormone cortisol. When cortisol levels drop, serotonin and dopamine, those “happy” hormones, increase; sometimes by as much as 28%!
This type of manual therapy also improves both sleep quantity and quality. Regular, deep sleep allows the body to restore and repair itself. When the body does not get a sufficient amount of sleep, it leads to inflammation, a reduced immune response, and more sensitive to pain. Studies show that those who receive regular massage therapy have improved sleep patterns, even for menopausal women who often find sleep elusive.
There are many more benefits that come from regular chiropractic massage therapy. You can read a full, detailed list here for more information.
There is no shortage of prescription medication in this world, but none that can match the healing power of physical therapy modalities. Whether you need chiropractic massage, sessions with a TENS unit, manual chiropractic adjustments or laser therapy, you won’t find a pill on the market at any price that can offer faster healing.
Physical therapy modalities can help everyone who is suffering from any type of musculoskeletal injury, recovering from surgery, or those who need help after suffering from difficulties such as balance or posture issues. Since modalities increase or stimulate the functioning of muscles, ligaments, and other soft tissues, this leads to faster healing, far shorter than just sitting on the sofa waiting for “things to get better.”
Even for simple injuries such as a sprained ankle, receiving modalities from your chiropractor will help you heal faster, with far less pain, than sitting for weeks with your foot resting on a pillow. With the guidance of a qualified chiropractor, physical therapy modalities can reduce swelling and inflammation, help the muscles regain strength, as well as improving ankle stability to reduce the risk of injury again in the future. No pharmaceutical pill in the world can offer you all of the above.
Don’t think that physical therapy modalities are a magic cure all. They are only as good as the person delivering them, but they have so much to offer, you might think they were heaven sent.
Your chiropractor and the modalities they choose for you can help you to manage chronic pain, including teaching you ways that you can minimize triggers that cause you pain. These techniques and teaching tools can greatly help to improve your quality of life.
If you suffer from chronic pain, you might believe that your only path to relief is through prescription pain medication. Many Americans believe that physical therapy rehabilitation and physical therapy modalities are only for the pain felt from actual injuries, such as surgery or a car accident, but there are several physical therapy modalities that work very well at controlling chronic pain.
Pain is the leading cause of disability and the most common reason Americans seek medical attention. There are several modalities and manual therapies that, when used in combination, are a powerful tool when it comes to stopping or controlling chronic pain.
Some of the best modalities for pain management are:
These modalities, especially when combined, such as chiropractic adjustments and spinal decompression, are very effective at reducing pain levels.
As with any medical procedure or practice, there is a variety of physical therapies and modalities that can treat an almost equal number of conditions.
Different types of physical therapy include:
All of the above can use physical therapy modalities and/or manual therapies, or a combination of the two, depending on the patient’s needs.
This will depend on the type of problem or injury you are having, but the truth is that this is rarely an either-or question. Most chiropractors employ physical therapists, or they have the same physical therapy modalities that can provide you with the benefits and healing that you will need.
In fact, you don’t need to fully understand your injury or issue before you make your choice. Almost all injuries involving joints, connective tissue, and/or the muscles will benefit from comprehensive chiropractic care. The same is true with many musculoskeletal complaints, such as wrist or shoulder pain, heel or knee pain, and back or shoulder pain. A chiropractor will do a complete exam and take a full medical history. If for any reason the chiropractor doesn’t feel that they will be the right health care professional to help you, they will refer you to a qualified specialist for further testing or evaluation.
Here are a few other things you might want to consider;
For those with chronic pain, your chiropractor can help to map out a daily problem of activities and find ways that help you manage your pain, such as different chairs or posture positions while sitting or stretches you can perform before you sit down at your keyboard.
Why not both? Since chiropractic care and massage therapy go hand in hand, it’s a rare clinic that doesn’t offer massage therapy. How many day spas offer chiropractic adjustments?
A massage therapist cannot diagnose injuries or health problems. Unless you are only looking for stress relief and relaxation, you would be better off seeing your chiropractor.
As primary healthcare providers, chiropractors diagnose and treat a number of health issues and injuries. Massage, while offering multiple benefits, only looks at muscle issues. Chiropractic massage helps to prepare the body for chiropractic adjustments.
Let’s not forget that many types of insurance will cover a massage done at a chiropractor’s clinic, but they certainly wont cover your local day spa massage! Remember, you don’t need a referral to see a chiropractor, no matter what state you live in.
When starting rehabilitation treatment, you can get the most out of your experience by following some of the following tips:
Your best sign that your physical therapy modalities are progressing well is a noticeable amount of time spent performing daily activities without pain and the return to what would be considered a normal range of motion.
Better Health Chiropractic and Rehab is unique in that it offers you physical rehabilitation, physical therapy modalities, and manual modalities such as chiropractic adjustments and massage therapy all in one location. This is a superior idea whose time has come and is a huge improvement from making separate appointments and driving to several locations for different treatments.
The helpful staff will be happy to help you set up appointments, check with your insurance, and guide you through the entire process from start to finish. Better Health was recently named one of the top 3 chiropractors in Anchorage, so you know this is a healthcare facility that you can rely on and trust.
Don’t wait another day! Call one of our 4 locations today for a same day appointment. We are the only clinic that offers the 3-promise pledge that ensures your complete satisfaction. Get started on the road to healing and make an appointment online today by clicking here or give us a call at 1.877.346.5255. This is one call you won’t regret making!
Dr. Brent Wells has been a trusted chiropractor since moving his family from Oregon to Alaska back in 1998 and founded Better Health Chiropractic & Physical Rehab – B.S. from Univ. of Nevada, Doctorate from Western States Chiropractic College, volunteer for Reflex Sympathetic Dystrophy Foundation, and member of the American Chiropractic Association. As a chiropractor his focus is on family, including his 3 children and wife of 20+ years, his clinics, and ongoing education.