What Are Modalities and How Are they Used in Physical Therapy?
Let’s begin by explaining what classifies a modality. Therapeutic modalities are classified according to the type of energy they produce. The various forms of energy that are relevant to therapeutic modalities include thermal conductive energy, electrical energy, electromagnetic energy, sound energy, and mechanical energy. Modalities are used to relieve pain, improve circulation, decrease swelling, reduce muscle spasm, increase range of motion (ROM), and improve tissue healing.
Here at PTSC we offer various types of modalities in order to give our patients the best treatment possible. These modalities include thermotherapy and cryotherapy, also known as hot and cold therapy, ultrasound therapy, electrical stimulation, iontophoresis, cervical traction, and lumbar traction.
Cryotherapy: The application of cold to the musculoskeletal system is a widely used practice in sports medicine. According to new research proposed in 2020 by the British Journal of Sports Medicine, ice therapy should be avoided immediately following an injury. Ice may potentially disrupt the inflammatory phase of an injury which is one of the most important phases as it increases the amount of blood flow to the site of injury to get more nutrients and white blood cells to the area in need (Dubois 2020). Therefore, ice should be used during the sub-acute phase of recovery. The most common method of cryotherapy is through ice or cold packs and immersion in cool or cold water. In most cases, the longer the cold exposure, the deeper the cooling. One may note that cold therapy can be more penetrating then heat therapy. Once a muscle has been penetrated through the subcutaneous fat, the fat acts as an insulator to slow the rewarming process.
Thermotherapy: The application of heat to treat disease and injuries has been used for centuries. The desirable therapeutic effects of heat include decreasing joint stiffness, reducing pain, relieving muscle spasm, reducing inflammation, edema, and exudates in the post-acute phase of healing, increases blood flow, and increases the extensibility of collagen tissue. Heat therapy is most commonly used through heat packs. However, there are limitations of the heat pack in that the deeper tissues, including the musculature, are not thoroughly heated because the heat transfer to the deeper tissue is obstructed by the skin and subcutaneous fat.
Therapeutic Ultrasound: Ultrasound is another widely used modality in physical therapy. Ultrasound is primarily used as a deep-heating modality and is used primarily for elevating tissue temperatures. This is one tool that enables therapists to treat those deep tissues that a regular heat pack cannot quite reach. Ultrasound is primarily used to stimulate the repair of soft tissue injuries, and for pain relief.
Electrical Stimulation: In physical therapy, the main goal of electrical stimulation is to help build strength and improve muscle function, relieve pain, and improve blood circulation which can promote healing. Some medical conditions that can be treated with electrical stimulation include, low back pain, post-surgical pain, muscle weakness or poor motor control, tendonitis and bursitis.
Iontophoresis: Iontophoresis with electrical stimulation is a therapeutic technique that involves the introduction of ions into the body tissues by means of direct electrical stimulation. It causes transdermal drug delivery by using low voltage to move ions across a dermal layer. Iontophoresis is used to decrease inflammation, scar modification, wound healing, treating edema, and decrease pain.
Traction: Traction is a drawing tension applied to a body segment. It is most commonly used in the cervical and lumbar regions of the spine. Traction can be applied through manual techniques or mechanical devices. Traction is used to provide separation of the vertebral bodies and in so doing can affect stretching of the joint and ligament capsules of the spine, stretching of spinal and paraspinal muscles, relieve pressure on nerves, and decrease central pressure of the intervertebral disks. The most common uses for traction includes the treatment of spinal nerve root impingement which can cause vertebral disk herniation or spondylolisthesis. It can also be used to decrease muscle guarding, treat muscle strain, and reduce any discomfort from abnormal spinal compression.
At PTSC we offer all of these modalities to provide the best patient care possible. Feel free to reach out to your physical therapist to see if any of these modalities may benefit your treatment plan.
About the Author: Tyler Cannella
Tyler Canella started as a student observer in our clinic, in his final year at CMU in the kinesiology program, and progressed to worked in our clinic as a PT tech for several months before just recently leaving to advance into the profession on physical therapy . He has a long standing history and played recently on the CMU football team.