What are Modalities and how are they Used in Physical Therapy?

Orthopaedic & Spine Center

 by Victoria Bartnikowski, LPTA

Dictionary.com defines a modality as: “Medicine/Medical- the application of a therapeutic agent, usually a physical therapeutic agent”. It is also expected that the use of a modality will produce some sort of physiologic response or change. So, it follows that treatments that we provide to patients for their musculoskeletal problems can be considered modalities. In this article, I will discuss the modalities we use here at OSC, and what their purpose served if treating patients in a Physical Therapy setting. This list is not inclusive of all modalities, but gives those most commonly used.

Electrical Stimulation – The use of an adjustable electric current to reduce muscle spasms by regulating and modulating contraction rhythm. This can help increase strength in a weak muscle and also help to increase blood flow to the area as the muscle contracts to improve healing. An excellent therapy after surgery or injury.

TENS – Transcutaneous Electric Nerve Stimulation – A small, battery operated device delivers a mild electric current, similar to electrical stimulation in the clinic, through electrodes applied to the skin. The patient feels a tingling sensation from the current which moderates discomfort by disrupting the pain signal sent to the brain. It is helpful for muscle spasms and chronic pain not helped with exercise or medication. This does not need a Physical Therapist to operate, is portable and can be adjusted by the patient anywhere.

Hot Packs – These are kept in a steamer and then wrapped in towels before being placed on the patient. The steam creates moisture, which along with the heat, penetrates tight and sore muscles, relaxing them and increasing blood flow to the area. They are especially helpful for arthritis, muscle spasms and strains.

Cold Packs – These are kept in a cold box and can be wrapped in either dry or wet towels before being applied to the patient. The cold reduces blood flow and inflammation thereby providing pain relief for the patient. The reduction in swelling is very beneficial for post-surgical patients and those with acute strains and sprains.

Ultrasound – Ultrasound is used to transmit sound waves into painful areas, relaxing and warming the tissues and causing increased blood flow. This treatment is great for muscle spasms and trigger points.

Traction – the use of a modulated force to pull the body lengthwise or longitudinally, to pull apart or distract spinal vertebrae to relieve pressure on compressed nerves, thereby reducing pain and inflammation. This can be done by placing the patient on a specially designed traction machine or it can be done manually. Traction can be used for both cervical and lumbar portions of the spine.

Low Level Laser Therapy – the use of red-beam light to detect impedances (resistance) found in tissue. This modality can be used in conjunction with electrical stimulation and can be used for both acute and chronic conditions, such as decreasing edema, pain control and reducing scar tissue.

Functional Dry Needling– performed by Physical Therapists, use of a monofilament needle to release myofascial trigger points or tight muscles, reducing pain and improving range of motion.

Modalities are therapeutic tools that we use to help our patients recover from surgery, injury or a condition that causes pain and dysfunction, so they can get back to the activities they enjoy.