Physical therapists do their work through a variety of methods and modalities, some of which may seem more mysterious than others. Many of my patients ask questions like “What is ultrasound?” or “What is electrical stimulation?” They also want to know how each can help their particular ailment. I thought perhaps a little clarification would benefit folks.
The term “modality,” when used in a medical context, simply means a therapeutic approach. In the more specific context of physical therapy, it usually implies the use of other equipment, like the ultrasound or electrical stimulation machines, both of which are often useful. Modalities have been used in the physical therapy realm of treatment since “physiotherapy” was first introduced. In the 1800s, heat and ice were commonly used to treat all sorts of musculoskeletal maladies. Some original tools and traction devices appear to us today to be barbaric (and many believe some were). Our modern modalities and tools are far from barbaric, however.
Over the years, scientific research has introduced a vast number of new modalities to augment the work of manual therapy and exercises in physical therapy. These new tools provide physical therapists with many options to meet patients’ needs with the most effective treatments. Well chosen modalities can assist the therapist in providing the best possible care.
Ultrasound is a non-invasive technique involving vibrations—sound waves—at a frequency above the range of human hearing. The vibrations, applied using a smooth head and lubricating gel, provide deep heating of soft tissues in the body such as muscles, tendons, ligaments and joints. This increases circulation to those tissues which then helps the healing process and decreases pain. An ultrasound treatment will usually take ten minutes or less. During the treatment, the ultrasound head is kept in constant motion, and the treatment usually feels relaxing to the patient.
Electrical stimulation, another commonly used therapy, may initially seem a bit scary or unknown to patients. You may hear us refer to it as “e-stim.” More than 100 years ago, medical researchers realized that the human body and its muscles operate on electrical impulses from the brain and spinal cord. The technique of stimulating muscles and tissues with electricity has evolved over the years to be a painless and dependable tool for physical therapists, especially in reducing pain. Treatments take from 10 to 20 minutes. Electrical stimulation involves the placement of electrodes on the part of the body being treated and may be used in physical therapy for the following situations:
- to assist in reducing pain, inflammation and swelling around a joint;
- to decrease pain and spasm in muscles;
- to assist a muscle in contracting to increase its strength; and
- in wound healing to stimulate tissue repair.
I try to take full advantage of modalities in my work with patients, incorporating both e-stim and ultrasound wherever appropriate. I find I use my hands as my eyes to understand a patient and form an assessment. This is part of what makes our approach unique here at Foothills. I believe it’s important for each person to receive individualized care, looking at the whole person and remembering that one size absolutely does not fit all!
It’s our goal to provide patients with lots of information about their physical therapy program, and to involve them as we go along in refining the plan. Patient understanding and involvement is actually critical to the success of our work together. If something we’re doing seems mysterious or confusing, it’s even more important that we talk it through. Ask plenty of questions!
~ Marion C. Howell, MS PT