02/07/2020
Every treatment has a time and place for adding certain modalities to it. In this post I am going to explain what each modality is, its benefits and the contraindications/precautions of using it.
Ultrasound - Ultrasound waves are generated by a vibration of crystals inside the transducer head which pass through the skin causing vibration/cavitation and can cause a deep heating locally (usually sensation of heat will be felt). This assists the body in healing from various injuries. It has shown to be beneficial in increasing: healing rates, tissue relaxation, tissue heating, local blood flow and scar tissue breakdown. It can also be paired with a medicated cream in order to introduce the medication to the tissues below the skin. Therefore it can be used to help reduce local swelling and chronic inflammation, and in some studies, promote bone fracture healing. Other conditions commonly treated are: tendonitis, chronic joint swelling and muscle spasm. Contraindications and Precautions for using this method are as follows: local malignancy, metal implants in the area being treated, local acute infection, directly over active epiphyseal regions (growth plates), over the spinal cord (laminectomy), vascular abnormalities, directly on the abdomen of pregnant women and over the eyes, skull or te**es.
TENS (Transcutaneous Electrical Nerve Stimulation) - This modality uses low-voltage electrical current for pain relief. Electrodes are typically placed on the area of pain or at a pressure point creating a circuit of electrical impulses that travel along nerve fibers. As the current is delivered, some people experience less pain as it is believed that the electricity stimulates he nerves in the affected area, and sends signals to the brain that "block" or "scramble" the bodies normal pain signals. Another theory is that the impulses stimulate the production of natural painkillers called endorphins, which may block the perception of pain. TENS has been shown to be beneficial in helping treat the following: osteoarthritis, fibromyalgia, low back pain, neck pain, tendonitis, endometriosis, multiple sclerosis, and bursitis. The electrical impulses may cause a buzzing/tingling or prickling sensation, which some people could find uncomfortable. Contraindications and Precautions for the use of this modality include: On the abdomen/pelvis of pregnant women, people with epilepsy, individuals with heart conditions, decreased tissue sensation, over open wounds, pacemaker or metal implants in the area of treatment.
NMES (Neuromuscular Electrical Stimulation) - This modality also uses electrical stimulation, but this time sends impulses to the nerves in order to create a contraction. It is often used to "re-train" or "re-educate" a muscle to function or assist in building muscle after surgery or a period of disuse. Often the patient will be required to perform an exercise with the machine on in order to help with muscle memory so that the machine is not required in the future, and the muscle can contract and function on it's own. Conditions that typically benefit from this treatment include: post-surgical patients, general muscle weakness, incomplete spinal injuries, stroke, cerebral palsy or brain injury. Contraindications and Precautions for this modality include: altered tissue sensation, impaired mental status, pacemaker, implanted pain stimulators, over malignant tissue, over open wounds, near the eyes, over the carotid sinus, front of the neck or reproductive organs.
IFC (Interferrential Current) - This device transmits electrical impulses in small quantities through the skin to underlying tissues and nerves in order to stimulate the healing process. The frequencies used have been shown to produce the production of endorphins (similar to TENS), which helps with the healing process without the need for medication. This form of therapy is beneficial in reducing pain, inflammation, edema and spasms. Conditions such as: general body pain, joint injuries and pre/post-op surgery. Contraindications and Precautions for the use of this modality are: altered tissue sensation, impaired mental status, pacemaker, implanted pain stimulators, over malignant tissue, over open wounds, near the eyes, over the carotid sinus, front of the neck or reproductive organs.
Included within your treatment there will also be manual techniques such as: hands on soft tissue work, mobilizations, therapist assisted stretching and fascial work as well as exercise prescription. All of these things together are designed to assist your body in recovering optimally.
**Everyone responds differently to modalities and hands on treatment, therefore your treatment plan may differ from someone else's as to whether or not one or more of these are included in your specific plan.**
