PHYSICAL THERAPY MODALITY AND PROCEDURES

Hot packs: A superficial moist heating source to relax muscles and relieve pain by increasing local blood supply.

Cold packs/ice massage: The use of individual packs or a forn of ice to decrease sensitivity of painful areas and relax muscle spasm. The cold causes a slowing of nerve impulses to the muscle and via vassal constriction, a decrease circulation allowing for a decrease in inflammation.

Ultrasound: Uses a diathermy type unit as a voltage generator and a porch crystal to produce ultrasonic energy. The high frequency waves produce deep heat as well as a "micro massage" of tissue substance. As a result increase circulation and muscle relaxation is obtained. Ultrasound is often used with cortisone cream, phonophoresis, to help decrease acute inflammation.

Electrical stimulation: Electrical currents of various frequencies are put through a muscle to improve circulation, caused some form of muscle contraction, and decrease pain. It is effective in acute, subacute and rehabilitative phases of a patient's recovery. There are various types available:

• Interferential
• E.G.S.
• E.M.S.
• Respond II
• Urinary incontinence vs. stimulator units

Iontophoresis is accomplished by using an electrical stimulator to drive a prescribed medication (usually an anti–inflammatory) into the tissue. Iontophoresis is used when there is one small local point of pain or spasm.

Phonophoresis is accomplished by using ultrasound to drive a prescribed medication (usually and antiinflammatory) into the tissue. The medication is mixed with the U.S. gel and is useful when there is a large area to be treated

Therapeutic exercise: There are many possibilities of therapeutic exercises, and the physical therapist may choose to –use it for prevention, rehabilitation or maintenance. Exercises may be classified in a variety of ways:

• Passive
• Active Resistive
• Progressive resistive
• Home exercise are given to compliment those exercises given in the clinic. The patient can then continue to work on his/her problem at home between therapy sessions.

Trigger points: Firm digital pressure applied to a hyper irritable spot in the muscle or fascia that is painful on compression and can give rise to referred pain, tenderness, and even autonomic phenomenon.

Soft tissue and joint mobilization/myofascial release: Manual skills are used to test and treat muscle and skeletal problems. They include passive physiological joint movements and passive excessary joint movements. The physical therapist will use mobilization to decrease pain and decrease muscle spasm, increase range of movement and improve the quality of movement. These techniques stretch the joint capsule, associated ligaments and affected muscles.

Spray and stretch: Flouromethane is sprayed over a muscle while it is stretched. The therapist continues to stretch the muscle as the flouromethane if sprayed on. The flouromethane acts to cool the skin over the muscle to inactivate the trigger points and therefore increase range of motion.

TENS– Transcutaneous Electrical Nerve Stimulation: It is the form of electrical stimulation that has found to be successful in the relief of pain. It is commonly used in home programs for patients.

Whirlpool: Either warm or cold water used for upper or lower extremities to increase blood supply and promote healing. Used with orthopedic and pediatric problems; also to cleanse open wounds and ulcers.

Paraffin: A wax treatment primarily for treatment of hands, used to increase blood supply and promote healing.

Fluidotherapy: Uses air– fluidized solids use the heat transfer medium in thermal therapy application.

Bio–feedback: The use of instrumentation to help patients gain voluntary control over muscle tension. Often used in headache patients with tight upper cervical muscle. It is effective in pain relief, decreasing swelling and desensitization programs. Often most effective with an application of ice immediately following fluidotherapy cervical muscle. It is effective in pain relief, decreasing swelling and desensitization programs. Often most effective with an application of ice immediately following fluidotherapy.