Physical agent modalities, also known as PAMs or modalities, are methods used by therapists to prepare the body for appropriate movements, during occupational engagement or functional activities, that were otherwise limited. Modalities can be used for a variety of reason including to decrease pain, decrease scar tissue, decrease edema or swelling and to increase tissue healing and extensibility for movement. So what exactly are modalities? Some examples of modalities used at All Care Therapies include hot packs, paraffin wax, ultrasound, TENS and iontophoresis.
Heat Modalities
Hot packs and paraffin wax are known as superficial thermal agents. These heat modalities are called superficial because they only penetrate the top part of tissue (approximately 1 cm). A therapist may apply a heat modality to provide pain relief to a specific area, increase blood flow or increase elasticity of tissues to allow for appropriate movements.
Ultrasound is another heat modality commonly used in the clinic. Ultrasound is known as a deep thermal agent because it penetrates the tissue deeper, approximately 3-5 cm, than a hot pack or paraffin can. Ultrasound can be used to promote wound healing, decrease pain and treat soft tissue disorders.
Electrical Modalities
TENS, or transcutaneous electrical stimulation, is a type of electrical modality that sends an electrical current to the affected area by way of electrodes, to stimulate nerves or muscles. TENS is used to decrease pain to a specific area, facilitate tissue healing, improve muscle strength/endurance and decrease swelling.
Iontophoresis is an electrical modality that uses electrical currents to deliver medications to the affected area. Iontophoresis is most commonly used with the medication, dexamethasone, to decrease pain in musculoskeletal disorders. It can be paired with other medications to accomplish different goals.
These modalities are the most common ones used at All Care Therapies. After an initial evaluation, a licensed therapist will determine whether or not you could benefit from the use of one of these modalities or others!
References
Chang, Y., Hsieh, S., Horng, Y., Chen, H., Lee, K., & Horng, Y. (2014). Comparative effectiveness of ultrasound and paraffin therapy in patients with carpal tunnel syndrome: A randomized trial. BMC Musculoskeletal Disorders, 15, 399. Retrieved from https://doi.org/10.1186/1471- 2474-15-399
Kaur, J., Malik, M., Sharma, P., Sangwan, P., & Rani, M. (2017). Effect of iontophoresis with dexamethasone in pain. Indian Journal of Physiotherapy & Occupational Therapy, 11(3), 1-6. Doi: 10.5958/0973-5674.2017.00062.4
https://now.aapmr.org/therapeutic-modalities/
https://www.verywellhealth.com/electrical-stimulation-2696122
https://ajot.aota.org/article.aspx?articleid=1876574