MODALITIES
Modalities
are adjunctive procedures some chiropractors use during treatment.
They basically fall into one of the following class types:
1.
Electricity
2. Temperature
3. Sound
4. Vibration
5. Light
These
are the physical agents capable of creating a therapeutic effect.
Modalities can be done before, during, or after an adjustment/
spinal manipulation. The goal can be to facilitate the adjustment
by relaxing surrounding muscles, reduce the pain/discomfort from
the adjustment, and to help accelerate healing in its own right.
Below
is a list of the most commonly utilized modalities:
Icepacks:
basically frozen gel packs applied to a region to lower the temperature.
Used primarily for acute (recent) soft tissue injuries to reduce
swelling and act as an analgesic by slowing down nerve signals
to the brain. Some chiropractors use ice massage, which employs
a sold piece of ice frozen in a cup pressed and rubbed over the
injured area.
Hotpacks:
usually from a hydrocollator tank, a medical grade tank that heats
water to 150 degrees. The hydrocollator pads are filled with a
clay-like material that has good heat-retaining properties. The
pads are placed over large muscle groups like the low back. Heat
increases blood flow to an area; dilates blood vessels, and brings
more oxygen to the area. Usually used for chronic or post-acute
conditions; or may be used alternating with ice packs to create
a regional "pumping" effect (ice constricts, heat dilates
blood vessels). Good for relaxing muscles before stretching.
Heat
can also be deliverd by an infrared heat lamp
or diathermy (for deep joints).
Muscle
stim: machines emit an electrical current in a special
waveform, with pre-set frequency (cycles) and amplitude. Self-adhering
electrodes are placed on muscles and are attached to wires coming
from the machine. Since muscles contract and relax via a bio-electrical
charge, it is believed that external electric muscle stimulation
can have an effect on muscle contraction and pain. Typically used
for combatting muscle spasms or hypertonicity and pain modulation/reduction.
The machines go by the names interferential, Russian stim, TENS,
or just stim.
Ultrasound:
high frequency sound waves delivered by a machine with a probe.
The sound waves generate deep heat when the waves bounce off bone.
The patient feels heat "inside" the body, under the
treatment head rather than on the surface of the skin. Used to
treat deep joint capsules such as the shoulder joint. Believed
to be able to break up adhesions (when joint surfaces "stick"together,
post injur due to inflammatory products and overproduction of
repair fibers).
Massage/Percussion
instruments: hand-held massage units that vibrate usually
in variable frequency; used to loosen tight muscles. Some instruments
deliver a very focused burst of percussive force. These particular
instruments are used to break up abnormal "fixations"
or "adhesions" of muscles and/or joints.
Low
Level Laser/ Phototherapy: a device that emits laser
light, or light in the therapeutic range (660 to 880 nm wavelength).
Therapeutic light has the tendency to increase cellular metabolic
activity. It is applied to an injury site with the goal of stimulating
the injured tissue to accelerate tissue regeneration/repair.