pt tech - physical agents

Physical agents

therapeutic modalities used in physical therapy to enhance recovery, manage pain, reduce inflammation, and improve overall function. These agents apply specific forms of energy to the body, such as heat, cold, light, electricity, or mechanical forces, to achieve desired therapeutic effects.

Inflammatory Stage (Acute)

Timeframe: Begins immediately after injury and lasts 3–7 days.

Purpose: Protect the injured area, remove damaged tissue, and prepare for healing.

Proliferative Stage (Subacute)

Proliferative Phase (Subacute Stage)Timeframe: Begins around day 3 and lasts up to 3 weeks (~20 days).

Purpose: Rebuild damaged tissue (via collagen, etc.) and form new blood vessels (angiogenesis).

Maturation Stage (Remodeling)

Timeframe: Begins around week 3 and can last several months to a year.

Purpose: Strengthen and remodel collagen fibers to restore tissue integrity and function.

Thermotherapy (Heat)

Purpose: Increases blood flow to the area.

Reduces muscle tension and stiffness.

Promotes tissue healing.

Methods: Hot packs, warm water baths, paraffin wax, heating pads.

Indications: Muscle spasms, joint stiffness, chronic pain, and subacute injuries.

Hot Packs

How to Use: Apply a hot pack wrapped in a towel to the target area (6-8 layers).

Duration: 15–20 minutes.

Precautions:

Avoid direct contact with the skin to prevent burns.

Not suitable for open wounds or areas with impaired sensation.

Perform regular skin checks (every couple minutes) for burns/ blanching, etc.

Paraffin Wax

Purpose:Provides deep heat to small or irregularly shaped areas (e.g., hands, feet).

Improves joint flexibility and reduces pain.

How to Use:

Dip the body part into melted paraffin wax (temperature: 120–130°F).

Repeat dipping 6–10 times to form layers, then wrap in plastic and a towel.

Duration: 15–20 minutes.

Cryotherapy (Cold)

Purpose:Reduces swelling and inflammation.

Decreases pain and muscle spasm.

Slows down cellular metabolism.

Methods: Ice packs, cold compresses, cryotherapy machines.

Indications: Acute injuries, sprains, and post-surgical swelling

Precautions: Avoid prolonged use to prevent frostbite or tissue damage.

Ultrasound

Purpose: Promotes tissue healing and reduces pain.

Improves blood flow and breaks up scar tissue.

How It Works: Uses sound waves to create deep heat in tissues

Indications: Tendonitis, bursitis, chronic pain, and scar tissue.

Precautions: Avoid over areas with infections, pacemakers, or fractures.

Ultrasound units have typical parameters/ setting that are utilized for different goals within treatment. These parameters will be dictated within the plan of care (POC) from the

supervising PT

Ultrasound Parameters

Frequency:

1 MHz: For deep tissues (up to 5 cm).

3 MHz: For superficial tissues (1–2 cm).

Intensity (Amplitude):

Measured in watts per square centimeter (W/cm²).

Higher intensity for therapeutic heating; lower intensity for non-thermal effects.

Traction

Purpose: Stretches soft tissues and relieves pressure on spinal discs and joints. Lumbar and cervical traction are typical.

Methods: Cervical or lumbar traction, manual or mechanical.

Indications: Herniated discs, nerve compression, and spinal pain.

Precautions: Not recommended for unstable spine conditions or osteoporosis

Compression

Purpose:

Improves blood flow and reduces swelling.

Prevents blood pooling and supports venous return.

Common Methods:

Compression bandages or wraps (e.g., Ace wraps).

Compression stockings (graded pressure levels).

Pneumatic compression devices (intermittent air pressure).

Indications:

Edema (swelling) from injury or chronic conditions.

Venous insufficiency or lymphedema.

Deep vein thrombosis (DVT) prevention post-surgery.

Precautions:

Avoid use with arterial insufficiency, blood clots, or active infections.

Ensure proper fit and pressure to prevent discomfort or further complications

Electrical Stimulation (E-stim)

Purpose:

Reduces pain and inflammation.

Improves muscle strength and circulation/ contractions.

How It Works: Uses electrical currents to activate nerves or muscles

Indications: Muscle atrophy, pain management, and wound healing.

Precautions: Avoid over pacemakers, pregnant abdomen, or open wounds.

Transcutaneous Electrical Nerve Stimulation (TENS)

Purpose: Provides pain relief by disrupting pain signals (pain gating)

How It Works: Delivers low-voltage electrical currents to the skin.

Indications: Chronic pain, arthritis, and nerve-related pain.

Precautions: Avoid over the neck, head, or areas with impaired sensation.

NMES (Neuromuscular Electrical Stimulation)

Purpose: Stimulates muscle contractions to build strength and prevent atrophy.

Uses: Muscle weakness, post-surgical recovery, and motor re-education

IFC (Interferential Current)

Purpose: Targets deep tissues for pain relief and swelling reduction.

Uses: Back pain, osteoarthritis, and muscle spasms.

HVPC (High-Voltage Pulsed Current)

Purpose: Promotes wound healing and reduces swelling.

Uses: Wound care, edema control, and acute injuries.

Russian Stimulation

Purpose: Enhances muscle strength/ neuromuscular reintigration using high-frequency stimulation.

Uses: Advanced strengthening for athletes or post-surgical recovery.

E-stim Parameters

E-stim units have typical parameters/ setting that are utilized for different goals within treatment. These parameters will be dictated within the plan of care (POC) from the supervising PT.

Cryotherapy Contraindications

Cold hypersensitivity or intolerance (e.g., Raynaud's disease).

Impaired sensation or circulation.

Open wounds or infections.

Peripheral vascular disease.

Cryoglobulinemia (abnormal proteins in the blood).

Ultrasound Contraindications

Over areas with malignancy.

Pregnancy (avoid over the abdomen, pelvis, or lower back).Pacemakers or implanted electronic devices.

Over fractures or bone growth plates in children.

Infections or areas with impaired circulation.

Traction Contraindications

Spinal instability or fractures.

Osteoporosis or severe degenerative joint disease.

Acute injury or inflammation.

Pregnancy (lumbar traction).Tumors or infections in the spine

Compression Therapy Contraindications

Deep vein thrombosis (DVT) or blood clots.

Severe arterial insufficiency or vascular disease.

Congestive heart failure.

Acute infections or skin conditions.

General Considerations for Modality Use

Always assess for impaired sensation or circulation issues before applying any modality.

Consult with the supervising therapist for patients with complex medical conditions.