Physical Therapy Modalities and Durable Medical Equipment

elbow tendonWhen you think about physical therapy, what comes to mind? Is it performing specific exercises focused on improving your current condition? Or how about receiving manual therapy techniques from your therapist to help restore you to your prior level of function? Both are common throughout course of treatment. However, another area that isn’t too frequently talked about is different modalities that may be added to your plan of care such as transcutaneous electrical nerve stimulation (TENS) or ultrasound. Additionally, you may receive different types of durable medical equipment (DME) such as orthotics or braces.

What makes us different here at Advanced Physical Medicine and Rehabilitation is that we believe ingiving our patients the total package to help them fully reach their maximum level of function. In addition to the therapeutic exercises and manual therapy that you receive, we can help you reach your full potential by using these modalities and DME as adjuncts to your plan of care. The purpose of this blog series is to be help you better understand the different types of modalities and DME that may be used with you during your therapy sessions. Over the course of the next few months, we will take a closer look at the modalities and DME that Advanced PMR can offer. We will discuss how the modality/DME works, different diagnoses that may benefit from using such, and provide you with additional information on how to inquire about each modality/DME so that you can reach your maximum potential.

Today we will briefly discuss the modalities of heat and ice. Quite often, these are the two most common modalities used by almost all physical therapy practices. However, a common question I hear asked by patients is: “Should I use heat or ice?” To put it simply, it depends!


There are many different types of modalities that physical therapists may utilize to apply heat to your affected area. For example, contrast baths, paraffin baths, and whirlpool baths are all examples. However, the most common and easiest to apply is a moist heat pack.

How Does It Work?

Whatever form of heat that is applied to body will heat up the underlying tissue underneath the skin. If the temperature is sufficient and the time of application is appropriate, heat can help penetrate to the deeper tissues such as muscle. This can help loosen up the “tight” muscles that we all commonly experience. Additionally, heat can cause increased circulation of blood flow to the area of application which is beneficial for pain relief and healing processes.

What Conditions/Diagnoses Can It Help?

  • Muscle Strains
  • Muscle Spasms
  • Osteoarthritis
  • Many more!!!

Contraindications to Using Heat (Not a full list, just the major ones)

  • Acute inflammation
  • Decreased sensation in area of application
  • Decreased arterial blood flow


There are also many different modalities that your therapist may use to help apply cold to your affected body region. Examples of these are ice packs, ice massages, cold immersion techniques, or vapocoolant sprays. However, ice packs are often the easiest to apply and therefore are most commonly used.

How Does It Work?

When cold substances are applied to your body, there is a transfer of heat from your body to the cold substance, causing the muscles and other tissues to cool down. This causes vasoconstriction or decreased blood flow to the area which can help reduce inflammation and pain.

Which Conditions/Diagnoses can it Help?

  • Osteoarthritis
  • Acute injuries
  • Swelling/Inflammation
  • Many more!!!

Contraindications to Using Cold (Not a full list, just the major ones)

  • Decreased sensation in area of application
  • Cold allergies
  • Long durations

In conclusion, heat and cold can both be used to combat injuries if used correctly. If you have questions about which modality to apply, please don’t hesitate to ask your physical therapist. Doing so may help speed up your recovery!
Also, be sure to check out the next installments of this series!
Installment 2: TENS
Installment 3: Ultrasound
Installment 4: Braces/Orthotics
Installment 5: Strapping/Taping

By: Matthew Frawley, PT, DPT

Posted in: Physical Therapy

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