Commonly Used Physical Therapy Modalities Explained

Physical Therapist patient with arms stretched outIf you’re suffering from chronic pain or your mobility has become limited, a physical therapist can provide the treatment you need to help you start feeling and functioning normally again.

Physical therapists device treatment programs that are customized to each patient’s specific needs and treatment often include therapeutic modalities. These modalities are used alongside exercise and manual treatment methods to minimize pain, assist the healing process, and restore functional mobility.

There are various types of modalities that can be used in physical therapy. While those that your therapist may choose to include in your treatment program will be based on your particular situation, here’s a look at some modalities that are commonly used.

Transcutaneous Electrical Nerve Stimulation

More commonly referred to as TENS, this modality involves using a low-voltage electrical current to relieve pain. With this modality, electrodes that are attached to a small battery operated machine are applied to the affected site. When the machine is turned on, a low electrical current passes through the electrodes and is delivered to the nerves. For many patients, this electrical current helps to reduce pain.

There are two theories that support the pain reducing effects of TENS therapy:

  1. The electrical current activates the nerves in the affected area and transmits signs to the brain that block pain signals.
  2. The electrical stimulation may aid in the production of endorphins, the body’s natural painkillers.

TENS therapy is used to treat many types of pain, including chronic back pain, pain caused by an injury, and fibromyalgia.


This form of treatment involves using a topical medication and ultrasound. The medication is applied to the skin and ultrasound waves are used to facilitate the passage of the medication through the skin and into the injured area. This modality is commonly used to treat inflamed tendons, ligaments, and muscles, as it helps to ease the inflammation so that the body can begin healing itself.

Phonophoresis is often used for the treatment of bursitis, tendonitis, and arthritis, though it can be used to treat any condition that involves inflammation.


This modality is essentially a combination of phonophoresis and TENS therapy. A topical medication is applied to the skin and electronic stimulation is used to pass the medication into the affected area. Iontophoresis is used to:

  • Reduce inflammation
  • Minimize pain
  • Lessen spasms of the muscles
  • Decrease swelling

Ice Therapy

You’ve probably used ice packs yourself to treat swelling. They are a modality that is commonly used in physical therapy, too. During ice therapy, packs that contain frozen gel are applied to the area that requires treatment. The cold temperature helps to reduce blood flow to the affected area, thereby reducing inflammation. Ice therapy is often used after therapeutic exercises to prevent swelling.

Heat Therapy

With this therapy, moist hot packs are wrapped in towels and applied to the area that requires treatment. The heat helps to relax tight muscles and tissues. It also increases circulation. Heat therapy can help to ease pain, prevent spasms, and improve muscle elasticity. Heat therapy is a physical therapy modality that is commonly used to treat muscle strains and spasms, as well as arthritis.

Ultrasound Therapy

During ultrasound therapy, a physical therapist moves a transducer (a handheld instrument) over the injured area. The transducer delivers ultrasound waves to the affected site. These ultrasound waves deliver deep heating to the muscles, tendons, ligaments and other soft tissues. This helps to increase circulation, which can help to speed up the rate of healing. Ultrasound therapy also delivers energy to the affected area, which causes the development of tiny gas bubbles around damaged tissues, allowing them to quickly expand and contract. This process is referred to as cavitation, and it is believed to enhance cellular processes allowing for better healing.

Ultrasound therapy is used to treat a variety of conditions, including frozen shoulder, tendonitis, bursitis, strained muscles, and damaged ligaments.

Which Modality is Right for You?

That depends on your specific condition. Your physical therapist will perform a thorough evaluation to gain a better understanding of your injury and how it is impacting you. Based on your evaluation, as well as your specific goals, your PT will determine which therapeutic modality is best suited for your particular needs.

Do Physical Therapy Modalities Hurt?

woman using pilates for physical therapyAgain, this is specific to each individual. Your injury, coupled with your tolerance for pain, will determine whether or not you will experience any discomfort. Therapeutic modalities are intended to minimize pain; however, there is a chance that you could feel slight discomfort initially. However, with repeated used and as your body begins to heal, any discomfort (which is generally mild) will subside.

If you do experience any pain and you’re concerned, speak to your therapist. Therapeutic modalities shouldn’t cause a significant amount of discomfort. If yours does, adjustments might need to be made, or another method may need to be used.

The modalities that are used in physical therapy aim to ease pain, restore functional mobility, and facilitate faster healing. When used in conjunction with other therapies, such as exercise, they can significantly improve your recovery time.