Although the emphasis of a good back rehab program is returning to function and activity while learning to control the symptoms of low back pain, there are instances where the use of "passive modalities" is indicated. In most cases, passive modalities should be used in conjunction with other, more active forms of physical therapy during treatment. Modalities can be utilized early in the course of physical therapy care to help control pain. However, as the physical therapy program progresses, the focus should move away from the use of modalities and include a progressive increase in activity and exercise and instruction in self-treatment techniques.

Passive modalities are described as the application of some form of cold, heat, or electricity to the body to assist in pain management. These modalities are referred to as "passive," as the recipient does not have to actively participate. The modality is applied while the patient is at rest. The most common forms of heat include moist hot packs and ultrasound. Cold treatments, or cryotherapy, can be used to minimize pain as well. This can be administered in the form of cold packs and ice massage to the low back. Fluoromethane is a spray that can also be applied to the skin by the therapist, and is usually followed by a series of therapist-assisted stretches.

Electric stimulation can also be used to control pain. Some specific types include TENS (transcutaneous electric nerve stimulation) and microcurrent. In cases where TENS has been found to be helpful in controlling pain, especially chronic pain, a portable TENS unit can be obtained for home use.

Reprinted with Permission
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