Passive Physical Therapy for Pain Management

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Physical therapy is a standard recommendation for just about anyone experiencing some type of temporary or chronic pain, or for patients looking to restore normal range of motion following surgery or while recovering from an injury. While most people think of physical therapy as involving some type of exercise requiring active participation on the part of the patient, it may also involve techniques that do not require participation. This type of PT is referred to as passive physical therapy, which is strictly therapeutic in nature.
Hot and Cold Therapy
Temperature-based therapy is the most common type of passive physical therapy. It involves the application of a safe level of heat or cold to the affected area of the body. Usually more effective when cold and heat applications are alternated, such treatments ease tissue swelling and increase circulation to the affected area. Hot and cold therapy is typically recommended to treat pain due to:

  • Muscle strain causing periodic spasms
  • Pain related to swelling or inflammation
  • Discomfort relegated to soft tissues in a specific area

Electrotherapy
Involving the delivery of low levels of current to disrupt the transmission of pain signals, electrotherapy is often used to manage spine-related pain, specially low back pain. The most common form of electrotherapy is TENS (transcutaneous electrical nerve stimulation). If relief is experienced during a trial use period with TENS, a self-controlled unit may be used by the patient to manage pain on a regular basis.
Ultrasound
Ultrasound is a form of passive PT that works by delivering sound waves through the skin to soft tissues that produce soothing warm sensations. It can be delivered as continuous sound waves (thermal ultrasound therapy) or as pulses (mechanical ultrasound therapy). While not effective for all types of chronic pain, ultrasound therapy may be effective for pain related to:

Massage Therapy
Directly targeting tense muscles, massage therapy can involve light touches or deep tissue stimulation. While it may be a standalone treatment, massage therapy often works best when combined with other pain management efforts, including the use of anti-inflammatory drugs and heat and cold applications to the affected area.
Patients who are unable to participate in active physical therapy due to chronic or debilitating pain may experience meaningful relief through passive PT alone. Patients who do well with passive PT sometimes reach a point where they can safely do therapeutic exercises or participate in other forms of active PT. Any form of physical therapy for pain management purposes will be more effective when likely pain sources have been correctly identified.