Abstract

Introduction: Physical agent modalities are used as an alternative source for pain management in long-term care facilities. Physical agent modalities are defined as, “modalities that consist of energy and materials that are applied to a patient to assist in their rehabilitation process.” This includes thermal, mechanical, and electromagnetic that consist of thermal, mechanical, and electromagnetic. Physical agent modalities are used in rehabilitation processes to reduce tissue inflammation, accelerates tissue healing, relieves pain, alters collagen extensibility, and modifies muscle tone. These modalities are beneficial to patients to increase their rehabilitation process to return to their prior level of function and become as independence as possible, which is the ultimate goal.

Pain management is important within long-term care facilities as most patients are experiencing some type of pain: acute, subacute, or chronic pain. In order to ease the pain, the patients are prescribed pain medication instead of attempting an alternate way to ease the pain. Taking medication can be an simple and quick fix, however after taking pain medication for so long, people may begin to rely on the use of the medication to much or abuse the ability to take the medication. It is no news break that opioid abuse is in the rise within all populations.

This paper will delve into types of physical agent modalities used and how they are used within a long-term care facility. I will personally be conducting my own study to research if physical agent modalities can decrease pain a patient is experiencing, which in hopes, will decrease the use of pain medication.

Methods: The different methods used for pain management using physical agent modalities are: heat, cold, water, pressure, sound, electromagnetic radiation, and electrical currents. Physical agent modalities consist of: cold packs, heating packs, fluidotherapy, shortwave diathermy, ultrasound, electrical stimulation, whirlpool, laser, and iontophoresis. These modalities are used depending on the patient’s medical history and the type of pain they are experiencing. Each modality serves a different purpose that coincides with the main goal of what the therapist would like to accomplish; whether that’s decrease pain, strengthen muscles, or reduce edema. The benefits or accomplishments of physical agent modalities are endless.

Results: When conducting the physical agent modality and opioid use study, I was able to personally work with the patient and discuss with the patient about their pain and how the modality had affected it. The only modalities used in the study were: ultrasound, electrical stimulation, and diathermy. There modalities are the most commonly used for pain management, as well as the only modalities available to me for my study. The study was conducted over 7 patients who were experiencing acute or chronic pain. Along with managing pain, there were other benefits to use the modalities such as wound healing, increase range of motion, and neuromuscular re-education. When looking at what modality to use – I investigated what other dysfunction or injuries the patient was experiencing. Not all patients are/were appropriate for the study due to contraindications or precautions. Five patients trialed diathermy, two patients trialed ultrasound, and three patients trialed electrical stimulation. All patients had pain medication readily available if needed during the use of physical agent modalities. Two patients experience acute or subacute pain and five patients experience chronic pain. The results from the case study show a decrease in acute, subacute, or chronic pain. Although there was a decrease in pain, the amount of time the patient experienced the decrease of pain varies from patient to patient. Since there was a minimal to moderate decrease in pain, the use of pain medication did decrease. However, since the patients used within the study experience pain in other locations than the one addressed with the modality, pain medication was still used. The time frame from the pain medication taken before the therapy session did increase until the next time the patient requests pain medication. This did not apply to all patients since two patients are unable to verbally communicate when they are in pain, but can use nonverbal communication (facial expressions, behaviors, etc.) to express their pain to staff. The greatest result of decreased pain was after using the modality consistently for three days.

Conclusion: In conclusion, the use of physical agent modalities did decrease the pain in seven patients. Although the pain was decreased, the use of pain medication was still used. There were differences in how the pain medication was used though. There would be a greater time span between one pain medication to the next after using the modalities or a decrease in the amount of pain medication taken. Since the modality used did decrease the pain, there was no certain modality where pain was decreased within multiple patients. The physical agent modality used specifically depended on the patient’s preferences.

Year Manuscript Completed

Fall 2019

Senior Project Advisor

George Barton

Degree Awarded

Bachelor of Integrated Studies Degree

Field of Study

Health Care Administration

Document Type

Thesis - Murray State Access only

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