In recent years, several new physical therapy modalities have been developed, which can provide relief from a number of conditions, including herniated discs, muscle injuries, and neuropathy, as an alternative to drugs. Infrared Light Therapy Infrared light therapy was first developed to treat diabetic neuropathy. Steve Foster, PT of Therapy South has found that it is equally beneficial for patients with nondiabetic neuropathy. “Infrared Light Therapy increases microcirculation at the site of the nerve endings and helps those nerve endings repair themselves, reducing inflammation,” Foster said. “So patients will get a reduction in pain levels and/or an increase in sensation. When that happens, their balance improves and they become more mobile. They’re able to go about their regular routines and stay on their feet, without a lot of discomfort.” Foster hopes more physicians will consider physical therapy for their neuropathy patients. “Generally physicians start by putting patients on Lyrica or some other by-mouth medication,” but the results from infrared light therapy are much better, Foster said. “Most of the patients we see have been through the medications without a whole lot of benefit.” Emmett Parker, PT, ATC, of Accelerated Physical Therapy has seen similar benefits from infrared light therapy. “This is the best modality that has come into physical therapy in years,” Parker said. “We’ve got all these neuropathy patients who have been miserable and not getting any relief from drugs like Neurontin and Lyrica, which make them feel loopy or groggy. Some have been in 24/7 pain, and for them to come in here and say, ‘Wow, this is really helping,’ it’s really exciting for us to be able to provide them that modality.” Tiffany Davis, PT, of Encore Rehabilitation in Athens said she has seen quick progress with her patients who undergo infrared light therapy. “The patients we’ve used it on have seen results probably within the first couple of visits,” she said. “Some have (seen results) immediately, as far as decreasing pain and feeling less tight. It helps them with their range of motion, and it helps to decrease inflammation, too.” Another advantage to infrared therapy is that it can be used directly over metal implants and directly over the spine. Because some insurance companies will not pay for infrared light therapy, Davis cautions therapists to verify the patient’s coverage before beginning treatment. “Some insurance companies feel like it is not medically necessary, so it’s one of those modalities that you want to check before you do it,” she said. Cold Laser Therapy Another modality offered at the Encore location in Athens is cold laser therapy, which is similar to infrared therapy. “It’s also light therapy, but it penetrates a little bit deeper than the infrared diodes do,” Davis said. “We use them a lot of time in conjunction with each other. With the particular unit that we have, it’s all together. We have the infrared diodes and we have the cold laser, so it’s all one unit. You can use them separately or in conjunction.” The two modalities can even be used simultaneously, Davis said. “You can put the diodes on either side of the area that you’re treating and the cold laser directly on top of it. You can use the diodes on top of it, too. It depends on what you’re wanting to do.” Either of the treatments can be used on a large scale of diagnoses, including neck and back pain, muscle strain and sprain injuries, carpal tunnel injuries, peripheral neuropathy and “frozen” shoulder. “We put it around the shoulder before we stretch the patient and allow the infrared light therapy to work, and we seem to get a much better stretch on these patients who have a lot of stiffness,” Davis said. Decompression Traction Decompression Traction, which is a modification to traditional traction, is used primarily on patients who have some type of compromise of the spinal nerve roots, such as a herniated disc. Foster explained that Decompression traction is unique because it is incremental. “When you place a patient on traction, it’ll go through usually six to seven steps to get up to the maximum degree of pull from the traction,” Foster said. “So it makes it very comfortable for the patient. They relax and the muscles don’t go into spasm or guard. The traction can be most effective that way, and most comfortable, too.” Parker said, “You really wouldn’t want to do it on an acute injury; if they ruptured a disc two days ago it’s probably not a good idea to try it. But if they’re in the sub-acute phase or chronic phase, it usually works pretty well. One of the great things about this therapy is you can take people who are more acute and do this with them because it’s more gentle. Before (with the older therapy), if an injury was too acute or too irritable, you couldn’t do the procedure. But with this, because it’s so much more gentle, you can actually do it sooner into an injury.” Foster agreed, “We’re using it more than we used to use the traditional traction, because the results are so much better.” October 2007