In most cases, back pain resolves quickly, regardless of the type of treatment. But if you experience severe back pain that doesn't improve after a couple of days of bed rest, you may want to consider physical therapy. A reader asks: What are passive and active physical therapy modalities, and how do they work?
A. Passive physical therapy is called passive because the modalities are done to you, whereas with active physical therapy you take an active role in the modalities.
Passive modalities typically are heat packs and/or ice massage and ultrasound. Heat and/or ice, the most commonly used type of modality, help reduce muscle spasm and inflammation. This usually works best over the first few days of back pain. You may find one or the other works better for you, or you can alternate them to reduce pain. Generally, you apply heat and/or ice for up to 20 minutes every two hours. Ultrasound uses sound waves applied to the skin to penetrate into and deeply heat soft tissues to enhance tissue healing. It is particularly useful to relieve acute pain.
Active physical therapy usually includes exercises to stretch and strengthen back muscles. Often, these exercises include a simple daily routine that may include knee pulls, hurdler stretches, modified toe-touches with and without rotation, abdominal curls, pelvic tilts, and back and hip extensions. Your physical therapist may also ask you to perform a spinal stabilization program consisting of progressive exercises that emphasize muscle strengthening to support the spine.
