Outpatient Services

Hot / Cold Therapy

Heat and cold are common modalities used by therapists. Therapeutic effects of heat include: increased tissue elasticity, decreased muscle spasm, and pain reduction. Heat is usually applied via a canvas-covered silica gel pack that has been heated in a hydrocollator. Paraffin and ultrasound are also methods of delivering heat to an area of the body.

Cold therapy is used by therapists to decrease pain and inflammation in an injured area. Cold therapy is applied via a vinyl-covered gel pack kept in a Col-Pac unit or freezer. Cold therapy can be used in conjunction with heat therapy in a therapy session.

Electrical Stimulation Treatment

Electrical stimulation (e-stim) is the application of an electric current to the body for therapeutic benefit. This type of therapy can be used to control pain or for neuromuscular retraining. It involves placement of two or four electrode patches on the body by the therapist and then an electric current is applied through them via a Sonicator Plus 994 or smaller hand-held unit.

Pain Control

The type of e-stim used for pain control is called transcutaneous electrical nerve stimulation (TENS). This type of treatment is commonly used to treat back pain, but can be used on other areas of the body as well. TENS can be very helpful in chronic pain management. Several trials can be done in the clinic by a qualified therapist to determine effectiveness and then the patient can be trained to apply this type of treatment at home.

Muscle Contraction

The type of e-stim used to create muscle contraction is called neuromuscular electrical stimulation (NMES). In this type of treatment the electric current actually produces a muscle contraction in the area of electrode placement. This contraction moves the joint that the muscle normally moves. This type of treatment is useful in stroke recovery for reeducation of muscles or reduction in spasticity.


Paraffin is a means of delivering heat to the body. It raises the temperature of superficial tissues that is then conducted to subcutaneous tissues. The therapy involves submersion of the affected area of the body, usually the hands or feet, into a tank filled with heated paraffin and mineral oil. The area is usually dipped into the tank a number of times to create a coating of the paraffin on the area, which is then wrapped to retain heat. This type of therapy is especially useful in treating chronic arthritic pain in the hands.


Ultrasound is the application of inaudible sound waves to the body to increase tissue temperature. It is a type of heat therapy. Hot packs have a superficial heating effect whereas ultrasound therapy affects deeper tissues.

This type of therapy involves application of ultrasound gel to the affected area and then the therapist moves a hand-held transducer that emits the sound waves over the area. This type of therapy is used primarily for pain relief but can also be used to reduce muscle spasm and increase range of motion when used in conjunction with stretching.