Are you getting the best care?

I want to take the time to explain the difference between active and passive modalities in chiropractic care. Modalities is a term used that can be interchanged with the word “treatment”.

Passive modalities are those that do not require any participation from the patient. Common modalities that fit in this category are e-stim, therapeutic ultrasound, heating pads, acupuncture, dry needling, ADJUSTMENTS and soft tissue therapy. 

Active modalities are those that require the patient to be physically active! Common modalities that fit in this category include stretching, rehab exercises, and strength training. 

So why does it matter that patients understand the difference between these two things???

Because at some point during care, patients should be participating in ACTIVE MODALITIES. This is a vital part of care. Passive modalities only provide TEMPORARY relief of symptoms. While active modalities help to provide LONG-TERM relief.

Why is it that active modalities provide long-term relief?

Because active modalities require muscle recruitment. In many cases, patients are dealing with chronic pain because they do not possess the strength to handle the amount of STRESS they are applying to their bodies. A heating pad and an adjustment won’t make you stronger, they may give you a few days of relief, but for YEARS of relief, you have to build up your muscle tissue to handle what you're asking it to do.

You may be thinking, “Well I sit at a desk for 8+ hours a day for my job, I don’t have to be strong to sit in a chair” ...YES YOU DO! You are asking your back muscles to hold you erect in a chair for 8+ hours! That is an incredible task! Could you hold a dumbbell curl for 8 hours?

Takeaway: If your chiropractor has never discussed active care with you, then they have done you a disservice. If they signed you up for some outrageous treatment plan with an exorbitant number of visits that don’t include ACTIVE CARE, ask for your money back for your unused visits (FYI they legally have to refund you for any unused visits in the state of Texas) and find yourself someone better. 



References
Jansen, Mariette J., et al. "Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilisation each reduce pain and disability in people with knee osteoarthritis: a systematic review." Journal of physiotherapy 57.1 (2011): 11-20.

• This article showed that mobilization with strengthening showed the best results.
  

Shipton, Edward A. "Physical therapy approaches in the treatment of low back pain." Pain and therapy 7 (2018): 127-137.

• Promoted that a combination of active and passive care be used. Even saying manipulation w exercise showed positive outcomes.