Insider Physical Therapy Tips That Doctors Don’t Want You To Know About

Transcutaneous Electrical Nerve Stimulation

If you experience chronic pain, you can most likely agree that pain is no fun to cope with. While you might have some great days, you probably also have some bad days when your pain and discomfort makes life very difficult. If you’ve been living this way for a while now, hope is not lost! You can do a lot of things to make the good days even better while also making the bad days less frequent. Physical therapy can help you eliminate persistent pain without the need for painkillers, injections, surgeries, or weekly visits to the doctor. 

Physical therapy can deal with pain in a variety of ways. The right physical therapist can often provide lasting recovery that a doctor or chiropractor cannot. Physical therapists can help you find more freedom and mobility, which will allow you to perform day-to-day activities and hobbies comfortably. They can also help prevent new injuries from occurring. Physical Therapy can re-educate your body to make it more resilient and less prone to injury and pain. Let’s walk through a few of the techniques and treatments that might reduce your pain.

Client Education

In addition to helping you recover, your physical therapist’s job is to educate you on what they’re doing. This means making certain you perform your exercises properly, showing you what can aggravate your condition, and also showing you techniques that you can do on your own to relieve your pain. Many therapists don’t do this and instead drop you on a bunch of different machines. This is wrong, and a big part of physical therapy is empowering the client to take control of their recovery through education.

Patient education can assist your understanding of what’s really going on in your body. For instance, Project Physical Therapy in New York strongly believes in empowering the patient by helping people get rid of pain AND giving them the knowledge they need to get their life back. Being informed provides an in-depth understanding of how to make healthy lifestyle choices now and in the future. It can help you choose what activities to include in your daily routine, what foods to consume, what movements and activities to avoid, and how to take care of yourself so that you can live a pain-free life. 


Many physical therapy exercises are passive. Generally, passive exercises are used to prevent stiffness and help with range of motion in the muscles. Active exercises don’t just help range of motion but will work to strengthen the muscle and train the body to achieve increased movement. Both passive and active exercises have their place in physical therapy, and you will likely be doing a combination of both types to achieve maximum recovery. 

Manual Therapy

Manual therapy is a key part of most treatment plans. At its core, manual therapy is all about the therapist using their hands to work on a specific problem area. Manual therapy can consist of massage, tissue mobilization, myofacial release, as well as a variety of other techniques. Many therapists avoid doing this type of work because it is difficult and time-intensive. But the results are almost always worth it. If your therapist rarely does any manual therapy and you’re spending most of your time on machines (electric stim, ultrasound, etc…) you might want to find a new physical therapist.  

Exercise, stretches, and manual therapy are some of the good tools in a physical therapists repertoire that will help you recover. There are others as well but I want to also point out some treatments that you should be cautious about. 

Transcutaneous Electrical Nerve Stimulation

Transcutaneous electrical nerve stimulation, or TENS, utilizes low-voltage electrical currents to help provide pain relief. The treatment is administered through electrodes connected to your skin. The theory is that the electrical stimulation from the electrodes intercepts pain signals from the nerves in that area, which then can decrease the sensation of pain. The electrical stimulation may also increase the production of endorphins, which act as natural painkillers. The problem with this treatment is that it is superficial and doesn’t address the root cause of the problem in most cases. If a physical therapist relies heavily on TENS units or other forms of electric stimulation with many patients or conditions, this is a red flag. 


Ultrasound provides heat to your soft tissue, which can help increase blood circulation. The theory is that it will also promote healing and decrease pain. Ultrasound is similar to TENS units in the sense that they are generally superficial and a waste of time for most people. It is a superficial treatment that does not address the root cause of most issues. Ask your physical therapist questions if they rely heavily on this machine.

Hot and Cold Therapies

Hot and cold therapies consist of the application of heat or cold to the painful area. Hot and cold treatments can consist of:

  • Using ice packs/hot packs
  • Cold or hot whirlpool baths
  • Ultrasound

Applying ice or heat is the typical advice you’ll find when you first have an injury. Cold decreases inflammation, while heat increases circulation. These are all things that you can do at home. For the most part, you don’t need a “specialist” to apply an ice pack to your leg. If your physical therapist is doing a lot of heat/cold therapy in the office, it’s mostly just a time-waster. 

There are many physical therapy treatments beyond the ones discussed here, but this overview should help you treat and ease chronic pain by helping you find the right solution. If you’ve been to physical therapy before and didn’t get the results you were looking for, ask yourself, did the therapist use some of the “time-waster” treatments on me? Did they educate me or just tell me to “trust them” because they’re the doctor?

The RIGHT type of physical therapy can change your life without the need for painkillers, injections, surgery, or constant visits to the doctor. If you struggle with persistent pain, don’t quit. With the right care you can get your freedom back and enjoy your life again! 

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