The clinical management of neuromusculoskeletal conditions involves using both passive and active care services for pain relief in San Francisco CA and to restore function. The passive care services include the clinical use of manual therapies and physiologic therapeutic modalities, while the active care services include the therapeutic procedures used in functional rehabilitation and personal fitness training. The Louis Valencia, DC, CSCS approach starts with palliative care, tissue-sparing strategies, gradual reactivation advice, and to provide assurance that the red flags of serious disease such as infection, tumor, and fracture have been ruled out, so that our patients do not imagine their injuries or illnesses as catastrophic.

Physiological therapeutic modalities is the therapeutic application of forces that induce a physiologic response, which allows the natural processes of the body to return to a more normal state of homeostasis and optimal health. This refers to a variety of modalities and procedures which work to gently encourage healing through stimulating the body’s own natural abilities. The goal is to relax your muscles so that you can better hold your adjustment. Often, your muscles are tight or in spasm, meaning it can be more difficult to deliver an effective adjustment. Physiological therapeutic modalities can be the perfect way to ensure that you get the care you need.

Physiological Therapeutic modalities encompasses Louis Valencia, DC, CSCS treatments of neuromusculoskeletal disorders of the body, utilizing for example:

1. Cold (ice) and heat packs are the most frequently used therapies used for 15–20 minutes per session with a thin layer of material such as a towel or T-shirt between the skin to prevent frostbite, and don’t repeat the cold or hot pack for at least 30-60 minutes. These work directly on local muscle and connective tissues to aid in muscle relaxation, spasms, inflammation, and pain.

Both may be effective for the reduction of pain and muscle spasm, but their other effects can be different. Raising or lowering the skin temperature will have different effects on the nervous system and circulation.

Lowering the skin temperature causes vasoconstriction, which can reduce circulation to that area, thus inhibits the body of allowing inflammation thus pain in that area, especially for acute injuries the first 48-72 hours and then move onto contrast baths or heat for subacute and chronic conditions thereafter.

Raising the skin temperature causes vasodilation, which can bring nutrients/oxygen and warm up that area before activity, especially in chronic conditions. Discontinue if the area becomes painful or inflamed.

The best approach for your circumstance depends on the age and severity of your condition (acute verses subacute verses chronic), the degree of muscle tension, the extent of your pain, and many other factors.

2. Contrast therapy uses both by alternating from cold pack to heat pack, in order to cause both vasoconstriction and vasodilation, which acts as a pumping mechanism to flush out the inflammation in that area. Most importantly, end the treatment cycle on ice (unless you’re treating chronic conditions, such as recurring injuries, tightness, or muscle spasms). By ending on ice, the vessels will be narrowed and will help keep inflammation from re-entering the area.

3. Electrical muscle stimulation involves use of various low level currents to stimulate body responses. Our nerves and muscles both have electrical functions and respond to different types of currents. Muscles may be stimulated to contract and relax. Nerves may be made more sensitive or pain may be blocked by varying currents. Changes in location of electrode pads, current frequency, wave form and strength all affect what this treatment will do. This modality in general is often used to reignite muscles’ ability to contract. Enhancing muscle contraction may help you get stronger, increase physical functioning, retrain movements you may have lost, manage inflammation, block pain signals, reduce muscle spasms, and improve blood circulation.


Our passive care services: help to reduce inflammation, pain, adhesions, and spasms, In addition, help restore joint, myofascial, and central/peripheral nervous system nerve entrapment and dysfunction.

  • Adjustments of the spine, pelvis, and extremity joints (98940-98943)
  • Manual traction, soft tissue mobilization/manipulation (i.e.myofascial release), and manual lymphatic drainage (97140)

Supervised Physiologic Therapeutic modalities:

  • Heat and cold pack therapy (97010)
    Electrical muscle stimulation (97014)
  • Louis Valencia, DC, CSCS active care services: helps to restore proper movement patterns, muscle balance, posture, and functional capacity (i.e. fitness).


Louis Valencia, DC, CSCS active care services: helps to restore proper movement patterns, muscle balance, posture, and functional capacity (i.e. fitness).

  • Therapeutic exercises (97110): to develop strength, endurance, ROM, and flexibility.
  • Neuromuscular re-education (97112): of movement, balance, coordination, posture, kinesthetic sense, and proprioception.
  • Group therapeutic activities (97150): therapeutic exercises for 2 or more people.
  • Therapeutic activities (97530): Use of dynamic activities to improve functional performance.
  • Self-care/home management training (97535): instruction in self-care at home.
  • Physical performance testing & measurements (97750): functional capacity testing.

Taken together the passive and active care Louis Valencia, DC, CSCS services facilitate the healing process by:

  • reducing inflammation, adhesions, muscle spasms, and pain
  • restoring the range of motion of the joints and soft tissues of the body
  • reactivating the neuromusculoskeletal system for the purpose of locomotion

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