Physiotherapy Ultrasound Therapy Treatment

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Ultrasound therapy is a treatment used by physical therapists to relieve pain and to promote tissue healing.

While ultrasound therapy is not effective for all chronic pain conditions, it may help reduce your pain if you have any of the following:

  • Osteoarthritis
  • Myofascial pain syndrome
  • Bursitis
  • Carpal tunnel syndrome
  • Pain caused by scar tissue
  • Phantom limb pain
  • Sprains and strains1

Types of Ultrasound Therapy

The two main types of ultrasound therapy are thermal and mechanical. Both use sound waves generated by a transducer head (which looks a bit like a microphone) to penetrate soft tissues.

The difference between the two types of ultrasound therapy is the rate at which the sound waves penetrate the tissues.2

Thermal ultrasound therapy uses a more continuous transmission of sound waves.

The sound waves cause microscopic vibrations in deep tissue molecules, increasing heat and friction. The warming effect encourages healing in soft tissues by increasing metabolism at the cellular level.

Mechanical ultrasound therapy uses pulses of sound waves to penetrate tissues.

While this still has a minor warming effect, it also causes expansion and contraction in tiny gas bubbles in soft tissues. This decreases the inflammatory response, which reduces swelling and decreases pain.

The type of ultrasound therapy you get depends on your condition. For myofascial pain, strains, or sprains, thermal ultrasound therapy is typical.3 For scar tissue or swelling, like with carpal tunnel syndrome, mechanical ultrasound may work better.

How Ultrasound Therapy Is Performed

When you go in for ultrasound therapy, your therapist will select a small surface area to work on for anywhere from five to 10 minutes.

A gel is applied either to the transducer head or to your skin, which helps the sound waves evenly penetrate the skin.

During your ultrasound therapy treatment, your therapist will continually move the transducer head over and around the selected area.4

Will I Feel Anything?

Some people feel a mild pulsing during ultrasound therapy, while others may feel a slight warmth in the skin.

Don’t be surprised, however, if you feel nothing at all, apart from the cold gel on your skin. If the area being treated is especially sensitive to touch, you could possibly feel discomfort as the transducer head passes over.

Ultrasound therapy, however, should not be painful.4

Is Ultrasound Therapy Safe?

Ultrasound therapy is deemed safe by the U.S. Food and Drug Administration (FDA) provided it is performed by a licensed person and provided the therapist keeps the transducer head moving at all times.

If the transducer head remains in one place for too long, there is a potential to burn the tissues underneath, which you may or may not feel.

Ultrasound therapy should not be used on these body parts:

  • Over the abdomen, pelvic regions, or lower back in women who are menstruating or pregnant
  • Over lesions, broken skin, or healing fractures
  • Around the eyes, breasts, or sexual organs
  • Over any areas with plastic implants
  • Over or near areas with malignant tumors
  • Over areas with impaired sensations or blood flow

Additionally, it should not be used on people who have pacemakers.4

Does Ultrasound Therapy Work?

The literature is mixed on the benefits of ultrasound therapy.

Some studies show that it can effectively control certain types of chronic pain,5 while others say there's little difference between ultrasound therapy and other traditional therapy treatments (such as heat, stretching and electrical stimulation) for pain control.6

A 2017 study showed that while people receiving ultrasound therapy showed some improvement, a platelet-rich plasma injection was more effective than both ultrasound therapy and steroid injections for shoulder periarthritis.7

  1. Draper DO. Facts and misfits in ultrasound therapy: steps to improve your treatment outcomes. Eur J Phys Rehabil Med. 2014;50(2):209-16.
  2. Watson T. Ultrasound in contemporary physiotherapy practice. Ultrasonics. 2008;48(4):321-9. doi:10.1016/j.ultras.2008.02.004
  3. Ilter L, Dilek B, Batmaz I, et al. Efficacy of pulsed and continuous therapeutic ultrasound in myofascial pain syndrome: A randomized controlled study. Am J Phys Med Rehabil. 2015;94(7):547-54. doi:10.1097/PHM.0000000000000210
  4. U.S. Food and Drug Administration. Ultrasonic therapy product or ultrasonic diathermy.
  5. Amjad F, Shahid AJ, Batool S, Ahmad A. A comparison on efficacy of transcutaneous electrical nerve stimulation and therapeutic ultrasound in treatment of myofascial trigger points. KMUJ 2016;8(1):3-6.
  6. Durmus D, Durmaz Y, Canturk F. Effects of therapeutic ultrasound and electrical stimulation program on pain, trunk muscle strength, disability, walking performance, quality of life, and depression in patients with low back pain: a randomized-controlled trial. Rheumatol Int. 2010;30(7):901-10. doi:10.1007/s00296-009-1072-7
  7. Kothari SY, Srikumar V, Singh N. Comparative efficacy of platelet rich plasma injection, corticosteroid injection and ultrasonic therapy in the treatment of periarthritis shoulder. J Clin Diagn Res. 2017;11(5):RC15-RC18. doi:10.7860/JCDR/2017/17060.9895

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