How effective is ultrasound therapy?
- Adequate controls, including placebo treatment and randomized group allocation.
- Adequate blinding of observers, subjects, and therapists to group allocation.
- Adequate description of treatment variables (including checking of machine output).
- Meaningful outcome measures (ie, valid for patient problem being treated).
What is therapeutic ultrasound and does it work?
What is ultrasound therapy? US has been used in physical and occupational therapy to promote healing, decrease pain, reduce swelling, remodel scar tissue, and decrease inflammation. Unlike traditional methods, therapeutic Ultrasound uses acoustic energy with modified frequencies to restore and heal soft tissues. How does ultrasound work?
What are the benefits of therapeutic ultrasound?
What is Ultrasound Therapy Used For?
- Tendonitis: Ultrasound therapy is quite effective to treat chronic tendon pain. ...
- Muscle sprain: This therapy can reduce muscle sprain and relax muscles.
- Osteoarthritis: The deep heat of ultrasound responds well with some chronic issues such as osteoarthritis, rheumatoid, and others.
How often can I Use Therapeutic ultrasound?
- over open wounds
- with women who are pregnant
- near a pacemaker
How does ultrasound work as a treatment?
As well as heating and relaxing the muscles, ultrasound therapy breaks down scar tissue and increases local blood flow. All of this combines to increase healing rates in the area, making it a suitable way to speed up slow-healing or chronic issues. We now think that it can also encourage the repair of damaged bones.
Can ultrasound therapy be harmful?
Benefits of Ultrasound Physical Therapy Therapeutic ultrasound has no known harmful effects when done right by your therapist. The therapy will help alleviate body pain in the affected areas. Ultrasound physical therapy is noninvasive; hence, it's safer than other methods.
How long should an ultrasound treatment last?
How does Ultrasound Therapy Work? Ultrasound waves are administered through use of a wand place directly on the patient's skin, generally using a protective gel. Treatment times for any one area is generally between 3 and 5 minutes.
How often should you use ultrasound therapy?
According to Rosenzweig, “Therapists use ultrasound anywhere from six to 12 sessions – it's part of the patient's therapy, so therapists might do it for five minutes, then perhaps twice a week anywhere from thee weeks to six weeks.
Does ultrasound help with inflammation?
Ultrasound (US) therapy is used to reduce pain and inflammation and to accelerate healing after soft tissue injury.
What are side effects of ultrasound?
External and internal ultrasound scans don't have any side effects and are generally painless, although you may experience some discomfort as the probe is pressed over your skin or inserted into your body.
Can ultrasound break up scar tissue?
One of the many benefits of ultrasound therapy is breaking up scar tissue caused by injuries or surgery. Scar tissue can cause pain and restrict joint movement. Ultrasound helps by using high-frequency sound waves to break the fibres of the scar tissue down into smaller fragments.
Is ultrasound good for healing?
Therapeutic ultrasound is often used by physiotherapists to reduce pain, increase circulation and increase mobility of soft tissues. Additionally, the application of ultrasound can be helpful in the reduction of inflammation, reducing pain and the healing of injuries and wounds.
What are the benefits of ultrasound?
Benefits of UltrasoundThey are generally painless and do not require needles, injections, or incisions.Patients aren't exposed to ionizing radiation, making the procedure safer than diagnostic techniques such as X-rays and CT scans. ... Ultrasound captures images of soft tissues that don't show up well on X-rays.More items...•
Does ultrasound help nerve pain?
Ultrasound therapy has been shown to be very effective in resolving inflammation and reducing pain, while promoting more rapid healing. Ultrasound therapy works by two mechanisms: thermal and mechanical.
Is ultrasound good for arthritis?
Ultrasound therapy can be useful in repair cartilage damage caused by arthritis. A study (Low Intensity Ultrasound as a Supporter of Cartilage Regeneration...) found that ultrasound therapy allows oxygen to be delivered to the injured tissue of the joints facilitating tissue repair.
Does ultrasound help muscle knots?
Ultrasound is just as effective a treatment as trigger point injections and should be offered as an alternative since it is a less invasive procedure. Psychological and social factors may play a role in chronic myofascial pain, so patients should be assessed and treated for any contributing factors.
Why do people use ultrasound?
For the last 80 years, ultrasound therapy has been used as a non-invasive procedure to treat a wide variety of ailments. It is often used to treat swelling, particularly when the swelling is spread over a larger area than usual.
What are the benefits of ultrasound?
As well as heating and relaxing the muscles, ultrasound therapy breaks down scar tissue and increases local blood flow.
How long does ultrasound last?
In general, ultrasound therapy sessions will last no longer than 5 minutes.
Is ultrasound therapy safe for pregnant women?
Despite its similarity to ultrasound machines, ultrasound therapy is not suitable for issues located near the womb of a pregnant woman. The wavelengths used in this therapy are different to those used in a prenatal ultrasound, and could put the pregnancy at risk.
Can ultrasound be used on other parts of the body?
However, the therapy can still be used on other parts of the body, regardless of whether or not a woman is pregnant. Ultrasound therapy may also be unsuitable for people with malignant growths, or cardiovascular issues. But again, this can depend on where the therapy is to take place on the body. Ultrasound therapy is completely unsuitable anywhere ...
What is ultrasound imaging?
Ultrasound imaging uses high-frequency sound waves to create an image of the inside of your body. It’s very good a looking at the soft tissues of the body and is often the first step in determining the cause for your symptoms. Also known as sonography, ultrasound imaging uses a small transducer ...
How long do you have to fast for an ultrasound?
For example, for an abdominal ultrasound, you will be asked to fast and have nothing to eat or drink (except water) for six hours prior to your exam. For some obstetrical ultrasounds, you will need to arrive with a full bladder.
How do sound waves travel?
Sound waves travel into the area being examined until they hit a boundary between tissues, such as between fluid and soft tissue, or soft tissue and bone. At these boundaries some of the sound waves are reflected back to the probe, while others travel further until they reach another boundary and are reflected back.
Is it safe to use ultrasound to detect a tumor?
Air and bone also reflect sound waves. Ultrasound has been around for over sixty years and is considered safe since there are no known risks and it doesn’t use radiation.
Can MSK ultrasound be used with X-ray?
Again the dynamic nature of ultrasound is an advantage for accurate diagnosis, since we can evaluate the area in question while it’s moving and watch as a patient performs the action causing symptoms. MSK ultrasounds may be requested on their own or in conjunction with an X-ray to rule out a fracture.
The Tissue Healing Process
When a tissue such as muscle or ligament is damaged, local blood flow and swelling brings an inflammatory soup of chemicals that begins the healing process. New tissue known as scar tissue is formed and laid down. As the scar tissue is generated, the fibres that make up the scar tissue are often laid down in an unorganised fashion.
How Does Ultrasound Work?
When tissue is exposed to ultrasound, the sound waves cause a micro-vibration within the tissue. This vibration creates heat energy that increases blood flow to the area. This increased blood flow causes an increase in oxygen and chemicals that are essential for healing of the damaged tissue.
What Injuries Do We Use Ultrasound For?
Ultrasound is most effective when used for soft tissue injuries including:
What is ultrasound used for?
It can also be used to inject drugs into tissues ( phonophoresis ), or to violently vibrate the tip of an invasive probe ( lithotripsy, usually used for gall stones).
What is ESWT ultrasound?
Many concerns about the widespread usage of therapeutic ultrasound, especially extracorporeal shockwave therapy ( ESWT) Ultrasound therapy ( US) is the use of sound waves above the range of human hearing 1 2 to treat injuries like muscle strains or runner’s knee.
Is ultrasound therapy reliable?
At worst, there is no rational basis for US at all. Although ultrasound is almost certainly useful for some patients, some of the time, it is not a reliable or evidence-based therapy, and enjoys far more credibility than it deserves.
Is ultrasound good for medicine?
Almost everyone seems to assume that ultrasound is proven — good technological medicine — but that just doesn’t seem to be the case. There’s a whole family of “stim” therapies based on the hope that biology will work better if it’s energetically stimulated: by electricity, by laser light, by far infrared radiation.
Is ultrasound quackery?
Ultrasound is pseudo-quackery. The disconnect between the popularity of US and the more or less total lack of informative research is troubling. A handful of good studies is a joke for a therapy that is worth literally billions of dollars in the marketplace.
What is ultrasound used for?
The images can provide valuable information for diagnosing and treating a variety of diseases and conditions. Most ultrasound examinations are done using an ultrasound device outside your body, though some involve placing a device inside your body.
Why do we need ultrasound?
Ultrasound is used for many reasons, including to: View the uterus and ovaries during pregnancy and monitor the developing baby's health. Diagnose gallbladder disease. Evaluate blood flow. Guide a needle for biopsy or tumor treatment. Examine a breast lump.
How does ultrasound help with tumors?
These images show how ultrasound can help guide a needle into a tumor (left), where material is injected (right) to destroy tumor cells. During a transvaginal ultrasound, your doctor or a medical technician inserts a wandlike device (transducer) into your vagina while you are positioned on an exam table.
What is the procedure to get heart images?
A transducer, inserted into your esophagus, obtains heart images. It's usually done while you are sedated. Transrectal ultrasound. This test creates images of the prostate by placing a special transducer into the rectum.
How does a transducer work?
The transducer sends sound waves into your body, collects the ones that bounce back and sends them to a computer, which creates the images. Sometimes, ultrasounds are done inside your body. In this case, the transducer is attached to a probe that's inserted into a natural opening in your body. Examples include:
How to prepare for an ultrasound?
Most ultrasound exams require no preparation. However, there are a few exceptions: 1 For some scans, such as a gallbladder ultrasound, your doctor may ask that you not eat or drink for certain period of time before the exam. 2 Others, such as a pelvic ultrasound, may require a full bladder. Your doctor will let you know how much water you need to drink before the exam. Do not urinate until the exam is done. 3 Young children may need additional preparation. When scheduling an ultrasound for yourself or your child, ask your doctor if there are any specific instructions you'll need to follow.
What happens after an ultrasound?
Your doctor will share the results with you. You should be able to return to normal activities immediately after an ultrasound.
How does ultrasound work?
Ultrasound is performed with a machine that has an ultrasound transducer (sound head). A small amount of gel is applied to the particular body part; then your physical therapist slowly moves the sound head in a small circular direction on your body.
Why is ultrasound used in the body?
Ultrasound is often used to provide deep heating to soft tissue structures in the body. Deep heating tendons, muscles, or ligaments increases circulation to those tissues, which is thought to help the healing process. Increasing tissue temperature with ultrasound is also used to help decrease pain.
What are the contraindications for ultrasound?
There are some instances where you should not use ultrasound at all. These contraindications to ultrasound may include: 1 Over open wounds 2 Over metastatic lesions or any active area of cancer 3 Over areas of decreased sensation 4 Over parts of the body with metal implants, like in a total knee replacement of lumbar fusion 5 Near or over a pacemaker 6 Pregnancy 7 Around the eyes, breasts, or sexual organs 8 Over fractured bones 9 Near or over an implanted electrical stimulation device 10 Over active epiphyses in children 11 Over an area of acute infection
What is therapeutic ultrasound?
Therapeutic ultrasound is a treatment modality commonly used in physical therapy. It is used to provide deep heating to soft tissues in the body. These tissues include muscles, tendons, joints, and ligaments.
Is ultrasound a passive treatment?
Many people argue that ultrasound can have a negative effect on your physical therapy by needlessly prolonging your care. Ultrasound is a passive treatment .
Can ultrasound be used for rotator cuff tears?
Generally speaking, any soft-tissue injury in the body may be a candidate for ultrasound therapy. Your physical therapist may use ultrasound for low back pain, neck pain, rota tor cuff te ars, knee meniscus tears, or ankle sprains.
Can a physical therapist use ultrasound?
Your physical therapist may use ultrasound to help improve your condition. If so, be sure to ask about the need for ultrasound and possible risks. Also, be sure that you are also performing an active self-care exercise program in the PT clinic and at home. If you are actively engaged in your rehabilitation, you can ensure that you have a safe and rapid recovery back to normal function.
How does ultrasound work?
How Ultrasound Physical Therapy Works. The ultrasound machine works by sending an electric current through crystals found in the ultrasound probe — also known as the ultrasound wand. The probe vibrates, causing waves to travel through the skin to the body underneath. The waves transfer energy to the tissues to cause the desired effects.
Why do we use ultrasound?
But, it's most commonly used to solve problems in muscle tissue. The heating effect of the ultrasound helps to heal muscle pain and reduces chronic inflammation. . Ultrasound also helps tissue fluids flow better — which means that more lymph passes through the tissues.
What is the process of creating bubbles in tissue?
In mechanical ultrasound — also known as cavitation ultrasound therapy — the waves created by the ultrasound create pressure differences in tissue fluids, which lead to the forming of bubbles. As these bubbles interact with solid objects, they burst and create shockwaves.
What is thermal ultrasound?
Thermal ultrasound therapy is used to treat stretch pain, soft tissue pain, and other musculoskeletal issues. It can also be adapted to treat advanced issues like uterine fibroids, prostate cancer, and skin problems. .
What is ultrasound in 2021?
Medically Reviewed by Dan Brennan, MD on June 23, 2021. Ultrasound — or ultrasonography — is an imaging technique used not just during pregnancy but also for many medical procedures. Ultrasound physical therapy is a branch of ultrasound, alongside diagnostic ultrasound and pregnancy imaging. It's used to detect and treat various musculoskeletal ...
What determines how ultrasound physical therapy is done?
The frequency and intensity of the ultrasound, the duration of the procedure, and the area of its application all determine how ultrasound physical therapy is done.
Why is ultrasound not used in physical therapy?
Therapeutic ultrasound is not used for problems near a pregnant woman’s womb because it could put the pregnancy at risk. It's also generally not used over the spine, eyes, pacemakers, other implants, and areas with active infections. Benefits of Ultrasound Physical Therapy. Ultrasound physical therapy has many advantages:
What are the biological effects of ultrasound?
Other potential mechanisms for biological effects of ultrasound include the direct action of the compressional, tensile, and shear stresses. In addition, second-order phenomena, which depend on transmitted ultrasound energy, include radiation pressure, forces on particles and acoustic streaming.
What frequency is ultrasound used for?
Low power ultrasound of about 1 MHz fre quency has been widely applied since the 1950s for physical therapy in conditions such as tendinitis or bursitis.
What is HIFU used for?
HIFU application in therapy and treatment of disease is one of the more active areas of research and development among all the non-ionizing-energy modalities such as radiofrequency, lasers, and microwaves. For example, HIFU is under investigation for therapeutic modulation of nerve conductance (Foley et al. 2008).
What is ultrasound assisted liposuction?
Another procedure, ultrasound assisted liposuction, is widely used in cosmetic surgery for the purpose of removing excessive fat tissue (Mann et al. 2008). The mechanism of action apparently involves cavitational fat cell break up with removal of the fat emulsion by suction through the probe.
When was ultrasound first used in physical therapy?
Physical Therapy. Unfocused beams of ultrasound for physical therapy were the first clinical application, dating to the 1950s , which often has been referred to simply as “therapeutic ultrasound” (Robertson and Baker, 2001). This modality now typically has a base unit for generating an electrical signal and a hand-held transducer.
How long does a flat transducer therapy last?
Therapy involves multiple treatments of 20 min each day by applying the large flat transducer to the site of injury and continuing treatment for periods of months. Although the process appears to be safe and effective, the therapy is slow and its use is predominantly limited to management of non-healing fractures.
What is ultrasonic energy used for?
The use of ultrasonic energy for therapy continues to expand, and approved applications now include uterine fibroid ablation, cataract removal (phacoemulsification), surgical tissue cutting and hemostasis, transdermal drug delivery, and bone fracture healing, among others.
Overview
- The best way to describe ultrasound therapy is by simply thinking of ultrasounds given to pregnant women, as the technology is largely the same. Small, handheld probes are placed on the problem area combined with gel or cream, which may be medicated depending on the condition in question. The probe vibrates, sending waves through the skin and into ...
Availability
Treatment
Advantages
Research
Criticism
- Garden-variety therapeutic US is cheap and available everywhere. The machines are small, even portable: you can buy small handheld ones. Treatment is brief and painless, and applied (indiscriminately?) to almost any common musculoskeletal problem.
Quotes
- ESWT uses much stronger sound waves shock waves!7 (Radial shock wave therapy is a bit different.8) Treatment is painfully intense and painfully pricey.9
Results
- On the one hand, ESWT is just a more is better version of standard US, because it is often used with the same imprecise clinical intention to stimulate/provoke tissues. On the other hand, because it was originally developed for smashing gall stones, ESWT is strong enough to actually disrupt tissue, such as calcifications in tendons which is a nice precise clinical goal and a whole …
Prognosis
- When I started studying for this article way back in the mid-2000s, I was quite surprised by how little there was to study. Back then, every scientific paper about US pointed out there is not enough research on this topic, or at least not enough good research and not much has changed. A 2015 review of ultrasound for rotator cuff tendinopathy (cited below) found only six trials, all po…
Marketing
- The disconnect between the popularity of US and the more or less total lack of informative research is troubling. A handful of good studies is a joke for a therapy that is worth literally billions of dollars in the marketplace. How can that much therapy be sold without a satisfactory body of evidence that it works? Bizarre! This is the ultimate example of pseudo-quackery: popular treatm…
Status
- This does not mean that US never works for anyone. It does mean that it has been prescribed and sold to patients for decades with unjustified confidence. And that is not cool. And so few patients are singing the virtues of standard US. It not only fails to generate testimonials, but actually generates many annoyed antimonials. Meanwhile, there is still just no basis for thinking that ultr…
Uses
- Ultrasound is an unusually easy treatment to test scientifically.10 If it works reasonably well, then the results should be pretty clear. Just compare results in patients who received real ultrasound to patients who get a fake instead! And yet there are just a few dozen such experiments in the scientific literature, and most of them are seriously flawed. Conclusions from evidence reviews l…
Symptoms
- Standard therapeutic ultrasound probably does little or nothing for most people. A sliver of hope remains that some specific conditions will respond to ultrasound with just the right settings.
Purpose
- Not only that, but ultrasound has found new life in the marketplace as shockwave therapy faster, stronger waves, with a bigger price tag! Consider this marketing language from a Canadian company, Shockwave Institute, specializing in ESWT:
Future
- Things seem to have changed for the better, though 80-85% effective would still be a hard claim to defend.
Example
- Bizarrely, ESWT is being used to treat conditions as unexpected as erectile dysfunction, stroke, and venous leg ulcers. Theres even some preliminary evidence for such uses though not all. But there are now multiple positive reviews of ESWT for its more common uses, like stubborn cases of plantar fasciitis, a painful irritation of the arch of the foot. A good 2016 example is Lou et al, w…
Society and culture
- Patients often express irritation with a common physical therapy business model: working with several patients at once, rotating between rooms or beds, often leaving patients with passive therapies (like a moist hot pack from a hydrocollator nice enough, but worth a steep fee?) Many patients often go a step further and complain specifically about ultrasound and TENS, skeptical …
Applications
- The big idea is this will blow your mind! that cells and tissues respond well to being shaken (not stirred). In theory, ultrasound works by vibrating tissues back to health, which sounds like something youd hear on an infomercial, or the Dr. Oz Show. What, exactly, does vibration do to tissues? Does anyone actually understand it?
Reviews
- There is lots of interesting ultrasound biology to consider, and scientists may eventually nail down effects that might be the basis for new evidence-based therapies. For instance, a decade later, Tsai et al declared that There is strong supporting evidence from animal studies about the positive effects of ultrasound on tendon healing31 but animal studies are notoriously misleadin…