| Ultrasound is a therapeutic modality that has been | | | | perfect for patients who are uncomfortable with |
| used by physical therapists since the 1940s. | | | | injections. With this technique, the ultrasonic energy |
| Ultrasound is applied using a round-headed wand or | | | | forces the medication through the skin. Cortisone, |
| probe that is put in direct contact with the patient's | | | | used to reduce inflammation, is one of the more |
| skin. Ultrasound gel is used on all surfaces of the head | | | | commonly used substances delivered in this way. |
| in order to reduce friction and assist in the | | | | A typical ultrasound treatment will take from 3-5 |
| transmission of the ultrasonic waves. Therapeutic | | | | minutes. In cases where scar tissue breakdown is the |
| ultrasound is in the frequency range of about 0.8-1.0 | | | | goal, this treatment time can be much longer. During |
| MHz. | | | | the treatment the head of the ultrasound probe is |
| The waves are generated by a piezoelectric effect | | | | kept in constant motion. If kept in constant motion, |
| caused by the vibration of crystals within the head of | | | | the patient should feel no discomfort at all. If the |
| the wand/probe. The sound waves that pass through | | | | probe is held in one place for more than just a few |
| the skin cause a vibration of the local tissues. This | | | | seconds, a build up of the sound energy can result |
| vibration or cavitation can cause a deep heating | | | | which can become uncomfortable. Interestingly, if |
| locally though usually no sensation of heat will be felt | | | | there is even a very minor break in a bone in the |
| by the patient. In situations where a heating effect is | | | | area that is close to the surface, a sharp pain may |
| not desirable, such as a fresh injury with acute | | | | be felt. This occurs as the sound waves get trapped |
| inflammation, the ultrasound can be pulsed rather | | | | between the two parts of the break and build up |
| than continuously transmitted. | | | | until becoming painful. In this way ultrasound can |
| Ultrasound can produce many effects other than just | | | | often be used as a fairly accurate tool for diagnosing |
| the potential heating effect. It has been shown to | | | | minor fractures that may not be obvious on x-ray. |
| cause increases in tissue relaxation, local blood flow, | | | | Some conditions treated with ultrasound include |
| and scar tissue breakdown. The effect of the | | | | tendonitis (or tendinitis if you prefer), non-acute joint |
| increase in local blood flow can be used to help | | | | swelling, muscle spasm, and even Peyronie's Disease |
| reduce local swelling and chronic inflammation, and, | | | | (to break down the scar tissue). Contraindications of |
| according to some studies, promote bone fracture | | | | ultrasound include local malignancy, metal implants |
| healing. The intensity or power density of the | | | | below the area being treated, local acute infection, |
| ultrasound can be adjusted depending on the desired | | | | vascular abnormalities, and directly on the abdomen |
| effect. A greater power density (measured in watt | | | | of pregnant women. It is also contraindicated to |
| cm2 is often used in cases where scar tissue | | | | apply ultrasound directly over active epiphyseal |
| breakdown is the goal. | | | | regions (growth plates) in children, over the spinal |
| Ultrasound can also be used to achieve | | | | cord in the area of a laminectomy, or over the eyes, |
| phonophoresis. This is a non-invasive way of | | | | skull, or testes. |
| administering medications to tissues below the skin; | | | | |