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