Therapeutic ultrasound

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Ultrasound is a method of stimulating the tissue beneath the skin's surface using
very high frequency sound waves, between 800,000 Hz and 2,000,000 Hz,
which cannot be heard by humans.

History

The first large scale application of ultrasound was around World War II. Sonar systems were being built and used to navigate submarines. It was realized that the high intensity ultrasound waves that they were using were heating and killing fish.[3] This led to research in tissue heating and healing effects. Since the 1940s, ultrasound has been used by physical and occupational therapists for therapeutic effects.

Physical therapy

Ultrasound is applied using a transducer or applicator that is in direct contact with the patient's skin. Gel is used on all surfaces of the head to reduce friction and assist transmission of the ultrasonic waves. Therapeutic ultrasound in physical therapy is alternating compression and rarefaction of sound waves with a frequency of >20,000 cycles/second. Therapeutic ultrasound frequency used is 0.7 to 3.3 MHz. Maximum energy absorption in soft tissue occurs from 2 to 5 cm. Intensity decreases as the waves penetrate deeper. They are absorbed primarily by connective tissue: ligaments, tendons, and fascia (and also by scar tissue).

Conditions for which ultrasound may be used for treatment include the follow examples: Ligament Sprains, Muscle Strains, Tendonitis, Joint Inflammation, Plantar fasciitis, Metatarsalgia, Facet Irritation, Impingement syndrome, Bursitis, Rheumatoid arthritis, Osteoarthritis, and Scar Tissue Adhesion.

Benefits of ultrasound

There are three primary benefits to ultrasound. The first is the speeding up of the healing process from the increase in blood flow in the treated area. The second is the decrease in pain from the reduction of swelling and edema. The third is the gentle massage of muscles tendons and/ or ligaments in the treated area because no strain is added and any scar tissue is softened. These three benefits are achieved by two main effects of therapeutic ultrasound. The two types of effects are: thermal and non thermal effects. Thermal effects are due to the absorption of the sound waves. Non thermal effects are from cavitation, microstreaming and acoustic streaming.

Cavitational effects result from the vibration of the tissue causing microscopic bubbles to form, which transmit the vibrations in a way that directly stimulates cell membranes. This physical stimulation appears to enhance the cell-repair effects of the inflammatory response. Effectiveness of therapeutic ultrasound for pain, musculoskeletal injuries, and soft tissue lesions remains questionable. Study has proven that Ultrasound helps in enhancing the metabolic activities of cells. Thus, ultrasound treatment helps in tissue repair, especially in soft tissue injuries (Ravi Patel, B.P.T)[Ref: Kerry G Baker, Valma J Robertson and Francis A Duck, Journal of Physical therapy.2001 July;Vol. 81(7):1851-1858].