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What is Ultrasound Therapy?

Therapeutic ultrasound (click here) is one of the most common treatments used in the management of soft tissue lesions, which constitute the majority of rheumatic complaints. Although many laboratory‐based research studies have demonstrated a number of physiological effects of ultrasound upon living tissue, there is remarkably little evidence for benefit in the treatment of soft tissue injuries. This may be related to several confounding factors, including technical variables, the complexity and variety of underlying pathologies in soft tissue lesions, methodological limitations of clinical studies, or true lack of effect. In this review the scientific basis for the use of therapeutic ultrasound in soft tissue lesions and the existing evidence relating to its clinical effect are detailed.

It is over 70 years since the interactions between high (‘ultra’)‐frequency sound waves and living tissue were initially studied and the use of such energy as a form of therapy was first suggested. Ultrasound has since been used to treat a wide variety of disorders, from skin wounds to malignant tumors. It has become one of the most commonly used treatments in the management of soft tissue injuries, and it has been estimated that over a million NHS treatments annually involve its use. However, although many laboratory‐based research studies have demonstrated a number of physiological effects of ultrasound upon living tissue, there is remarkable little evidence for benefit in the treatment of soft tissue injuries. In this paper, the scientific basis for the use of therapeutic ultrasound in soft tissue lesions and the existing evidence relating to its clinical effect are reviewed.

Ultrasound therapy is a treatment that is used for many causes of chronic pain including arthritis, fibromyalgia, MS, bone breaks, and various injuries including muscle pains and joint injuries. It is so called because it uses ‘ultrasound’ to treat these conditions – which is high frequency sound waves which can produce heat deep into painful tissue. At the same time it is intended to stimulate blood flow (in order to deliver more nutrients), stretch the musculoskeletal structure, stimulate cell membranes and reduce inflammation. Studies are being carried out to ascertain for certain the effectiveness of these treatments, though many people find them helpful in reducing pain and speeding the healing process. In one study it was demonstrated to be able to encourage the creation of new bone cells in mice.

The Process

Should you attend an ultrasound therapy session you will be covered in a light blanket and seated in a chair. The therapist will then turn on the ultrasound machine and this will be a probe attached to a transducer (transducers are devices which convert electrical energy into sound waves). The patient will then apply a hypo-allergenic/anti-inflammatory gel to the area to be treated using circular motions (for further therapeutic benefit). The probe will then be applied to the area and the patient will notice a soothing tingling sensation of the sound-waves vibrating the area. Of course you cannot hear these sound waves as they are out of the spectrum of human hearing. This process will normally last for about fifteen minutes and can be used daily if necessary.

It is also possible to buy your own ultrasound therapy machines for home use. When using them yourself be careful to keep them away from your face, genitals and spine.

Types of Ultrasound Therapy

There are two main types of ultrasound therapy which are pulsed wave and continuous wave ultrasound. Pulsed wave ultrasound is delivered in pulses as the name suggests and this does not create heat. This is used for those who need pain relief for their injuries. Continuous wave ultrasound meanwhile means that the ultrasound is used continuously and this means that heat is generated and this is more commonly used for chronic conditions.

Thermal ultrasound therapy. Thermal ultrasound therapy uses a more continuous transmission of sound waves. The sound waves cause microscopic vibrations in the deep tissue molecules, increasing heat and friction. The warming effect encourages healing in the soft tissues by increasing the metabolism at the level of the tissue cells.

Mechanical ultrasound therapy. Mechanical ultrasound therapy uses pulses of sound waves to penetrate tissues. While this still has a minor warming effect on the tissues, it also causes expansion and contraction in the tiny gas bubbles of the soft tissues. This helps to decrease the inflammatory response, reducing tissue swelling and thus decreasing pain.

Low-intensity pulsed ultrasound in the treatment of nonunions.

Nolte PA, van der Krans A, Patka P, Janssen IM, Ryaby JP, Albers GH.

Source (click here)

Department of Orthopaedics, Academic Medical Center, University of Amsterdam, The Netherlands. panolte@knmg.nl



Low-intensity ultrasound has demonstrated an acceleration of bone healing and more profound callus formation in animal and human clinical experiments. In this study, the effect of pulsed, low-intensity ultrasound was determined in established nonunion cases.


The enrolled cases were reviewed for the time from their last surgical procedure and evidence of no healing or progression of healing during the 3 or more months before the start of low-intensity ultrasound therapy to determine whether the cases were established nonunions. Twenty-nine cases, located in the tibia, femur, radius/ulna, scaphoid, humerus, metatarsal, and clavicle, met the criteria for established nonunions. On average, the postfracture period before the start of ultrasound treatment was 61 weeks. Initial fracture treatment was conservative in 8 cases and operative in 21 cases. Additional treatments including bone grafting, reosteosynthesis, and other surgical procedures were performed an average of 52 weeks before the start of ultrasound treatment. Daily, 20-minute applications of low-intensity ultrasound at the site of the nonunion were performed by the patients at home.


Twenty-five of the 29 nonunion cases (86%) healed in an average treatment time of 22 weeks (median, 17 weeks). Stratification of the healed and failed outcome for age, gender, concomitant disease, bone location, fracture age, prior last surgery interval, nonunion type, smoking habits, and fixation before and during treatment showed a significant difference only in the smoking habit strata.


Noninvasive ultrasound therapy can be useful in the treatment of challenging, established nonunions.

Acupoint stimulation device using focused ultrasound.

Tsuruoka N, Watanabe M, Seki T, Matsunaga T, Hagaa Y.

Source (click here)

Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan. a6tb1177@cs.he.tohoku.ac.jp


Acupuncture is used widely in oriental medicine. But it is difficult to stimulate continuously or intermittently in daily life with conventional acupuncture. An acupoint stimulation device using focused ultrasound has been developed. Because the device size is about 6 mm in diameter, it can be easily put on the skin during daily life. Appropriate stimulation intensity and pattern can be chosen by changing driving voltage and pattern. In this paper, we stimulated acupoints with this device and measured the blood flow volume of brachial artery. As a result, the blood flow volume increased significantly as well as acupuncture. Because the device stimulate acupoints with intactness of skin, advantages of this device is free from infection and fear and pain by insertion of acupuncture needles.