Ultrasound is a therapeutic modality that has been used by manual therapy practitioners for greater than sixty years. Ultrasound is applied using a round-headed wand or probe that is put in direct contact with the patient's skin. Therapeutic ultrasound is in the frequency range of about 1.0 - 3.0 MHz.

The waves are generated by what’s known as a “piezoelectric effect”, caused by the vibration of crystals within the head of the ultrasound wand/probe. These sound waves pass through the skin and cause a vibration of the local tissues, thereby creating a deep heating locally (although often no sensation of heat will be felt by the patient). In situations where a heating effect is not desirable, such as a new injury with acute inflammation, the ultrasound can be pulsed rather than continuously transmitted.

Therapeutic Ultrasound can produce many effects other than just the potential heating effect. It has been shown to cause increases in tissue relaxation, local blood flow, and scar tissue breakdown. The effect of the increased local blood flow includes that of a local reduction in swelling and chronic inflammation. Further, according to research, this increased local blood flow can promote bone fracture healing. The intensity (or power density) of the Therapeutic Ultrasound can be adjusted depending on the desired effect. For example, a greater power density (measured in watt/cm2 ) is often used in cases where scar tissue breakdown is the goal.

Typically, an ultrasound treatment will last from 3-5 minutes depending on the size of the area being treated. In cases where scar tissue breakdown is the goal, this treatment time can be significantly longer. During treatment, the head of the ultrasound wand is kept in constant motion. If kept in constant motion, the patient should feel no discomfort at all. (If the wand were to be held in one place for more than just a few seconds, a build-up of the sound energy would result, and discomfort would ensue).

Interestingly, if there is even a very minor break in a bone in the area that is close to the surface, a sharp pain may be felt. This occurs as the sound waves get trapped between the two parts of the break and build up until becoming painful. In this way ultrasound can often be used as a relatively accurate tool for diagnosing minor fractures that may not be obvious on x-ray.

Some conditions treated with ultrasound include tendinopathy (or tendinitis), strains and sprains, joint swelling, and muscle spasm.

There are a few contraindications to Therapeutic Ultrasound. These may include local malignancy, metal implants below the area being treated, local acute infection, vascular disorders, and direct application of the wand on the abdomen of pregnant women. Further, it is contraindicated to apply Therapeutic Ultrasound directly over active epiphyseal regions (growth plates) in children, over the spinal cord in the area of a laminectomy, or over the eyes, skull, or testes.

For further information about this form of therapy, please feel free to contact Dr. Carney.