Ultrasound was first used for therapeutic purposes in the treatment of sciatica in 1938. Ultrasound therapy is one of the best-studied methods of physical therapy, both in terms of physical phenomena and physiological reactions induced by ultrasound. The effectiveness of this treatment and the side effects that may arise from improper use of the therapy have also been well recognized.

Ultrasoundsare mechanical vibrations with a frequency higher than 20,000. Hz. In physiotherapeutic treatment, those in the range from 0.8 to 3 MHz are used. During their application, no electric current flows through human tissues. The effectiveness of the therapy depends on the correct determination of the indications for their application, the use of the appropriate dose and the method of application.

How does ultrasound work?

The action of ultrasound may be local or systemic. During ultrasound treatments, the tissues are heated up, which is called the thermal effect. The nervous tissue overheats the most, and the muscle tissue and fat tissue are overheated a little less.

Warming up tissues with a high collagen content (tendons, ligaments, fascia, joint capsules, scars) increases their elasticity, but does not reduce their strength.

Ultrasound treatments are a good preparation before starting stretching exercises. The heating of tissues also promotes the acceleration of repair processes in chronic inflammatory processes.

The athermic effects of ultrasound can be induced by stimulating the flow of intra- and extracellular fluids.

These are physical phenomena (cavitation, acoustic flux and micromassage) that are a consequence of the changing pressure generated as a result of the ultrasonic wave flow. These mechanisms are believed to have anti-inflammatory properties and accelerate repair processes.

The treatment with ultrasound changes the potential of cell membranes and improves fluid flow in the cells. Protein synthesis is increased, the secretion of active substances by cells is increased, blood vessels are created and their permeability is increased. The production of collagen is also stimulated.

The general biological effect of ultrasound is when the roots, tangles,or ganglia. The changes that occur in the body are reflexive and stimulating for the sympathetic nervous system. In other words, the part of the autonomic nervous system that is responsible for the mobilization of the whole organism.

Ultrasound: indications

The healing effect of ultrasound can be used for:

  • fight pain and inflammation
  • vasodilation
  • acceleration of lymph flow in lymph vessels
  • acceleration of tissue absorption
  • increasing the temperature of local tissues subjected to the treatment
  • reduce muscle tone
  • increasing the extensibility of connective tissue in scars, contractures, muscle fibrosis, contractures of the joint capsule
  • acceleration of the wound healing process (not only of soft tissues, but also of bone tissue)
  • formation of biologically active compounds
  • influence on body enzymes
  • stabilization of the sympathetic nervous system
  • release of biologically active histamine-like substances

Ultrasounds: treatment technique

To perform the procedure, you must have a device generating ultrasound at frequencies that can be used in therapy. The type of technique will depend on the way the head is guided over the patient's body and the place of the procedure.

1. Heading

  • labile method - the ultrasound head is carried out in circular (circular) movements or in bands (e.g. during treatments in the paraspinal area)
  • stable (standing) method - with the use of impulse ultrasounds, when the treatment is performed on selected points, nerve ganglia and calcium deposits. Currently, this method is rarely used due to the risk of tissue overheating

2. Place of treatment

  • local (direct) method - the treatment is performed directly on the skin and tissues lying deeper in the area of ​​the lesions (e.g. elbow, knee, ankle joints) or painful places
  • segmental method (indirect or segmental-paraspinal) - the treatment is performed in the paraspinal area, in the line of the nerve roots that innervate the diseased areas

Ultrasounds: how long does the procedure take?

Treatments with the use of ultrasounds can be performed at different times, which depends on, for example, the location of the lesions, the size of the ultrasound surface, the type and stage of the disease or the general condition of the patient.
The treatment may take place:

  • short - from 1-3 minutes
  • medium - from 4-9 minutes
  • long - 10-15 minutes
  • segmental sonication is carried out for 2 minutes

Ultrasound treatments in rehabilitation are used in series.

The first is usually up to 10 treatments for chronic diseases that have been going on for several months. The number of these treatments, if the doctor deems it necessary, may be extended to 12-15 treatments. This is called full treatment cycle.

In acute diseases, up to 6 treatments in one series, but a 1 or 2-day break between treatments should be maintained.

When treating injuries or post-traumatic contractures, treatments are usually performed every day (5 days a week). After a series of treatments, there should be a 3-4 month break.

What do ultrasounds treat?

  • back and lower back pain
  • sciatica
  • pain syndromes in osteoarthritis of the cervical spine
  • osteoarthritis of the hip (coxarthrosis) and knee (gonarthrosis)
  • degeneration of the joints of the hands and feet
  • painful shoulder syndrome
  • pain in the elbow joint
  • heel spurs
  • neuralgia
  • phantom pains after limb amputations
  • scars
  • shin ulcers
  • Dupuytren's contracture, i.e. palmar fascia contracture

Ultrasounds: contraindications

No treatments are performed:

  • in cancer patients and after removal of proliferative changes
  • during pregnancy
  • with bleeding disorders
  • in failure of the cardiovascular system (circulatory failure, arrhythmias)
  • in people with an implanted pacemaker
  • for peripheral circulatory disorders
  • with blood coagulation disorders
  • with thrombophlebitis
  • for varicose veins
  • ongoing acute inflammation and high fever
  • skin lesions (especially in the process of ongoing infectious diseases)
  • in people after endoprosthesis implantation
  • after irradiation and heavy surgery

The treatments are also not used in people with vegetative neurosis and with neuralgia of unknown origin.

Ultrasound is not used on the organs of the thorax and the abdominal cavity.

Great caution in prescribing such treatments should be exercised in people with advanced atherosclerosis.

Particular attention should also be paid to performing treatments within the face and skull to avoid the effects of ultrasound on the brain and eyeballs.

Also, do not use the treatments abovethird cervical vertebrae to avoid exposure to the waves of the medulla.

About the authorAnna Jarosz A journalist who has been involved in popularizing he alth education for over 40 years. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice the "Crystal Pen" in the national competition for journalists promoting he alth, and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.

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