Ultrasound Therapy Indications, Contraindications

Ultrasound Therapy Indications, Contraindications

Ultrasound Therapy Indications/Ultrasound is one of the most widely used physical modalities in the clinical practice of rehabilitation. In particular, therapeutic ultrasound in rehabilitation has a number of uses including the treatment of musculoskeletal disorders such as pain, muscle spasm, joint contracture, and tissue injury,. Therefore, it is now recognized as a major therapeutic method in treating musculoskeletal disorders,,. Essential treatment parameters for therapeutic ultrasound include frequency, intensity, duty cycle, treatment time, and treatment area. The frequency for therapeutic ultrasound ranges from 1 to 3 MHz, with 3 MHz used specifically for the treatment of superficial tissues, and 1 MHz is applied to treat deeper tissues.

Ultrasound therapy is a popular method of treatment for chiropractors, physical therapists, and other medical care providers. It involves transferring sound waves with frequencies greater than the human sound spectrum (above 20 kilohertz) into a patient. The energy that is transferred with the sound waves can be used to treat focused, isolated areas of tissue to help with relieving pain in affected areas of the body and to speed the recovery process for injured muscle or other tissues.

The Indication of Ultrasound Therapy

Conditions for which ultrasound may be used for treatment include the following examples

  • Osteoarthritis of knee
  • Rheumatoid arthritis
  • Musculoskeletal disorders
  • Carpal tunnel syndrome
  • Ankylosing spondylitis
  • PLID in the acute phase
  • Tennis elbow
  • Ligament Sprains
  • Muscle strains
  • Tendonitis,
  • Joint inflammation,
  • Plantar fasciitis,
  • Metatarsalgia,
  • Facet irritation,
  • Impingement syndrome,
  • Bursitis & scar tissue adhesion.
  • Adhesion formation
  • Pain and muscle spasm
  • Rotator cuff tendinopathy
  • Hematoma
  • Bursitis
  • Tendonitis
  • Muscle strains and tears
  • Sprains and ligament injuries
  • Joint contracture or tightness
  • Stroke rehabilitation
  • Ankle sprains/ Strain
  • Capsulitis
  • Joint stiffness
  • Frozen shoulder
  • Scar tissue
  • Chronic low back pain
  • Calcified tendinitis
  • Tuberculosis of lungs or bone
  • Deep vein thrombosis
  • Anaesthetic area
  • Haemophilia
  • Reproductive organ
  • Acute infection
  • Brain and spinal cord
  • During the inflammatory phase to stimulate the release of growth factors and accelerate the phase itself
  • During the proliferative phase to stimulate fibroblast migration and proliferation and to accelerate wound contraction
  • During the epithelialization phase to stimulate the release of growth factors and to increase the vascularity of the tissue
  • During the maturation phase (if treatment commenced in the inflammatory phase) to improve scar collagen density and organization
  • To disperse the hemorrhagic material associated with bruising5
  • To reduce bacterial burden
  • To enhance transdermal drug delivery
  • Debridement
  • Venous leg ulcers
  • Pressure injuries
  • Vascular ulcer
  • Neuropathic ulcers
  • Burns scar
  • Surgical wounds
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Contraindications to Using Ultrasound

There are some instances where you should not use ultrasound at all. These contraindications to ultrasound may include:

  • Open wounds
  • Metastatic lesions
  • Areas of decreased sensation
  • parts of the body with metal implants, like in a total knee replacement of lumbar fusion
  • Near or over a pacemaker
  • the uterus during pregnancy
  • Over the gonads
  • Malignancies and precancerous lesions
  • On patients with vascular abnormalities, i.e. deep vein thrombosis, emboli, severe atherosclerosis
  • The eye
  • Over the stellate ganglion
  • For hemophiliacs not covered by factor replacement
  • The spinal cord after laminectomy
  • Directly over metal implants
  • Over an electronic device
  • Tissues previously treated with deep Xray or radiation
  • Tuberculosis (local)
  • Damaged or at risk skin, i.e. skin rash,eczema
  • Anesthetic areas
  • Excitable tissue,
  • With pregnant women
  • Around the eyes, breasts, or sexual organs
  • Over fractured bones
  • Near or over an implanted electrical stimulation device

A listing of FDA approved modes for ultrasound therapy.

Therapy Method Therapeutic Outcome Bioeffect Mechanism Device Characteristics General Reference
Applicator Frequency Delivery
Unfocused beam tissue warming heating portable hand-held 1–3 MHZ continuous or repeated bursts
Hyperthermia cancer therapy regional heating multi-element applicator 1–3.4 MHz 1 hour [rx]
HIFU uterine fibroid ablation thermal lesion computer directed 0.5–2 MHZ long bursts
HIFU glaucoma relief permeabilization fixed probe with waterbath 4.6 MHZ 1–3 s
HIFU laproscopic tissue ablation thermal lesion hand-held 4 MHz long bursts
HIFU laparoscopic or open surgery thermal lesion hand-held 3.8–6.4 MHz long bursts
Focused ultrasound skin tissue tightening thermal lesion hand-held, imaging and treatment 4.4–7.5 MHz 20–50 ms bursts
Extracorporeal Lithotripsy kidney stone comminution mechanical stress; cavitation mainframe with image guidance ~150 kHz shockwaves
Intracorporeal lithotripsy kidney stone comminution mechanical stress; cavitation Percutaneous probes 25 kHz continuous
Extracorporeal shockwave therapy plantar fasciitis epicondylitis unknown mainframe with applicator head ~150 kHz shockwaves
Phacoemulsification lens removal vibration ; cavitation generator with probe 40 kHz continuous
US assisted liposuction adipose tissue removal fat liquifaction; cavitation generator with probe 20–30 kHz continuous
Tissue cutting and vessel sealing laparoscopic or open surgery thermal lesion, vibration hand-held 55.5 kHz continuous
Intravascular US thrombus dissolution unknown; gas body activation intravascular catheter 2.2 MHZ continuous
Skin permeabilization transdermal drug delivery unknown hand held 55 kHz continuous
Low intensity pulsed US bone fracture healing unknown attached transducer 1.5 MHz pulsed, long duration
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References

Ultrasound Therapy Indications

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