Ultrasound

Overview of Treatment

Ultrasound therapy is a non-invasive physical treatment technique that uses high-frequency sound waves to penetrate tissues, generating heat and mechanical effects. It is primarily used to alleviate musculoskeletal injuries, promote tissue repair, and reduce pain. This technology combines principles of physics with biological responses and is widely applied in rehabilitation medicine and clinical treatments.

By adjusting the frequency and energy intensity of sound waves, therapists can perform precise treatments targeting different tissue layers. Its core advantage lies in its ability to penetrate subcutaneous tissues to reach deep muscles and joints without invasive surgery. Modern medical devices also integrate real-time imaging systems, enhancing the accuracy and safety of treatments.

Types and Mechanisms of Treatment

Ultrasound therapy is divided into two main types: Thermal Effect Therapy and Mechanical Effect Therapy. The thermal effect utilizes frequencies of 0.8-3.0 MHz to heat deep tissues, promoting blood circulation and metabolism. The mechanical effect uses higher frequencies (such as 3.0-5.0 MHz) to enhance cell membrane permeability and accelerate tissue repair.

The mechanisms include three core effects:

  • Thermal energy effect: vasodilation to enhance nutrient supply
  • Cavitation effect: promotes exchange of substances within cells
  • Micro-massage effect: loosening fibrotic tissues
The treatment head is moved at a power density of 0.1-1.5 W/cm², typically for 3-5 minutes per session.

Indications

Mainly suitable for musculoskeletal injuries:

  • Tendonitis (e.g., shoulder or neck tendonitis)
  • Ligament injuries (e.g., knee ligament sprain)
  • Capsulitis and synovitis
It also shows significant efficacy in chronic fascial adhesions and post-surgical tissue calcification.

Common applications include:

  • Joint stiffness caused by shoulder periarthritis
  • Occupational repetitive motion injuries
  • Microtrauma repair in athletes
Some medical institutions also use it for nerve relaxation and lymphatic circulation improvement.

Usage and Dosage

The treatment process consists of three steps:

  1. Applying a coupling agent on the skin to ensure sound wave conduction
  2. Moving the treatment head in a slow spiral motion
  3. Adjusting frequency and intensity based on tissue depth
The number of treatments per day depends on the condition; acute injuries may be treated every other day, while chronic cases are typically treated 2-3 times per week.

Standard parameter examples:

  • Soft tissue injuries: 1.5-2.0 MHz, 0.3-0.8 W/cm²
  • Capsulitis: 0.8 MHz, 1.0-1.5 W/cm²
  • The contact surface of the treatment head is usually 1-3 cm in diameter
Energy output should be fine-tuned according to patient feedback on pain.

Benefits and Advantages

Key advantages include:

  • Non-invasive treatment reduces infection risk
  • Can penetrate deep tissues up to 4-6 cm
  • Promotes collagen fiber remodeling and neovascularization
Clinical studies show it can shorten tendon healing time by up to 30-40%.

Compared to other physical therapies, its advantages are:

  • More precise targeting of affected areas than electrical therapy
  • Active tissue repair effects compared to hot packs
  • Can be combined with exercise therapy for enhanced effects
Suitable for patients who cannot undergo medication treatments.

Risks and Side Effects

Possible adverse reactions include:

  • Skin redness and swelling (incidence approximately 5-8%)
  • Transient nerve paresthesia
  • Over-treatment leading to tissue overheating
Serious complications such as deep tissue edema are extremely rare.

Serious Risk Warnings:

  • Contraindicated in pregnant patients
  • High-intensity treatment may cause microfractures of bone tissue
  • Patients with electronic medical devices should be evaluated by a physician beforehand
Therapists must strictly follow energy density guidelines to avoid injury.

Precautions and Contraindications

Absolute contraindications include:

  • Malignant tumors
  • Bleeding disorders (e.g., hemophilia)
  • Areas with pacemakers
>Patients should confirm whether they have electronic medical devices before treatment.

Relative contraindications include:

  • Open wounds at the treatment site
  • Recent radiation therapy
  • Coagulopathy
Metal objects should be avoided within 30 cm of the treatment area.

Interactions with Other Treatments

Can be combined with other physical therapies:

  • Enhances tissue repair when combined with electrical therapy
  • Improves joint mobility when combined with traction therapy
  • Controls acute inflammation when alternated with cryotherapy
>Avoid simultaneous use with anticoagulant medications in the same area.

Interactions to avoid:

  • Using with heat therapy may cause excessive heating
  • Must wait at least 2 hours after chemical injections
  • Assess energy accumulation effects when combined with phototherapy
Complex treatment plans should be devised jointly by physical therapists and physicians.

Treatment Outcomes and Evidence

Clinical studies show effectiveness for tendon disorders:

  • Shoulder tendinitis pain index decreases by an average of 40-60%
  • Tendon regeneration occurs 1.5-2 times faster than control groups
  • Postoperative tissue adhesion separation success rate increases by 30%
Meta-analyses indicate an efficacy rate of 78% for chronic post-traumatic syndromes.

Durability of effects:

  • Acute injuries typically require 4-6 weeks of treatment
  • Chronic conditions need 8-12 sessions
  • Effects persist for over 6 months after cessation
It is suitable as an initial treatment alternative to surgery.

Alternatives

Other physical therapy options include:

  • Low-frequency electrical stimulation
  • Laser therapy
  • Ultrasound drug delivery
Cold and hot therapy and hot packs can be used as adjuncts.

Pharmacological options:

  • Non-steroidal anti-inflammatory drugs
  • Localized corticosteroid injections
  • Autologous blood therapy
Choose the most appropriate treatment combination based on tissue injury depth and extent.

 

Frequently Asked Questions

What should I do if I experience local discomfort after ultrasound therapy?

If mild redness or tenderness occurs post-treatment, applying ice for 10-15 minutes can alleviate symptoms. If discomfort persists over 48 hours or worsens (e.g., swelling, fever), consult a physician to evaluate whether treatment parameters need adjustment. It is recommended to avoid vigorous exercise within 24 hours after treatment to prevent aggravating tissue response.

What precautions should be taken for daily care during ultrasound treatment?

Avoid self-administering other physical therapies (such as electrical or heat therapy) on the same area during treatment to prevent excessive tissue stimulation. If there are open wounds, pacemakers, or pregnancy, inform your physician beforehand, as treatment adjustments or suspensions may be necessary.

How should the frequency and interval of ultrasound treatments be scheduled for optimal results?

Typically, treatments are scheduled 2-3 times per week, with a total of 6-12 sessions depending on the severity. At least 48 hours should pass between sessions to allow sufficient tissue repair. Chronic issues may require staged treatments, with adjustments made by the physician based on response.

Does combining ultrasound therapy with medication cause interactions?

Ultrasound itself does not directly chemically interact with medications, but if combined with phonophoresis (drug penetration therapy), medication concentration and dosage should be controlled under medical guidance. During physical therapy alone, painkillers or anti-inflammatory drugs in use are usually unaffected, but all medications should be disclosed to the physician for safety.

How soon can symptom improvement be observed after treatment? What are the key factors affecting efficacy?

Mild inflammation or muscle tension may improve after 3-5 sessions, while severe adhesions or chronic conditions may require 8-12 treatments to see effects. Variability in outcomes mainly depends on the depth of the lesion, tissue repair capacity, and patient activity control (e.g., avoiding overuse). Elderly patients or those with metabolic diseases may need longer treatment courses.