Ultra Sound Therapy for Pain Management and Injury Rehabilitation

Ultra Sound Therapy is a safe and effective treatment for pain management and injury rehabilitation. It is used in conjunction with a physical therapy program and has no side effects when performed by a qualified therapist. Therapeutic ultrasound (US) is mechanical energy transmitted through the body’s soft tissues at frequencies above the upper limit of human hearing (16 Hz). The frequency of US generated by a therapeutic device depends on its design: lower frequencies produce US at a greater depth, higher frequencies at a lesser depth, or both. Frequencies of 1 MHz to 3 MHz are typically found on commercial devices, but longer-wave systems exist with higher frequencies (e.g., 40-50,000 Hz).

The basic structure of an ultrasound machine consists of an alternating current generator that powers the head, and a transducer that converts electrical energy to mechanical energy (sound vibrations). When the US machine is turned on, an ultrasound conductive gel is placed between the skin and the head, and the device is moved over the target area. The acoustic waves travel through the tissue and generate two distinct effects: mechanical and thermal.

Mechanical US creates cavitation, a formation of small gas bubbles that rapidly expand and contract, reducing inflammation and increasing blood flow to the affected region. In addition, it has a slight heating effect that increases tissue mobility and decreases stiffness.

Thermal US increases the activity of cells, stimulating and enhancing normal repair mechanisms, thereby speeding up the overall process of healing. The US energy also interacts with the cells’ membrane, causing it to become more reactive and able to respond to changes in cell metabolism.

In addition to its traditional use as an imaging and diagnostic modality, a wide variety of therapeutic applications have developed for US. A few examples include the following:

During these procedures, the therapist applies an ultrasound-generating gel to the skin over the affected area and uses the transducer to deliver high-frequency sound waves into the tissue. The therapeutic effects of these high-frequency sounds are based on the interaction of the mechanical energy of the US waves and the cells’ acoustic response to the reflected waves.

In advanced image guided pain intervention, IR’s use the same techniques of US in combination with CT or fluoroscopy to perform injections in difficult-to-access locations such as the facet joints, nerve roots and bursae. Such procedures are often more accurate and safer than those that are rely solely on palpation, C-arm fluoroscopy or anatomic landmarks. They are also more likely to achieve the desired therapeutic effect. Examples of these procedures include spinal injections and pericapsular nerve group blocks for hip pain. These injections can be performed by most IR’s and are documented real time with CT or fluoroscopy to ensure the medication reaches its target. This type of intervention is a significant benefit for patients with chronic and persistent pain. It allows them to return to a more active lifestyle and reduce or eliminate the need for pain medications.