Ultrasound Therapy can be used on both chronic and acute conditions and is proposed to reduce the healing time of certain soft tissue injuries. It is commonly used in the rehabilitation of muscle, tendon and ligament injuries, haematomas and oedema. High frequency sound waves are focussed around the site of an injury by gently moving an ultrasonic head over the affected area.
Effects on the Inflammatory and Repair Processes: Ultrasound is thought to accelerate the normal resolution time of the inflammatory process by attracting more mast cells to the site of injury. This may cause an increase in blood flow which can be beneficial in the sub-acute phase of tissue injury.
Ultrasound may also stimulate the production of more collagen- the main protein component in soft tissue such as tendons and ligaments. Hence ultrasound may accelerate the proliferative phase of tissue healing.
Ultrasound is thought to improve the extensibility of mature collagen and so can have a positive effect on fibrous scar tissue which may form after an injury.
Thermal Effect: As the ultrasound waves pass from the treatment head into the skin they cause vibrations to occur leading to the production of heat in the surrounding tissues, particularly those that contain collagen. This increase in temperature may cause an increase in the extensibility of structures such as ligaments, tendons, scar tissue and fibrous joint capsules. In addition, heating may also help to reduce pain and muscle spasm and promote the healing process.
- Patients with reduced sensation to pain and/or heat
- Pregnancy (direct exposure to abdomen
- Local malignancy or cancerous tissue
- Local acute infection
- Direct application to the eye, brain, spinal cord, heart, reproductive organs, epiphyseal regions in children
- Over areas of thrombosis or other vascular abnormalities
TENS (Transcutaneous Electrical Nerve Stimulation)
TENS is often used in the treatment of chronic pain. TENS primarily aims to provide a degree of symptomatic pain relief by exciting sensory nerves and thereby stimulating either the pain gate mechanism and/or the opioid system: The tingling sensation of the TENS inhibits the amount of pain signals received by the brain and/or TENS increases the levels of the body’s own natural pain killing substances called endorphins and enkephalins.
TENS is a safe and effective technique and involves the use of a battery operated device and is delivered across the skin via conducting pads. Clinically it is important to enable the patient to find their optimal treatment frequency – which will almost certainly vary between individuals. Setting the machine and telling the patient that this is the ‘right’ setting is almost certainly not going to be the maximally effective treatment, though of course, some pain relief may well be achieved.
Some simple precautions should be observed do not;
- Use on or near the torso of a pregnant woman.
- Use on the front of the neck as it may cause spasm or reflex loss of blood pressure.
- Use from one side of the chest to the other – front to back or left to right.
- From one side of the head to the other.
- Over or near the eyes (similar issues with possible increase in fluid pressure).
- From one side of the spinal column to the other
- Over or near a cardiac pacemaker
- On broken skin