Ultrasound therapy

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The ultrasound therapy is an area of physical therapy or electrical therapy and describes a medical procedure for pain relief and support of self-healing processes by means of ultrasound . The frequency range of ultrasound therapy is between 0.8 and 3 MHz.

For treatment, a transducer is moved evenly over the diseased area covered with contact gel, which is supposed to generate heat and tissue movement inside the body. A distinction must be made between treatment with continuous sound and treatment with impulse sound.

effect

Both continuous and pulsed sound are used in ultrasound therapy. The type of sound plays a major role for the total duration of treatment and the ultrasonic strength to be set. Because of the strong heat generation, the entire face, spine and genital area should be excluded from the treatment.

In ultrasound therapy, both the diseased area can be treated locally and the supplying nerves can be stimulated. The area to be treated is covered with a contact gel to ensure optimal sound transmission. The transducer is now moved evenly and slowly over the area to be treated. It is important here to delimit the area to be treated as precisely as possible and not to cover more than three areas per treatment unit. The treatment time for an area is between one and two minutes. Chronic illnesses are treated for up to ten minutes, depending on their severity.

The strength of the ultrasound is given in watts per cm², the strength being between a minimum of 0.05 W / cm² and a maximum of 1.00 W / cm², which is strongly dependent on the type of sound.

There are also some combination procedures such as the simultaneous ultrasound procedure, which is a combination of ultrasound therapy and electrotherapy applications . In addition, similar to iontophoresis , what is known as phonophoresis is possible.

The ultrasound acting on the body has a mechanical and thermal effect on the tissue.

The mechanical effect is a vibration effect. The sound pressure causes strong compressions and expansions in the surrounding tissue , which corresponds to the effect of a strong massage or connective tissue massage .

The thermal effect is created by the sound absorption of the body's own tissue. This generation of heat can certainly be used therapeutically, but it also gives cause for caution. The skin absorbs far less sound than the periosteum, which can lead to severe burns of the periosteum even if the skin is only slightly warm . The heat generation of the impulse sound is significantly less than that of the continuous sound, so that only the impulse sound is used when applied locally to bones.

In addition, it can lead to cell destruction and blood leakage into the tissue, as well as the formation of gas bubbles in the body tissue ( cavitation ).

Possible application

Ultrasound is sometimes used for myalgia , chronic muscle or tendon pain, fractures or scar / tissue adhesions. However, no treatment recommendations can be derived for these clinical pictures from the available data. As far as the application for fracture healing is concerned, a meta-analysis of 26 randomized controlled studies could not find any relevant effect. Because of the lack of effectiveness and in view of the expensive ultrasound devices, use for bone healing is not recommended.

On the basis of animal experiments, it is speculated whether ultrasound therapy could contribute to faster healing of (chronic) wounds on the skin, e.g. in older people with diabetes .

Contraindications include patients treated with radiation therapy, blood coagulation disorders ( hemophilia , anticoagulant drugs such as heparin or Marcumar ), vascular diseases ( varices , thromboses ), acute febrile diseases, tumors and metastases , as well as use over joint replacements made of polyethylene .

Related topics

Individual evidence

  1. ↑ G. Ebenbichler: Evidence-based medicine and ultrasound therapy of the skeleton. Journal of Rheumatology, 2009 Sep; 68 (7): 543-8. PMID 19669770
  2. ↑ Stefan Schandelmaier, Alka Kaushal, Lyubov Lytvyn, Diane Heels-Ansdell, Reed AC Siemieniuk: Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials . In: BMJ (Clinical research ed.) . tape 356 , February 22, 2017, ISSN  1756-1833 , p. j656 , doi : 10.1136 / bmj.j656 , PMID 28348110 , PMC 5484179 (free full text).
  3. ^ Rudolf W. Poolman, Thomas Agoritsas, Reed AC Siemieniuk, Ian A. Harris, Inger B. Schipper: Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline . In: BMJ (Clinical research ed.) . tape 356 , February 21, 2017, ISSN  1756-1833 , p. j576 , PMID 28228381 .
  4. ↑ James A Roper, Rosalind C Williamson, et al. a .: Ultrasonic Stimulation of Mouse Skin Reverses the Healing Delays in Diabetes and Aging by Activation of Rac1. In: Journal of Investigative Dermatology . 2015, volume 135, p. 2842, doi: 10.1038 / jid.2015.224 .