Table of ContentsView AllTable of ContentsWhat Is Therapeutic Ultrasound?How Does It Work?When Is It Used?What to ExpectContraindicationsDoes Evidence Support Its Use?Is It Right For You?
Table of ContentsView All
View All
Table of Contents
What Is Therapeutic Ultrasound?
How Does It Work?
When Is It Used?
What to Expect
Contraindications
Does Evidence Support Its Use?
Is It Right For You?
Therapeutic ultrasound is atreatmentcommonly used in physical therapy to provide deep heating to soft tissues in the body. These tissues include muscles, tendons, joints, and ligaments.
Ultrasound in physical therapy is different than diagnostic ultrasound. With the latter, healthcare providers use ultrasound to see the inside of the body. For example, diagnostic ultrasound lets healthcare providers check on a fetus during pregnancy.
This article explains how therapeutic ultrasound works and when it’s used.
maria_esau / Getty Images
Therapeutic ultrasound is used to heat tissues and introduce energy into the body.
Deep Heating Effects
Ultrasoundcan provide deep heating to soft tissue structures in the body. Deep heating tendons, muscles, or ligaments could have the following benefits:
Deep heating can increase the “stretchiness” of muscles and tendons that may be tight.
If you haveshoulder painand have been diagnosed with afrozen shoulder, your physical therapist (PT) may use ultrasound. This therapy is usually done before performingrange of motionexercises because it can help improve the ability of your shoulder to stretch.
1:46Click Play to Learn More About the Use of Therapeutic Ultrasound
1:46
Click Play to Learn More About the Use of Therapeutic Ultrasound
Non-Thermal Effects (Cavitation)
In addition to heat, ultrasound introduces energy into the body. This energy causes microscopic gas bubbles around your tissues to expand and contract rapidly, a process called cavitation.
It is theorized that the expansion and contraction of these bubbles help speed cellular processes and help injured tissue heal faster.
When cavitation is unstable, it can be dangerous to your body’s tissues.So, yourphysical therapistwill work to ensure that the cavitation during therapy is stable.
RecapTherapeutic ultrasound uses heat and energy to increase circulation, decrease pain, increase flexibility, and speed healing.
Recap
Therapeutic ultrasound uses heat and energy to increase circulation, decrease pain, increase flexibility, and speed healing.
How Does Ultrasound Work?
Inside your physical therapist’s ultrasound unit is a small crystal. When an electrical charge hits this crystal, it vibrates rapidly, creatingpiezoelectricwaves (an electric charge that accumulates in some solid materials). These waves emit from the ultrasound sound head as ultrasound waves.
During treatment, the ultrasound wave then enters into your injured tissues. This exposure to ultrasonic waves increases blood flow and cavitation, leading to the theorized benefits of the treatment.
PTs may use therapeutic ultrasound to treat some injuries and chronic pain.
Injuries
Usually, PTs treat orthopedic (musculoskeletal) injuries with ultrasound. These may include:
Generally speaking, any soft-tissue injury in the body may be a candidate for ultrasound therapy. For example, your physical therapist may use ultrasound for low back pain, neck pain, rotator cuff tears, knee meniscus tears, or ankle sprains.
Chronic Pain
There is also some evidence that you may benefit from ultrasound treatments if you have chronic pain. It is thought that the ultrasound waves help improve tissue extensibility and circulation, leading to increased mobility and, ultimately, decreased pain.
RecapPTs use therapeutic ultrasound for specific soft-tissue injuries, including joint pain, muscle strains and tears, and ligament injuries. In addition, they sometimes use it for chronic pain.
PTs use therapeutic ultrasound for specific soft-tissue injuries, including joint pain, muscle strains and tears, and ligament injuries. In addition, they sometimes use it for chronic pain.
Ultrasound Therapy for Chronic Pain
Ultrasound uses a machine that has an ultrasound transducer (sound head). First, a PT applies a small amount of gel to the particular body part; then, your physical therapist slowly moves the sound head in a small circular direction on your body.
What Ultrasound Feels LikeWhile receiving an ultrasound treatment, you will most likely not feel anything happening, except perhaps a slight warming sensation or tingling around the treatment area.If the ultrasound sound head is left in place on your skin and not moved in a circular direction, you may experience pain. If this occurs, tell your physical therapist right away.
What Ultrasound Feels Like
While receiving an ultrasound treatment, you will most likely not feel anything happening, except perhaps a slight warming sensation or tingling around the treatment area.If the ultrasound sound head is left in place on your skin and not moved in a circular direction, you may experience pain. If this occurs, tell your physical therapist right away.
While receiving an ultrasound treatment, you will most likely not feel anything happening, except perhaps a slight warming sensation or tingling around the treatment area.
If the ultrasound sound head is left in place on your skin and not moved in a circular direction, you may experience pain. If this occurs, tell your physical therapist right away.
Settings
The therapist may change various settings of the ultrasound unit to control the ultrasound wave’s penetration depth or change the ultrasound’s intensity. In addition, they may use different settings during various stages of healing.
Methods
Alternative methods of ultrasound application are available if the body part is bony and bumpy or if there’s an open wound. (The ultrasound gel and sound head may harbor bacteria that can enter the wound.) These include:
Ultrasound + Medication
Your PT may use ultrasound gel combined with a topical medication to help treat inflammation around the soft tissue in the body. This process is calledphonophoresis.
While there is evidence that ultrasound waves help deliver the medicated gel to the injured tissues, many published studies indicate that this treatment may be ineffective.
RecapTherapeutic ultrasound does not result in many bodily sensations, other than the feeling of the ultrasound wand against your skin. Your PT may use various settings or different application methods depending on your situation.
Therapeutic ultrasound does not result in many bodily sensations, other than the feeling of the ultrasound wand against your skin. Your PT may use various settings or different application methods depending on your situation.
There are some instances where you should not use ultrasound at all. These contraindications to ultrasound may include:
Studies have been mixed as to whether or not ultrasound offers benefit to the overall outcome of physical therapy. One found that focused low-intensity pulsed ultrasound was a safe and effective treatment for relieving pain and improving quality of life in patients with knee osteoarthritis.
On the other hand, a 2014 study in theAmerican Journal of Physical Medicine and Rehabilitationexamined the effect of ultrasound on pain and function in patients withknee osteoarthritis.The researchers found no difference in knee function and pain with rehab using ultrasound, no ultrasound, and sham (fake) ultrasound.
Ultrasound may not work for everyone, but it may be worth a try if you have chronic, ongoing pain. Some people may suggest that the benefit of ultrasound for chronic pain is due to the placebo effect. But, if it gives you relief, then it is the proper treatment for you.
Ultrasound is a passive treatment. In other words, you can’t provide the therapy yourself; you are a passive receiver of the ultrasound. If your physical therapist uses ultrasound during your treatment, make sure you are engaged in an active exercise program to help improve your functional mobility.
Exercise and active involvement should always be the main components of your rehab program.
Summary
Therapeutic ultrasound is different from diagnostic ultrasound. PTs use it to treat some injuries and chronic pain. Evidence is mixed on the purported benefits of therapeutic ultrasound. However, since it is low-risk for most people, it may be worth trying, especially if you experience chronic pain.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jia L, Wang Y, Chen J, Chen W.Efficacy of focused low-intensity pulsed ultrasound therapy for the management of knee osteoarthritis: a randomized, double blind, placebo-controlled trial.Sci Rep. 2016;6:35453. doi:10.1038/srep35453Petrofsky JS, Laymon M, Lee H.Effect of heat and cold on tendon flexibility and force to flex the human knee.Med Sci Monit. 2013;19:661-667. doi:10.12659/MSM.889145Brennen CE.Cavitation in medicine.Interface Focus. 2015;5(5):20150022. doi:10.1098/rsfs.2015.0022Morishita K, Karasuno H, Yokoi Y, et al.Effects of therapeutic ultrasound on intramuscular blood circulation and oxygen dynamics.J Jpn Phys Ther Assoc. 2014;17(1):1-7. doi:10.1298/jjpta.Vol17_001Yeğin T, Altan L, Kasapoğlu Aksoy M.The effect of therapeutic ultrasound on pain and physical function in patients with knee osteoarthritis.Ultrasound Med Biol. 2017;43(1):187-194. doi:10.1016/j.ultrasmedbio.2016.08.035Katzap Y, Haidukov M, Berland OM, Itzhak RB, Kalichman L.Additive effect of therapeutic ultrasound in the treatment of plantar fasciitis: a randomized controlled trial.J Orthop Sports Phys Ther. 2018;48(11):847-855. doi:10.2519/jospt.2018.8110American Academy of Physical Medicine and Rehabilitation.Therapeutic modalities.Baghdadi S, Harwood K, Greenberg E, Baldwin KD, Lawrence JTR.Effects of therapeutic ultrasound on growth plates: a systematic review.Pediatr Phys Ther. 2022;34(1):2-8. doi:10.1097/PEP.0000000000000846National Library of Medicine, National Institutes of Health.Ultrasound therapy.Cakir S, Hepguler S, Ozturk C, Korkmaz M, Isleten B, Atamaz FC.Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: a randomized, controlled, and double-blind study.Am J Phys Med Rehabil. 2014;93(5):405-12. doi:10.1097/PHM.0000000000000033
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jia L, Wang Y, Chen J, Chen W.Efficacy of focused low-intensity pulsed ultrasound therapy for the management of knee osteoarthritis: a randomized, double blind, placebo-controlled trial.Sci Rep. 2016;6:35453. doi:10.1038/srep35453Petrofsky JS, Laymon M, Lee H.Effect of heat and cold on tendon flexibility and force to flex the human knee.Med Sci Monit. 2013;19:661-667. doi:10.12659/MSM.889145Brennen CE.Cavitation in medicine.Interface Focus. 2015;5(5):20150022. doi:10.1098/rsfs.2015.0022Morishita K, Karasuno H, Yokoi Y, et al.Effects of therapeutic ultrasound on intramuscular blood circulation and oxygen dynamics.J Jpn Phys Ther Assoc. 2014;17(1):1-7. doi:10.1298/jjpta.Vol17_001Yeğin T, Altan L, Kasapoğlu Aksoy M.The effect of therapeutic ultrasound on pain and physical function in patients with knee osteoarthritis.Ultrasound Med Biol. 2017;43(1):187-194. doi:10.1016/j.ultrasmedbio.2016.08.035Katzap Y, Haidukov M, Berland OM, Itzhak RB, Kalichman L.Additive effect of therapeutic ultrasound in the treatment of plantar fasciitis: a randomized controlled trial.J Orthop Sports Phys Ther. 2018;48(11):847-855. doi:10.2519/jospt.2018.8110American Academy of Physical Medicine and Rehabilitation.Therapeutic modalities.Baghdadi S, Harwood K, Greenberg E, Baldwin KD, Lawrence JTR.Effects of therapeutic ultrasound on growth plates: a systematic review.Pediatr Phys Ther. 2022;34(1):2-8. doi:10.1097/PEP.0000000000000846National Library of Medicine, National Institutes of Health.Ultrasound therapy.Cakir S, Hepguler S, Ozturk C, Korkmaz M, Isleten B, Atamaz FC.Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: a randomized, controlled, and double-blind study.Am J Phys Med Rehabil. 2014;93(5):405-12. doi:10.1097/PHM.0000000000000033
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Jia L, Wang Y, Chen J, Chen W.Efficacy of focused low-intensity pulsed ultrasound therapy for the management of knee osteoarthritis: a randomized, double blind, placebo-controlled trial.Sci Rep. 2016;6:35453. doi:10.1038/srep35453Petrofsky JS, Laymon M, Lee H.Effect of heat and cold on tendon flexibility and force to flex the human knee.Med Sci Monit. 2013;19:661-667. doi:10.12659/MSM.889145Brennen CE.Cavitation in medicine.Interface Focus. 2015;5(5):20150022. doi:10.1098/rsfs.2015.0022Morishita K, Karasuno H, Yokoi Y, et al.Effects of therapeutic ultrasound on intramuscular blood circulation and oxygen dynamics.J Jpn Phys Ther Assoc. 2014;17(1):1-7. doi:10.1298/jjpta.Vol17_001Yeğin T, Altan L, Kasapoğlu Aksoy M.The effect of therapeutic ultrasound on pain and physical function in patients with knee osteoarthritis.Ultrasound Med Biol. 2017;43(1):187-194. doi:10.1016/j.ultrasmedbio.2016.08.035Katzap Y, Haidukov M, Berland OM, Itzhak RB, Kalichman L.Additive effect of therapeutic ultrasound in the treatment of plantar fasciitis: a randomized controlled trial.J Orthop Sports Phys Ther. 2018;48(11):847-855. doi:10.2519/jospt.2018.8110American Academy of Physical Medicine and Rehabilitation.Therapeutic modalities.Baghdadi S, Harwood K, Greenberg E, Baldwin KD, Lawrence JTR.Effects of therapeutic ultrasound on growth plates: a systematic review.Pediatr Phys Ther. 2022;34(1):2-8. doi:10.1097/PEP.0000000000000846National Library of Medicine, National Institutes of Health.Ultrasound therapy.Cakir S, Hepguler S, Ozturk C, Korkmaz M, Isleten B, Atamaz FC.Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: a randomized, controlled, and double-blind study.Am J Phys Med Rehabil. 2014;93(5):405-12. doi:10.1097/PHM.0000000000000033
Jia L, Wang Y, Chen J, Chen W.Efficacy of focused low-intensity pulsed ultrasound therapy for the management of knee osteoarthritis: a randomized, double blind, placebo-controlled trial.Sci Rep. 2016;6:35453. doi:10.1038/srep35453
Petrofsky JS, Laymon M, Lee H.Effect of heat and cold on tendon flexibility and force to flex the human knee.Med Sci Monit. 2013;19:661-667. doi:10.12659/MSM.889145
Brennen CE.Cavitation in medicine.Interface Focus. 2015;5(5):20150022. doi:10.1098/rsfs.2015.0022
Morishita K, Karasuno H, Yokoi Y, et al.Effects of therapeutic ultrasound on intramuscular blood circulation and oxygen dynamics.J Jpn Phys Ther Assoc. 2014;17(1):1-7. doi:10.1298/jjpta.Vol17_001
Yeğin T, Altan L, Kasapoğlu Aksoy M.The effect of therapeutic ultrasound on pain and physical function in patients with knee osteoarthritis.Ultrasound Med Biol. 2017;43(1):187-194. doi:10.1016/j.ultrasmedbio.2016.08.035
Katzap Y, Haidukov M, Berland OM, Itzhak RB, Kalichman L.Additive effect of therapeutic ultrasound in the treatment of plantar fasciitis: a randomized controlled trial.J Orthop Sports Phys Ther. 2018;48(11):847-855. doi:10.2519/jospt.2018.8110
American Academy of Physical Medicine and Rehabilitation.Therapeutic modalities.
Baghdadi S, Harwood K, Greenberg E, Baldwin KD, Lawrence JTR.Effects of therapeutic ultrasound on growth plates: a systematic review.Pediatr Phys Ther. 2022;34(1):2-8. doi:10.1097/PEP.0000000000000846
National Library of Medicine, National Institutes of Health.Ultrasound therapy.
Cakir S, Hepguler S, Ozturk C, Korkmaz M, Isleten B, Atamaz FC.Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: a randomized, controlled, and double-blind study.Am J Phys Med Rehabil. 2014;93(5):405-12. doi:10.1097/PHM.0000000000000033
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