In health care, there’s no substitute for clinical skill, judgment and decision making. These essentials help you diagnose, manage and treat a host of patients. But sometimes, you need help to achieve treatment goals. In those cases, you can turn to modalities to jumpstart the healing process. The following is a brief primer on ultrasound.

Ultrasound is a form of deep heat generated through a piezo-electric crystal soundhead. Sound waves cause vibration of the cells in the soft tissue, therefore increasing temperature and inducing vasodilatation. Ultrasound can separate collagen fibers, thereby increasing tissue extensibility, or it can increase membrane permeability, increasing ion exchange. Ultrasound waves can cause thermal and nonthermal effects.

As a thermal agent, this modality can increase the tissue temperature to depths of 5 cm or more. By increasing collagen tissue extensibility, it promotes circulation, relaxes tight muscles, changes nerve conduction velocity, reduces pain and decreases inflammation.

In rehabilitation, ultrasound serves many uses. For the patient with joint contracture, ultrasound can help raise tissue temperature. The combined effect of heat and stretch will promote greater tissue extensibility, thus increasing range of motion.

Ultrasound is indicated to treat soft tissue shortening (joint contractures, scarring); subacute and chronic inflammation; painful conditions, including muscle guarding; neuroma; trigger points and warts.

Ultrasound is contraindicated in people with poor arterial circulation. It can’t be used over an area with bleeding or infection, on someone who is pregnant or doesn’t know she’s pregnant, on someone who has known cancer, over the spinal cord after a laminectomy and over the carotid sinus or cervical ganglia.

Advance for Physical Therapists & PT Assistants

Making Progress: Modalities can jumpstart the healing process

By Danielle Montbriand, MPT, and Jessica F. Broussard, OTR/L