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Benefits of Ultrasound Treatment for Osteoarthritis
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What Is Therapeutic Ultrasound?
Therapeutic ultrasound is a technique which utilizes sound waves (which cause vibration) to decrease pain or improve joint function. These vibrations occur at high frequency—so high that the vibrations are undetectable to the person receiving ultrasound treatment.
The vibrations may be pulsed or continuous. Continuous ultrasound vibrations generate noticeable heat, while pulsed ultrasound vibrations do not. It’s thought that both thermal and non-thermal effects are responsible for any effects these treatments may have.
Typically, therapeutic ultrasound is performed in a physical therapy clinic or in a healthcare provider’s office. Although it is a treatment option for osteoarthritis, its effectiveness is still questioned.
Therapeutic ultrasound differs from diagnostic ultrasound in that therapeutic ultrasound is used for treatment (as a therapy) whereas diagnostic ultrasound is used to diagnose disease (or manage pregnancy). Just as diagnostic ultrasound has been around for quite some time, therapeutic ultrasound has been available since 1950.
How It Works for Arthritis
Therapeutic ultrasound may work by either thermal or non-thermal (mechanical) effects. When using ultrasound for thermal effects, tissues must reach a temperature of 40°C to 45°C (104 F to 113 F) for at least 5 minutes.
Effectiveness for Knee and Hip Arthritis
Studies evaluating the effectiveness of therapeutic ultrasound on arthritis have been mixed; some studies finding no benefit, and others finding some benefits, especially in osteoarthritis of the knee.1 Overall, there has been few studies evaluating the benefits of therapeutic ultrasound, and the studies we have are often small or unreliable. Further research is needed, but let’s look at what we know at the current time.
In 2010, a Cochrane review of studies utilizing therapeutic ultrasound for knee and hip osteoarthritis was performed. The review evaluated studies that compared ultrasound to sham or no intervention for pain and function. Five small trials, involving a total of 341 patients with knee osteoarthritis, were included in the Cochrane review. Two of the five evaluated pulsed ultrasound, two evaluated continuous ultrasound, and one evaluated a combination of pulsed and continuous ultrasound. Reviewers concluded that ultrasound may be beneficial for osteoarthritis of the knee. Yet, they were uncertain about how significant the beneficial effects were on pain and function and felt there was a need for better-designed studies.2
Yet another study published in 2011 in the journal Orthopaedic Surgery, concluded that ultrasound significantly relieved joint symptoms and joint swelling while improving joint mobility and reducing inflammation in people with osteoarthritis. The study involved 87 people with knee osteoarthritis who received ultrasound treatment for 9 months.3
More recently, a 2016 study looking at the effectiveness of low energy pulsed ultrasound on 106 people with osteoarthritis of the knee did find that therapeutic ultrasound was valuable in reducing pain (for about 4 weeks) and improving function and quality of life. It should be noted that this was a very small study on which to base these conclusions, and at the current time, more research is needed.4