The ultrasound therapy equipment generates ultrasonic waves by means of the two main components generator and treatment head. Ultrasound is successfully used by its mechanical, thermal, chemical and biological effects for: inflammatory rheumatic diseases of the musculoskeletal system, disorders such as traumatic contusions, sprains, spasms, inflammatory diseases of the peripheral nerves as neuritis or neuralgia and peripheral circulatory disorders.
The ultrasonic waves are generated by means of the two main components of the generator and the treatment head. A distinction is three effects of ultrasound:
- a) Mechanical effects (primary effect): By ultrasound, the mass particles experienced in sonicated tissue vibration and acceleration (= high frequency vibration massage).
- b) Thermal effects (primary effect): In the environment of the sonicated tissue locally increases the respective temperature. Energy flow and temperature in the treated tissue is determined by absorption and reflection of ultrasound and is therefore highly tissue specific.
- c) Piezoelectric effect (primary action): Under varying mechanical pressure electric potentials are induced in particular in bone, leading to an increase cell activity.
- In addition: biological effects (secondary effects): Due to thermal and mechanical effects, biological effects, such as better membrane permeability, vasodilation achieved with resultant pain relief.
The duration of treatment depends not only on the size of the body area being treated and the size of the treatment probe used, but also on the relative stage of the disease.
Treatment with ultrasound lasting 5 minutes is usually sufficient for an average-size zone. With disorders accompanied by changes in the tissue structure, such as sclerodermatitis, arthrosis, etc., it is frequently advantageous to lengthen the exposure to about 10 minutes per field. Treatment zones extending over some length, such as courses of nerves, are divided up into several fields, which are exposed to ultrasound one after another for 5 (or 10) minutes.
The golden rule is: the more acute the process, the lower the intensity to be used, and the more chronic the process, the greater the intensity to be used. Take care with the dosage when beginning treatment. This is particularly advisable when treating the trunk of the body with ultrasound: don’t forget that there may be sensitive organs close by (see chapter 7 Contraindications). The upper limit of the permissible intensity is generally signaled by the occurrence of periosteal pain, provided the patient does not exhibit any sensory disturbance. Treatment can be regarded as therapeutically appropriate when the intensity is such that a just detectable feeling of warmth is produced in the normally sensitive patient. Underdosage runs the risk of being ineffectual, and thus a waste of time.
The number of treatments required (carried out daily or each second day, depending on the circumstances) depends on how successful the treatments are. Usually only one or two further treatments are necessary after the symptoms subside. A total of 10 to 15 treatments generally suffices. Where improvement is only slow, continue therapy until a satisfactory result obtained. Even where there is an apparent worsening, we do not recommend giving up treatment before third or fourth sitting. If deterioration continues, it is advisable to check the diagnosis (e.g. slipped disk with sciatica, foci). It is frequently the case that structure-changing processes can be favorably influenced by an extended therapy of up to 40 treatment sessions.