Ultrasound Therapy Contraindications, FDA Warning

Ultrasound Therapy Contraindications
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Ultrasound Therapy Contraindications/Ultrasound is one of the most widely used physical modalities in the clinical practice of rehabilitation. In particular, therapeutic ultrasound in rehabilitation has a number of uses including the treatment of musculoskeletal disorders such as pain, muscle spasm, joint contracture, and tissue injury,. Therefore, it is now recognized as a major therapeutic method in treating musculoskeletal disorders,,. Essential treatment parameters for therapeutic ultrasound include frequency, intensity, duty cycle, treatment time, and treatment area. The frequency for therapeutic ultrasound ranges from 1 to 3 MHz, with 3 MHz used specifically for the treatment of superficial tissues, and 1 MHz is applied to treat deeper tissues.

Ultrasound therapy is a popular method of treatment for chiropractors, physical therapists, and other medical care providers. It involves transferring sound waves with frequencies greater than the human sound spectrum (above 20 kilohertz) into a patient. The energy that is transferred with the sound waves can be used to treat focused, isolated areas of tissue to help with relieving pain in affected areas of the body and to speed the recovery process for injured muscle or other tissues.

Ultrasound Therapy Contraindications

The Indication of Ultrasound Therapy

Conditions for which ultrasound may be used for treatment include the following examples

  • Osteoarthritis of knee
  • Rheumatoid arthritis
  • Musculoskeletal disorders
  • Carpal tunnel syndrome
  • Ankylosing spondylitis
  • PLID in the acute phase
  • Tennis elbow
  • Ligament Sprains
  • Muscle strains
  • Tendonitis,
  • Joint inflammation,
  • Plantar fasciitis,
  • Metatarsalgia,
  • Facet irritation,
  • Impingement syndrome,
  • Bursitis & scar tissue adhesion.
  • Adhesion formation
  • Pain and muscle spasm
  • Rotator cuff tendinopathy
  • Hematoma
  • Bursitis
  • Tendonitis
  • Muscle strains and tears
  • Sprains and ligament injuries
  • Joint contracture or tightness
  • Stroke rehabilitation
  • Ankle sprains/ Strain
  • Capsulitis
  • Joint stiffness
  • Frozen shoulder
  • Scar tissue
  • Chronic low back pain
  • Calcified tendinitis
  • Tuberculosis of lungs or bone
  • Deep vein thrombosis
  • Anaesthetic area
  • Haemophilia
  • Reproductive organ
  • Acute infection
  • Brain and spinal cord
  • During the inflammatory phase to stimulate the release of growth factors and accelerate the phase itself
  • During the proliferative phase to stimulate fibroblast migration and proliferation and to accelerate wound contraction
  • During the epithelialization phase to stimulate the release of growth factors and to increase the vascularity of the tissue
  • During the maturation phase (if treatment commenced in the inflammatory phase) to improve scar collagen density and organization
  • To disperse the hemorrhagic material associated with bruising5
  • To reduce bacterial burden
  • To enhance transdermal drug delivery
  • Debridement
  • Venous leg ulcers
  • Pressure injuries
  • Vascular ulcer
  • Neuropathic ulcers
  • Burns scar
  • Surgical wounds
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Ultrasound Therapy Contraindications

There are some instances where you should not use ultrasound at all. These contraindications to ultrasound may include:

  • Open wounds
  • Metastatic lesions
  • Areas of decreased sensation
  • parts of the body with metal implants, like in a total knee replacement of lumbar fusion
  • Near or over a pacemaker
  • the uterus during pregnancy
  • Over the gonads
  • Malignancies and precancerous lesions
  • On patients with vascular abnormalities, i.e. deep vein thrombosis, emboli, severe atherosclerosis
  • The eye
  • Over the stellate ganglion
  • For hemophiliacs not covered by factor replacement
  • The spinal cord after laminectomy
  • Directly over metal implants
  • Over an electronic device
  • Tissues previously treated with deep Xray or radiation
  • Tuberculosis (local)
  • Damaged or at risk skin, i.e. skin rash,eczema
  • Anesthetic areas
  • Excitable tissue,
  • With pregnant women
  • Around the eyes, breasts, or sexual organs
  • Over fractured bones
  • Near or over an implanted electrical stimulation device

A listing of FDA approved modes for ultrasound therapy.

Therapy MethodTherapeutic OutcomeBioeffect MechanismDevice CharacteristicsGeneral Reference
Unfocused beamtissue warmingheatingportable hand-held1–3 MHZcontinuous or repeated bursts
Hyperthermiacancer therapyregional heatingmulti-element applicator1–3.4 MHz1 hour[rx]
HIFUuterine fibroid ablationthermal lesioncomputer directed0.5–2 MHZlong bursts
HIFUglaucoma reliefpermeabilizationfixed probe with waterbath4.6 MHZ1–3 s
HIFUlaproscopic tissue ablationthermal lesionhand-held4 MHzlong bursts
HIFUlaparoscopic or open surgerythermal lesionhand-held3.8–6.4 MHzlong bursts
Focused ultrasoundskin tissue tighteningthermal lesionhand-held, imaging and treatment4.4–7.5 MHz20–50 ms bursts
Extracorporeal Lithotripsykidney stone comminutionmechanical stress; cavitationmainframe with image guidance~150 kHzshockwaves
Intracorporeal lithotripsykidney stone comminutionmechanical stress; cavitationPercutaneous probes25 kHzcontinuous
Extracorporeal shockwave therapyplantar fasciitis epicondylitisunknownmainframe with applicator head~150 kHzshockwaves
Phacoemulsificationlens removalvibration ; cavitationgenerator with probe40 kHzcontinuous
US assisted liposuctionadipose tissue removalfat liquifaction; cavitationgenerator with probe20–30 kHzcontinuous
Tissue cutting and vessel sealinglaparoscopic or open surgerythermal lesion, vibrationhand-held55.5 kHzcontinuous
Intravascular USthrombus dissolutionunknown; gas body activationintravascular catheter2.2 MHZcontinuous
Skin permeabilizationtransdermal drug deliveryunknownhand held55 kHzcontinuous
Low intensity pulsed USbone fracture healingunknownattached transducer1.5 MHzpulsed, long duration
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Ultrasound Therapy Contraindications

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