Save Physiotherapy fees - but don't diagnose yourself

Therapeutic ultrasound device for home use

The newest gadget on the market is actually one of the oldest EPA in the business - therapeutic Ultrasound (US). 

A small portable ultrasound machine is now available for purchase by the public from some pharmacies and the net. With the costs of healthcare rising it is no wonder we see promoters of this device suggesting that home use of ultrasound for muscular aches and strains will save on physiotherapy fees.

What worries me is that people will not seek professional diagnosis at all. That sort of shortcut carries real risks of misdiagnosis and/or wrong treatment. For example, someone may apply the ultrasound  over a stress fracture, thinking the problem is shin splints. The consequence is more costly, and longer rather than shorter, recovery times.

It is reasonable to be concerned by the assumptions and misleading use of language used to promote sales of this potentially useful, if not very sturdy, ultrasound machine.

No one would decry the rights of people to have daily treatment when indicated. This device is the first to offer an affordable option for daily ultrasound therapy in the home. However....

FOR MAXIMUM BENEFIT most people need to

1. be shown exactly how to hold and move the device over the area of injury
2. have the initial dose prescribed by a professional
3. be advised whether or not the dose should be altered as the condition changes
4. know how to add other healing activities, (ice or heat, massage, rest or exercise) into a complete home treatment program.

PLEASE don't give your local health professional (chiropractor, osteopath, physio, doctor) the swerve. FOR BEST RESULTS get the correct diagnosis and ask for a treatment plan from a qualified health professional first. Good therapists will be delighted to show you how to use the home ultrasound device safely and effectively.

Yea, David Draper! Go, the Americans

Happy New Year. Your correspondent perceives most EPA research, and particularly ultrasound dose studies, has a certain polarity (ahem). The British tend to be the conservatives, focusing on athermal effects and potential to stimulate healing. The Americans seem to be more interested with thermal doses and tissue temperatures. As you'd expect, physio students are exhorted to avoid any potentially unsafe applications and so the English model of low dose applications feature in their training and lab practice. How gratifying to find A Prof David Draper's case series (6 patients) where therapeutic ultrasound (3 MHz, 1.4 W/cm^2, 6 minutes) heats adaptively shortened connective tissues of the wrist joint capsule so that manual joint glides and passive mobilizations succeed in restoring active and passive range. The reference is:

Draper, D.. (2010). Ultrasound and Joint Mobilizations for Achieving Normal Wrist Range of Motion After Injury or Surgery: A Case Series. Journal of Athletic Training, 45(5), 486-491.  Retrieved January 3, 2011, from Research Library. (Document ID: 2147735161).

This article is an interesting read and I won't critique it or reiterate his data here. What a find! Common sense and sound clinical reasoning prevails. 

David is a prolific EPA researcher and co-author of a useful textbook (illustrated) "Therapeutic Modalities the Art and Science".