Ultrasound Therapy for Inflammation

[Davidcara]

Wondering if anyone has had ultrasound therapy for tendinitis or muscle strain. Was at physical therapy for achilles tendinitis. Was told could try ultrasound for healing but, contraindicated in people with cancer. Tech said, she would recheck this. Wondering if anyone has experienced anything like this? Thank You

[Ironj]

No but I’ve used a Tens unit

[Davidcara in reply to Ironj]

Yes, I have used TENs too. Although, I think you are not suppose to use it with cancer.

[Ironj in reply to Davidcara]

I heard that as well. But I asked my Cll Specialist Dr Zent and he said yes you can use it. I said I was told it’s not good to use with cancer. He replied that’s not true. That said I’m not confident either way but I’ve used one on accession.

[mrsjsmith]

Interesting because I have had ultrasound several times for foot/knee issues. The most recent treatment was from a very experienced physiotherapy who ran through full medical history. I have found that it’s still used by private clinics.

Colette

[veteranoak in reply to mrsjsmith]

I'm sorry to hear you have an achilles tendon problem; they can be a real nuisance and source of pain. As a retired physiotherapist I can assure you that while diagnostic ultrasound is fantastic, therapeutic ultrasound is only placebo. Although some practitioners in private practice use it, in the latter part of my career no-one in the NHS did. There are several papers and a brilliant PhD (1986) by I. Hashish 'The effects of U.S. therapy on post-operative inflammation', U of London. These large, properly blinded studies demonstrated U.S. has no effect whatsoever over placebo unless turned up too much when it can cause cell cavitation & worsen pain and swelling. They showed that even the placebo (machine switched off unbeknownst to both patient AND therapist) could reduce reported pain, measured swelling and even alter blood cortisol levels. The PhD reports the sub-study showing that what matters is that the therapist (i.e. not the subject) holds the ultrasound head, even if the machine is not actually switched on. There are no good, properly controlled & blinded studies showing ultrasound has any efficacy for any soft tissue condition. And why should it?

Unfortunately there is no electrotherapy that has a real and lasting physical effect. Therapists can be persuaded to use it as this is easier than saying "No". I'm seeing signs of 'magic boxes' creeping back again, with unsubstantiated claims made by the manufacturers and some practitioners who are not critical when reading the literature.

The cancer issue is for direct sound radiation over tumours: it was thought this might precipitate metastases, so practitioners were warned not to use it in case this is possible.

[Psmithuk in reply to veteranoak]

This is really interesting, thank you. I have used a tens machine after a road accident, and didn’t find it helped at all. Now I know it was a waste, I feel better about dispensing with it!

[mrsjsmith in reply to veteranoak]

That’s interesting opinion because my Podiatrist who has a private and NHS London practice uses ultrasound on her patients and so does another physiotherapist I see. I have always been happy with the results, which I don’t consider to be the results of a placebo.

Colette

[Davidcara in reply to veteranoak]

Thank you for the reply veteranoak. The PT said, there is no reliable data proving US benefit. But she thought it might still be worth trying since I am not making progress on stretching.

[Davidcara in reply to mrsjsmith]

Thanks for the info mrsjsmith

[veteranoak]

TENS is specifically for pain, not for physical outcomes like improved flexibility, physical function, blood flow, inflammation, swelling etc. TENS is based on the Pain Gate theory, but it has no impact on what is physically or chemically wrong, only on the nervous system.

TENS studies are mixed in their outcomes, but then pain is complex with the two major types – chronic and acute that are totally different – as well as sharp, dull, aching etc. and with or without injury at the start. Some small studies indicate it can be a helpful distractor, a few subjects find it helpful for aching pain, but good large studies have not been done.

For me, if TENS helps someone’s pain that’s fine, a good thing being that it is not something where they become dependent on someone else to administer it. It’s far from helpful for all people or for all types of pain: many find it of no help at all, and frankly, if it’s not helping you get back to work and doing the things you enjoy doing, it’s not worth it – or all the faff of using it. Once an injury has occurred then understanding what continuing pain is and isn't, and gradually getting back to using the part normally again, improving fitness/tissue toughness and gaining confidence in doing this should be the focus.

[SofiaDeo]

Have you tried far infrared? It can reduce associated muscle swelling, which is part of tendonitis recovery as well as muscle strain. My fibromyalgia presentation includes small, palpable "knots" in the fascia at certain muscle-tendon attachment points in my shoulder blades, and this helps me a lot. My elderly neighbor with W&W CLL uses it to help with exercise related muscle recovery (like, he shovels a foot of snow out of his driveway at a time. Or splits wood for hours).

There are far infrared heating pads as well as far infrared saunas. In a heating pad, I look for one with temperature controls. I don't necessarily want "heat" unless it is winter, just the far infrared effect which does cause some slight warming. These cost a little more. Amazon has a small "neck" one I purchased that I use on my dogs (instead of a pricey "specially made for dog" unit) as well as spot treatments on various body parts. It has a Velcro clasp, so I can spot treat my shoulder blade in back with a Velcro extension.

ncbi.nlm.nih.gov/pmc/articl...

There aren't a lot of studies out, the few there are have very small numbers.

pubmed.ncbi.nlm.nih.gov/329...

mayoclinic.org/healthy-life...

webmd.com/skin-problems-and...

If you purchase from Amazon, please consider going through "smile.amazon.com" instead of plain Amazon.com, and donating to Dr. Koffman's US based CLL society. They are a listed US charity. It doesn't cost us anything.

[Davidcara in reply to SofiaDeo]

Thanks SofiaDeo. I think I will give infrared a try. I was unaware of Smile Amazon, will need to look into it.

[SofiaDeo in reply to Davidcara]

If you use an Amazon app, there is a setting you can toggle inside it, so your eligible purchases occur automatically. You just have to sign up for Smile.amazon, initially.

[LeoPa]

I did, 10 years ago before CLL. It was useless.

[Davidcara in reply to LeoPa]

Thanks for the reply