Diagnostic Ultrasound vs. Therapeutic Ultrasound Therapy for Chronic Pain

Difference Between a Therapeutic Ultrasound and a Diagnostic Ultrasound

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What is the difference between diagnostic and therapeutic ultrasounds for chronic pain?. Capifrutta/E+/Getty Images

If your doctor or physical therapist has recommended ultrasound therapy you may be wondering exactly what it is. Is there a difference between diagnostic ultrasounds used to diagnose a medical condition and therapeutic ultrasound meant to treat a condition such as chronic pain?

Diagnostic vs Therapeutic Ultrasounds: What's the Difference

You may hear the term "ultrasound" thrown around here and there during your chronic pain diagnosis or treatments.

With all of the types of ultrasound out there, it's easy to get confused. Here's what you should know about diagnostic ultrasounds and ultrasound therapy, which are commonly used in the diagnosis and treatment of chronic pain.

Diagnostic Ultrasounds

To get a clearer picture of what is going on under the skin, a doctor may order a diagnostic ultrasound. Diagnostic ultrasounds use high-frequency sound waves that bounce around, providing a picture of specific areas in the body. If you think of the type of ultrasound used in pregnancy, you are picturing something pretty close to a diagnostic ultrasound for chronic pain.

Diagnostic ultrasounds may be used to determine the cause of pelvic pain, to diagnose tumors causing pain or to examine other structural abnormalities that may cause certain types of chronic pain.

Ultrasound Therapy

Ultrasound therapy is often performed by a physical therapist as a pain treatment.

Ultrasound therapy can be used in two ways: thermally, as a heat agent, and mechanically, as a vibration agent. A physical therapist may choose one or both ultrasound approaches, depending on your chronic pain condition.

Ultrasound therapy for chronic pain is not usually used as the sole therapy, but is considered a useful adjunct for some forms of chronic pain.

Thermal Ultrasound

This type of ultrasound therapy is like applying a very deep heat: It penetrates the deep tissues, warming them up to encourage the healing of soft tissues. A physical therapist might use thermal ultrasound to treat a strained muscle that has not healed as expected. Thermal ultrasound may be helpful with symptoms related to strains and sprains. A 2017 study looking specifically at the role of therapeutic ultrasound in knee arthritis found that it did reduce pain (especially at night) and improve function for a period of time but did not help substantially in the long term control of pain.

Mechanical Ultrasound

A mechanical ultrasound causes tiny vibrations in the soft tissue, which can decrease swelling and inflammation in order to reduce some types of pain. Mechanical ultrasound, like thermal ultrasound, also promotes soft tissue healing. A physical therapist might use mechanical ultrasound to break up deep scar tissues in the muscles or ligaments. Mechanical ultrasound is often recommended for conditions in which there is a build up of scar tissue (fibrosis).

Which Is Right for You?

The type of ultrasound you will have depends on whether your doctor is focusing on your diagnosis or your treatment. If she is looking for the cause of your pain, you will probably receive a diagnostic ultrasound. This may take place in the office, at a clinic or in a hospital, depending on what kind of detail is needed.

If you have already been diagnosed and your doctor has ordered ultrasound treatment, you will be receiving ultrasound therapy, most likely performed by a physical therapist. This usually takes place in an outpatient therapy clinic, though it can be performed in the hospital setting if you are recovering there. Even if your doctor has ordered ultrasound therapy, you should expect to receive additional physical therapy as well, as ultrasound is often administered along with other treatments such as exercise and stretching.

What Conditions May Be Treated with Therapeutic Ultrasound?

Ultrasound therapy does not work on all chronic pain conditions. It may be helpful for those with arthritis, myofascial pain, pain caused by fibrosis (scar tissue), strains an sprains, and bursitis.

Treating Chronic Pain

If you are living with chronic pain, you're probably very familiar with the fact that the best treatment plans use a combination of different therapies.

Medications are often used to treat chronic pain, but most of these have significant side effects when used long term, ranging from kidney disease or peptic ulcer disease with non-steroidal anti-inflammatory drugs, to the potential for addiction with narcotics (opioids). In addition, medications treat pain, not the underlying condition which is causing the pain.

Therapies such as ultrasound and others, in contrast, may treat the underlying cause of your pain while providing pain relief. Even if you need medication, additional ways of treating chronic pain may decrease your need for these drugs. In addition, relaxation practices for chronic pain are helpful no matter which treatments you and your doctor choose.

Coping with Chronic Pain

Coping with chronic pain is one of the more difficult trials people face, and if you have not lived with chronic pain it may be difficult to understand how pain can affect every aspect of your life. If you are living with chronic pain, check out these tips on living and coping with chronic pain.

If you have a loved one living with chronic pain, check out these points on what everyone should know about chronic pain.

Sources:

O’Reilly, M., and K. Hynynen. Emerging Non-Cancer Applications of Therapeutic Ultrasound. International Journal of Hyperthermia. 2015. 31(3):310-8.

Schuhfried, O., Vukanovic, D., Kollmann, C., Pieber, K., and T. Paternostro-Sluga. Effects of Pulsed Ultrasound Therapy on Sensory Nerve Conduction Parameters and the Pain Threshold Perceptions in Humans. PM & R. 2016 Nov 30. (Epub ahead of print).

Yegin, T., Altan, L., and M. Kasapoglu Aksoy. The Effect of Therapeutic Ultrasound on Pain and Physical Function in Patients with Knee Osteoarthritis. Ultrasound Medicine and Biology. 2017. 43(1):187-194.

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