Ultrasound Therapy at Home in Narayan Peth, Pune

Therapeutic ultrasound is a modest, well-known tool in physiotherapy. A small head is moved gently over a gel on the skin, and the sound energy it emits is absorbed by deeper tissues, where it produces mild warmth or mechanical effects. It is used for tendon problems, ligament sprains and muscle injuries, and it is not painful when used properly.

The ultrasound therapy page covers how it works in general. Here we describe one situation where it is considered in old-city homes, and where the evidence stops.

The household lifting that irritates the elbow

• Heavy pots and vessels. Lifting a full cooking pot by its rim with the wrist cocked loads the tendons on the outer elbow.
• Wringing and scrubbing. Twisting wet clothes and scrubbing floors involve repeated gripping and forearm rotation.
• Carrying bags and water cans. Carrying by the handles, hour after hour, strains the forearm tendons at the elbow.
• Repetitive hand work. Writing, accounts, sorting papers and using a keyboard in a long working day place a steady load on the same area.
• Heel pain from standing. People who stand or walk on stone floors for long periods can develop painful heels, another tendon-type problem.

These are overuse problems. The tendon is irritated because it was loaded more than it could cope with, and a short stretch of rest rarely solves it alone.

What the evidence says

Ultrasound therapy has been used for many years. For some tendon and soft-tissue problems the results point to a small benefit; for others there is little difference from a sham treatment with the machine switched off. The most reliable gains for tennis elbow and similar overuse problems come from gradually loading the tendon with exercise, adjusting the tasks that irritate it and giving it time. Because of this, ultrasound is not offered as a stand-alone treatment. If it helps ease the pain enough to let you do the exercises, we use it. If it makes no difference, we drop it.

What happens in a home session

The physiotherapist first examines the elbow, wrist and neck, since pain in the forearm can come from several places. Gripping tests and pressure over the tendon show whether it is the cause. If ultrasound seems suitable, the skin is checked, a gel is applied and the head is moved slowly over the area for a few minutes. You should feel at most a mild warmth. Afterwards comes the main part: a graded exercise plan for the forearm and shoulder, with advice on how to lift pots and carry bags. For shoulder-related loading, frozen shoulder physiotherapy describes a related set of problems, and for hands-on release of tight forearm muscles, see myofascial release therapy.

When ultrasound is not used

Therapeutic ultrasound is avoided over a pacemaker, over the abdomen or lower back in pregnancy, over the eyes, over a growing bone in a child, over a suspected tumour or infection, over areas with poor circulation or reduced feeling, and over a possible blood clot. It is also avoided over fresh wounds and over metal implants in some cases. Where there is doubt, we ask your doctor.

Easing a tendon between visits

• Lift pots with both hands and with the palm facing up, and keep the load close to the body.
• Take the weight of bags on the shoulder or the forearm instead of gripping with the fingers.
• Do the strengthening exercises regularly, even when the pain is better, since the tendon recovers slowly.
• Break up repetitive tasks, and swap hands where you can.

When arm or heel pain needs a doctor

Pain after a fall or a blow, a swollen and hot joint, or numbness spreading down the arm needs medical review. So does any chest pain that spreads to the arm, which can come from the heart.

To discuss whether ultrasound suits your problem, book a visit. For the lanes and timings, see home physiotherapy in Narayan Peth.