Understanding ultrasound

Whether it is with heat, light, electricity or any number of alternative means, DCs are open to trying different therapies in the name of healing their patients and adding ancillary profit centers to their practice.  That is why chiropractic medicine is generally considered alternative medicine; it is not bound by one simple technique.  It is a combination of techniques based around the central concept of diagnosing and treating patients with health problems of the musculoskeletal system and the effects of those problems on the nervous system and a patient’s general health.

According to the Occupational Outlook Handbook for 2008-09 published by the United States Department of Labor, “Chiropractic medicine is based on the principle that spinal joint misalignments interfere with the nervous system and can result in lower resistance to disease and many different conditions of diminished health.”

In an effort to correct spinal joint misalignments and restore the nervous system to its optimal condition, DCs use many different forms of the healing arts.  One type of therapy that has become common in many chiropractic offices is the use of ultrasound therapy.

Ultrasound is an extremely high frequency sound that is out of the range of human hearing but in the case of alternative medicine, the use of ultrasound is known as therapeutic ultrasonography.  Ultrasonography is the use of high frequency sounds to visualize subcutaneous structures within the body including muscles, joints, tendons, vessels and internal organs.

Ultrasonography dates back to the 1940s when it was first used at the Cherite medical school in Berlin, Germany.  At that time Dr. Raimar Pohlman experimented with its benefits mainly in the destruction of tissue, and it was not until years later that its benefit in therapy was identified.

In 1951, a group of 24 physicians attending the American Congress of Physical Medicine and Rehabilitation in Denver, Colorado found common ground on the subject of ultrasonic therapy and in 1952 established the American Institute of Ultrasound in Medicine.  Since then, they have dedicated time and resources to advancements in ultrasonic medicine and as their mission states, “The American Institute of Ultrasound in Medicine is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of guidelines, and accreditation.”

In the case of DCs and physical therapists, the goal of therapeutic ultrasonography is not to visualize those subcutaneous structures, but to speed the healing of a joint, muscle or tendon by using a higher frequency ultrasound.  In therapy, ultrasonography is commonly known to have two distinct benefits. 

In one application, the use of ultrasound induces hyperemia, or increased blood flow, as tissue is heated to 40 to 45 degrees Celsius.  The thermal affects from the energy produced by the sound waves speeds healing and reduces inflammation.  The second common application of therapeutic ultrasonography is a cavitational effect that results from the vibrating of tissue.  The vibration seems to stimulate cell membranes which encourages repairing effects of cells in inflamed areas.

For DCs, ultrasound therapy can be useful for many different patients.  The ‘micro-massage’ that ultrasound creates can help reduce swelling, increase blood flow, and decrease pain, stiffness, and spasms, making it a viable therapy for numerous applications.  From patients who have suffered car accidents to those that have chronic back pain from any number of sources, ultrasound therapy can help them.

When it comes to purchasing an ultrasound machine, there are a number of options.  New units range in price from around $1000 to well over $4000 and the one that is right for you depends on the size of your practice and your specific applications. 

For more information on therapeutic ultrasound, visit the American Institute of Ultrasound in Medicine’s website at www.aium.org or subscribe to the Journal of Ultrasound in Medicine at www.jultrasoundmed.org.