Therapeutic ultrasound is categorically as any form of ultrasonic procedure where ultrasound is used in advancing therapeutic benefits. Ultrasound is defined as a systematic oscillating pressure wave that has a higher frequency capacity compared to the human hearing frequency range. Its frequency in most cases supersedes the upper limit of the hearing range of human beings .The execution of the procedures is normally under the use of focused ultrasound (FUS) and unfocused ultrasound. Therapeutic ultrasound is used to reduce pain that emanates from body tissues by providing a viable solution to swelling and edema of the tissues. . Secondly, it is used to catalyze healing processes of body tissues such as tendons that in turn foster blood flow in the treated areas. Likewise, it is used to facilitate systematic softening of scar tissues and relieve the tissues from any form of strain
Tennis elbow (TE) is also known as lateral epicondylitis defined injury in tendon of muscles extensors wrist because of the most repetitive motion that is commonly encountered by individuals when undertaking sporting or overuse . The aim of this essay is to discuss the therapeutic effects of ultrasound in the treatment of tennis elbow injuries, which are thermal and non-thermal.
A literature review was carried on using the databases such as MEDLINE, Science direct and Cinahal (EBSCO) and key words used in the research included, words such as therapeutic tennis elbow, lateral epicondylitis, lateral humeral epicondyle, ultrasound, ultrasound therapy, songraphic, thermal and non-thermal effects of ultrasound and biological effects of ultrasound. The studies conducted from 1996 to present were considered.
Thermal and non-thermal for ultrasound overview:
Thermal and non-thermal ultrasounds are two major categories of biophysical effects of ultrasound that influences the quality of therapeutic treatment. They have a frequency range of 0.75-3MHZ, and most machines that power its operations are set at a frequency rate of 1 or 3 MHZ. In the most circumstances, thermal and non-thermal effect are accompanied by some heating . The heating is evident because of the simultaneous thermal and mechanical nature of the interaction between the ultrasound and tissues In particular, the extent of tissue heating under thermal effects is dependent on diverse variables that include pulsed ultra-sound level in comparison to continuous ultrasound. The heating levels and variation that are generated by electric energy under non-thermal and thermal effects is highly similar .The energy is then changed to sound power via mechanical twist of a piezoelectric crystal situated in the transducer .
Thermal effect for soft tissue ultrasound:
There has been an increase in the number of researches examining the cellular and molecular consequences of ultrasound .The studies indicate that thermal effects facilitate clinical complications particularly when ultrasound is provided at non-thermal settings despite its relevance in advancing heating in the deep tissue . It causes an increase in the tissue temperature that varies depending on a range of variables . For instance, it depends on the amount of time, intensity, and size of the transducer and frequency the ultrasound. It also depends on the area of the skin applied and depth and type of tissue at which it penetrates into the damaged tissue .
Non-thermal (ultrasound) effect of soft tissue:
According to a number of suggestions, cavitation and acoustic micro streaming should be applied when treating soft tissue . In particular, stable cavitation is important for the healing of a damaged tissue while unstable cavitation causes destruction of the effected tissues. Acoustic microstrearming that instigated by the non-thermal effects can change the structure of the cell membrane . All the above changes are believed to be capable of stimulating tissue repair . Therapeutic ultrasound is used to treat tennis elbow by passing sound waves with high energy via the skin to the region that is causing pain and inflammation .
Therapeutic effects of Ultrasound on tennis elbow
Various thermal and non-thermal therapeutic effects have been associated with the use of ultrasound in treating tennis elbow . As discussed earlier, the ultrasound functions as a heating agent, where the sound waves bring energy that is later changed into heat . The heat is then passed into the tendonitis of the lateral side of elbow through the blood purposely to foster the speed of chemical process . For instance, this process is highly beneficial to the individuals who suffer from elbow tissues injury, by giving vasodilation to increase blood flow to reach the affected tendinosis of the elbow . It also facilitates systematic softening of scar tissues from any form of strain .
For instance, it reduced swelling to the tennis elbow by decreased the pain at the affected limb using myotendinosis . Likewise, the pulse capability in the cells prevents heat from reaching the tennis elbow tissue . Therefore, non-thermal ultrasound activates the discharge of immune cells that lead to positive non-thermal effect that causes cellular recovery.The positive effect is apparent since it is useful in reducing inflammation in the tennis elbow tissues. This implies that a swollen tennis elbow may gain from pulse ultrasound to assist in reducing the inflammation and swelling hence the healing process will be fast .The healing normally starts due to the effective protein synthesis that transforms the structure of the cell membrane. This facilitates recovery of body tissues especially at the joints. Physiological and biological effects of ultrasound include the increase in collogen extensibility and decrease in muscle contraction of the tennis elbow (Melegat, et al, 2004). Imperatively, ultrasound therapy provides credible solutions to soft tissue patients in a systematic manner . The ultrasound sound devices ensure that the tissues such as tennis elbow tissues receive favorable heat that is necessary for absolute recovery. The ultrasound devices also facilitate cleaning up of the tissues, and rejuvenate body cells hence advance the level of recovery . The reasons explain why tennis elbow patients are always advised to seek for ultrasound therapy services for quick recovery
Research evidence to justify the use of Ultrasound:
Various empirical studies and research conducted indicate clearly that the ultrasound treatment for tennis elbow is effective . Manifestly, the credibility of ultrasound in treating tennis elbow soft tissues was established in a study involving six groups of patients that was conducted exclusively. As well as the results obtained from the study indicated that all the patients registered immense improvement to who used of ultrasound therapy medication.
In particular, the improvement started to be registered where VAS was in use on patient’s treatment . The improvement advanced further with the use of ultrasound due to its thermal and non-thermal effects. On the other hand, six studies were also conducted where a sample size of 332 subjects were examined. From the results obtained, quality scores were registered within a range of 25 to 41 out of 48 that was the possible figure . The results showed out rightly, the importance of ultrasound in treating elbow tennis tissues. In particular, it was established in the four studies that the use of ultrasound singularly including ultrasound with other major treatment processes decreases pain from lateral epicondylitis .
It is imperative to conclude that ultrasound provides essential incentives that foster effective treatment of tennis elbow complications or soft tissue injuries. This is evident from the research conducted where it became apparent that tennis elbow complications improve effectively with the employment of ultrasound medication. It has highly functional capacity since it contains high-frequency mechanical waves and vibrations that are generated by an electric energy. The generated vibrations are transported by propagation via molecular bombardment and vibration to the tissue areas .
Variably, the use of ultrasound singularly including ultrasound with other major treatment processes decreases pain immensely from lateral epicondylitis. It is also clear as established that ultrasound in combination with diverse treatments such as the friction message, and phonophoresis alone fosters reduction of pain emanating from tennis elbow tissues. Even though a number of medical practitioners believe that ultrasound is applied to achieve heating in the deep tissue, many people state that heating alone cannot be used to explain the clinical affects . Particularly, when ultrasound is provided at non-thermal settings, it is able to generate both thermal and non-thermal therapeutic effects to the human body tissues. On the other hand, there are lacks of evidence approve the ultrasound therapy treat tennis elbow.
In ensuring the realization of reliable results and information, an explorative research strategy was adopted. The selection of the strategy was due its viability and capacity in facilitating studies of such nature. It was selected based on the researcher’s judgment on its suitability. Under the strategy, effective research from diverse sources was executed from the preamble stages. Secondary data gathering technique was adopted due to the time limit that was available. The secondary sources selected were mostly journals that are available at EBSCOHOST library.
The strategy aided the realization of quality findings on the topic that sought to discover the therapeutic effects of ultrasound in the treatment of a tennis elbow soft tissue. Major terms that have been defined include ultrasound, therapeutic ultrasound, tennis elbow, and lateral epicondylitis overuse or by not playing some. In particular, therapeutic ultrasound is a common treatment whose usage in the management of soft tissue lesion complications is gaining credibility and prominence. Ultrasound has a frequency range of 0.75-3MHZ, and most machines that power its operations are set at a frequency rate of 1 or 3 MHZ
On the other hand, tennis elbow soft tissue injury is defined as the most repetitive motion injury that is commonly encountered by individuals when undertaking sporting or other activities. Consequently, lateral epicondylitis, is a condition of the elbow that is caused by overuse or by not playing some type of games. As evident, the main body of the study discuses the therapeutic effects of Ultrasound in the treatment of a tennis elbow soft tissue injury.
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