I have found home ultrasound helpful in chronic back pain but there has been little research in its effectivenesss. Now there is a study in low back pain combining it with exercise that found it useful. TENS worked well to but I find if there is any instability, TENS might aggravate the problem so ultrasound is safer.
Rheumatol Int. 2009 Jul 31. [Epub ahead of print] Effects of therapeutic ultrasound and electrical stimulation program on pain, trunk muscle strength, disability, walking performance, quality of life, and depression in patients with low back pain: a randomized-controlled trial. Durmus D, Durmaz Y, Canturk F.
- ultrasond involved ” continuous US … 1 MHz frequency and 1 W/cm2 intensity and a transducer head with an area of 5 cm, an ERA of 4 cm, and a BNR of 1:5. Slow circular movements were applied by the transducer head over the paravertebral low back region. The treatment duration was 10 min.”
- Electrical stimulation
- (15 min).
- four electrodes were placed on L2–L4 levels over the erector spinae muscles bulks motor points symmetric biphasic wave was applied with the frequency of 50 Hz and 50 ms of
- intensity of the current was arranged separately one by one for each patient until apparent muscle contraction was established (60–130 mA).
- The stimulation was applied as 10 s of contraction and 10 s of relaxation
- Motion, flexibility, and back strengthening exercises of the cervical, thoracic, and lumbar spine; stretching of the erector spine muscle, hamstring muscles, pelvic muscles, and abdominal muscles:
(1) pelvic tilt,
(2) knee to chest,
(3) lower abdominal exercises,
(4) cat and camel,
(5) back extension exercises.
- Special exercises to correct mobility of the spine andhip joints, activate the stabilizing muscles of the spine,and increase flexibility of the lower limb muscles.
- Functional exercises to improve postural control,dynamic body balance, and coordination.
- Progressive relaxation exercises to normalize muscle tension.
This study showed a doubling of the effects of exercise program. However, it should be noted that the “exercise program” was a necessary component of their results and actually included a relaxation program (progressive muscular relaxation)
Comment – I find ultrasound to be helpful in chronic back pain – even for the more upper back pains – but may have a short lived effect so best given at home by a partner. Cost outlay is an issue though.