Can Ultrasound Help Relieve Rheumatoid Arthritis Pain?

Heat can help people with RA relieve their achiness and painful symptoms. Does that make the deep heat of therapeutic ultrasound a valuable RA treatment?

A bottle of hot water or an electric blanket can be a paradise for sore joints. The application of heat to the joints is an important way for people with rheumatoid arthritis (RA) to relieve their pain. Therefore, it seems logical to apply deep heat, in the form of therapeutic ultrasound, as a treatment for pain related to RA. But is that all?

What Is Therapeutic Ultrasound, Exactly?
Anyone who has been pregnant is likely familiar with ultrasound, a device that uses high-frequency sound waves — in the case of pregnancy, to produce an image. With therapeutic ultrasound, similar sound waves travel deep into the body’s soft tissue, including muscles, tendons, joints, and ligaments, creating a gentle heat that proponents say can boost circulation and reduce stiffness.

Ultrasonic therapy can be applied in a doctor’s office or a physical therapist’s treatment center. Or it can be applied via a portable device you purchase for use at home, typically for a couple hundred dollars.

Does Therapeutic Ultrasound Improve RA Symptoms?
As with most nondrug products, funds for research have been limited. The most comprehensive review, published in 2002 in the Cochrane Database of Systematic Reviews, found only two studies, with just 80 participants total, that were randomized, double-blind studies — the highest quality of research. Still, the reviewers concluded from these studies that therapeutic ultrasound performed on the hand can be helpful for increasing grip strength, and that it may improve wrist flexion, joint pain, and morning stiffness.

Should You Try Ultrasound for Pain Relief?
If you have moderate to severe rheumatoid arthritis, the best way to relieve symptoms and alter the course of the disease is to take disease-modifying anti-rheumatic drugs (DMARDs). No other treatment can curb inflammation, prevent damage to the joints, and reduce the risk of long-term complications that are associated with rheumatoid arthritis the way DMARDs can. There are traditional DMARDs as well as newer biologic DMARDs, which work more quickly than conventiona ones but must be injected by a doctor.

If you are undergoing medical treatment for RA but are still experiencing pain, talk to your doctor regarding your medication and whether it makes sense to add on complementary therapies, such as massage, physical therapy, acupuncture, or an anti-inflammatory diet.

If your physical therapist or doctor suggest incorporating therapeutic ultrasound into your treatment plan, you might give it a try, says Daniel Muller, MD, a rheumatologist at UCHealth in Fort Collins, Colorado. “If the fees are reasonable, there is little downside,” he says.

What to Expect From Ultrasonic Therapy
An ultrasound machine has a wand at the end. A small amount of gel is applied to the parts of the body that will be treated, to allow the wand to slide better. The wand then touches the body part and is moved in a small circular direction over the skin.

A typical session lasts several minutes for each part of the body that is treated. During the session, the settings on the ultrasound unit might be adjusted as needed to change the intensity of the sound waves. It’s important to keep the wand continually moving so it doesn’t heat up any one piece of tissue too much.

What Getting Treated with Ultrasound Feels Like
Ultrasonic therapy does not hurt. You may feel a little tingling, but as long as the wand is continually shifted, it should not feel too hot.

“The warming of the joints might even feel good to someone with RA,” Dr. Muller says.

Home Ultrasound Devices Are Not Regulated
Large ultrasound machines used in a clinical setting have likely been reviewed for safety by the Food and Drug Administration (FDA). That may not be the case for smaller, at-home devices, whose energy outputs and applicator sizes can vary a great deal. That’s why the FDA cautions that you should read the instructions carefully and precisely follow any warnings that come with the device.

Cautionary Notes Regarding Ultrasound Therapy
For a clinical office ultrasound, it is important to inform the doctor if you have a pacemaker or other implanted medical device, a bone fracture in the area or if you are pregnant, as it may be necessary to keep the rod sensitive. . areas, or they may suggest that the treatment is not good for you ....

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