Tuesday, May 11, 2010

Ultrasound and anti-inflammatory gel

Today I encountered a customer looking for a gel to use in ultrasound. What first came to my mind is the picture of a probe and the tummy of a pregnant lady. So I showed him to the KY jelly. Although I don't know what gel exactly does the radiotherapist use but KY jelly seems like the most probable option available here. The customer then said he's looking for an anti-inflammatory gel so I asked what kind of ultrasound he is using it for and he told me for arthritis or tendonitis this kind of inflammatory conditions. He claimed to be a sport therapist.

Ignorant me never heard of that before, infra-red have... Anyway, I showed him the Voltaren gel but he said that is not exactly what he is looking for and it is too expensive. He said he used Bengay before, so I cautioned him that having too much systemic absorption of that can cause salicylate toxicity especially when ultrasound could enhance drug penetration.

Here I am doing some readings about this field of treatment. Here's my find:

How does ultrasound work in physical therapy?
The sound waves penetrate the skin's surface causing soft tissues to vibrate, creating heat. In turn, the heat induces vasodilation: drawing blood into the target tissues. Increased blood flow delivers needed oxygen and nutrients, and removes cell wastes.

More about ultrasound...

"Phonophoresis is the therapeutic application of ultrasound with a topical drug, most commonly a corticosteroid. The drug is placed on the skin in the form of a gel, cream, ointment or liquid and serves as the ultrasound transmission medium. This procedure is intended to enhance transdermal penetration of the drug while providing the therapeutic effects of ultrasound. For ultrasound to have these effects, it must be transmitted through the medium to the skin."

"Human studies of transdermal penetration of an anesthetic and a
nonsteroidal anti-inflammatory drug failed to demonstrate enhanced penetration with ultrasound. The topical anesthetic was in a cream, and the nonsteroidal anti-inflammatory was a gel documented to have 87% to 139% ultrasound transmission as compared with water. We believe that with such good transmission, the lack of effect found with the nonsteroidal anti-inflammatory must be due to factors other than poor ultrasound transmission. The authors suggest that ultrasound may not affect transdermal penetration because either the drug used is unsuitable for this method of administration or the method used was not sensitive enough to distinguish a treatment effect."

So there is indeed such a therapy as using ultrasound with an anti-inflammatory, and with the aim of enhancing the penetration of the topical drug. However, with higher penetration of the drug into the body system would also equate to higher risk of side effects and toxicity if the duration of application and drug amount used exceeds safety limits. It seemed that the gel he is looking for could be one that is steroid-containing which would require prescription from a doctor.

So how good or effective exactly is ultrasound therapy? Maybe the physical therapist would be able to tell you more on that or you would have to experience it for yourself.

1. http://www.thefreelibrary.com/Relative+transmission+of+ultrasound+by+media+customarily+used+for...-a011951703
2. http://www.spineuniverse.com/treatments/physical-therapy/ultrasound-common-treatment-used-physical-therapy

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