Almost everyone seems to assume that ultrasound is proven — good technological medicine — but that just doesn’t seem to be the case.
There is a jarring, bizarre lack of research for such a popular therapy.Unfortunately — although there are some interesting exceptions and tantalizing hopes for some conditions — ultrasound is not a promising therapy for most of the painful problems it is used for. There is a jarring, bizarre lack of quality research for such a popular, mainstream therapy. What little research is available paints a bland picture. Ultrasound therapy isn’t even on good theoretical foundations. At best, it’s more complicated and unpredictable than most therapists believe. At worst, there is no rational basis for US at all.
Ultrasound is an unusually easy treatment to test scientifically.10 If it works reasonably well, then the results should be pretty clear. Just compare results in patients who received real ultrasound to patients who get a fake instead! And yet there are just a few dozen such experiments in the scientific literature, and most of them are seriously flawed. Conclusions from evidence reviews like this one from van der Windt et al are typical:
As yet, there seems to be little evidence to support the use of ultrasound therapy in the treatment of musculoskeletal disorders. The large majority of 13 randomized placebo-controlled trials with adequate methods did not support the existence of clinically important or statistically significant differences in favour of ultrasound therapy.
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