Design and evaluation of a wearable self-applied therapeutic ultrasound device for chronic myofascial pain.

Ultrasound therapy for pain and healing is a versatile treatment modality for musculoskeletal conditions that is used daily in rehabilitation clinics around the world. Our group designed and constructed a wearable, battery-operated, low-intensity therapeutic ultrasound (LITUS) device that patients could self-apply and operate during daily activity for up to 6 h. Thirty patients with chronic trapezius myofascial pain evaluated the LITUS system in a double-blind, placebo-controlled, 10-d study under institutional review board approval. While continuing their prescribed medication regimen, patients with the active device reported on average 1.94× reduction in pain and 1.58× improvement in health relative to placebo devices after 1 h of treatment. Both of these results were statistically significant (p < 0.05) for the first 2 d of the study. Male patients reported the majority of benefit, and there is a sex-treatment confound in the sample. The study indicates that wearable, long-duration LITUS technology improves mobile access to drug-free pain relief.

[1]  A. Bélanger Evidence-based guide to therapeutic physical agents , 2003 .

[2]  E Hultman,et al.  Changes in muscle morphology in chronic trapezius myalgia. , 1991, Scandinavian journal of work, environment & health.

[3]  J. Mathews,et al.  Back pain and sciatica: controlled trials of manipulation, traction, sclerosant and epidural injections. , 1987, British journal of rheumatology.

[4]  George K Lewis,et al.  Cost-effective broad-band electrical impedance spectroscopy measurement circuit and signal analysis for piezo-materials and ultrasound transducers , 2008, Measurement science & technology.

[5]  Mohit Bhandari,et al.  Low-intensity pulsed ultrasound: Nonunions , 2009, Indian journal of orthopaedics.

[6]  George K Lewis,et al.  Development of a portable therapeutic and high intensity ultrasound system for military, medical, and research use. , 2008, The Review of scientific instruments.

[7]  C. Chai,et al.  Ultrasound effect on level of stress proteins and arthritic histology in experimental arthritis. , 1999, Archives of physical medicine and rehabilitation.

[8]  Ling Qin,et al.  Low intensity pulsed ultrasound increases the matrix hardness of the healing tissues at bone-tendon insertion-a partial patellectomy model in rabbits. , 2006, Clinical biomechanics.

[9]  George K Lewis,et al.  Design and characterization of a high-power ultrasound driver with ultralow-output impedance. , 2009, The Review of scientific instruments.

[10]  F. Aguilera,et al.  Immediate effect of ultrasound and ischemic compression techniques for the treatment of trapezius latent myofascial trigger points in healthy subjects: a randomized controlled study. , 2009, Journal of manipulative and physiological therapeutics.

[11]  C. A. Kelencz,et al.  Trapezius upper portion trigger points treatment purpose in positional release therapy with electromyographic analysis , 2011, North American journal of medical sciences.

[12]  Lennart D Johns,et al.  Nonthermal effects of therapeutic ultrasound: the frequency resonance hypothesis. , 2002, Journal of athletic training.

[13]  M. Esenyel,et al.  Treatment of myofascial pain. , 2000, American journal of physical medicine & rehabilitation.

[14]  D. Eggett,et al.  Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles , 2010, Physiotherapy theory and practice.

[15]  A. Wright Exploring the evidence for using TENS to relieve pain. , 2012, Nursing times.

[16]  J F Greenleaf,et al.  Low‐intensity ultrasound stimulates proteoglycan synthesis in rat chondrocytes by increasing aggrecan gene expression , 1999, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[17]  J. Sarrafzadeh,et al.  The effects of pressure release, phonophoresis of hydrocortisone, and ultrasound on upper trapezius latent myofascial trigger point. , 2012, Archives of physical medicine and rehabilitation.

[18]  J. Richardson,et al.  Effect of low-intensity pulsed ultrasound on the cartilage repair in people with mild to moderate knee osteoarthritis: a double-blinded, randomized, placebo-controlled pilot study. , 2012, Archives of physical medicine and rehabilitation.

[19]  Neill M Pounder,et al.  Low intensity pulsed ultrasound for fracture healing: a review of the clinical evidence and the associated biological mechanism of action. , 2008, Ultrasonics.

[20]  H. Unalan,et al.  High-power pain threshold ultrasound technique in the treatment of active myofascial trigger points: a randomized, double-blind, case-control study. , 2004, Archives of physical medicine and rehabilitation.

[21]  S. Monica Nursing approaches to nonpharmacological pain control , 1990 .

[22]  S. Larsson,et al.  Chronic trapezius myalgia. Morphology and blood flow studied in 17 patients. , 1990, Acta orthopaedica Scandinavica.

[23]  Byoung-Hyun Min,et al.  Effects of low-intensity ultrasound on chondrogenic differentiation of mesenchymal stem cells embedded in polyglycolic acid: an in vivo study. , 2006, Tissue engineering.

[24]  J. Richardson,et al.  Efficacy of ultrasound therapy for the management of knee osteoarthritis: a systematic review with meta-analysis. , 2010, Osteoarthritis and cartilage.

[25]  J. Dickey,et al.  Stimulation of myofascial trigger points with ultrasound induces segmental antinociceptive effects: A randomized controlled study , 2008, PAIN.