September 2, 2008

CALCIUM DEPOSIT DISSOLUTION
WITH ULTRAHIGH FREQUENCY SOUND^©

Lyn Paul Taylor, A.A., B.A., M.A., R.P.T.

(Editing Assistant and Computer Consultant: Joanna Soon, B.S.)

Ultrahigh frequency sound (ultrasound) has been used successfully for the treatment and apparent dissolution of calcium deposits associated with myositis ossificans, free floating bodies of calcium (“joint mice”) and other fixed ionic calcium structures termed “bone spurs”.  This treatment generally reduces the subject's apparent pain almost immediately (especially when coupled with soft tissue manipulation), producing improved ranges of motion in affected joints and increasing functional abilities.

It has not been firmly established how treatment with ultrasound is able to effect these results.  It has been surmised by many, however, that the molecular vibration produced by ultrasound weakens the molecular bonding responsible for ionic calcium deposit formation, essentially dissolving at least part of the formation, and softening rough edges and rounding off sharp points.  However, controlled radiographic studies to confirm this premise have not been published (though radiographic evidence has been observed clinically).  It has also been postulated that the effectiveness of ultrasound treatment lies in its ability to desensitize the tissues surrounding a calcium deposit, effectively accommodating the involved soft tissues to the deposit's presence and raising the pain threshold of these surrounding tissues.  Another theory has it that ultrasound simply relieves the pain by reducing the inflammation and interstitial swelling associated with the deposit by increasing circulation in the surrounding tissues (especially if an anti-inflammatory is additionally phonophoresed into the tissues).  The truth may be that a combination of these postulates provides the basis for effective ultrasound treatment.  Only further study will produce a satisfactory explanation of why ultrasound may be effective.

Clinical experience has suggested that pulsed waveform ultrasound is the most effective form for reducing or managing calcium deposits.  Pulsed wave ultrasound can be applied at intensity levels that would ordinarily be painful to the subject if the continuous waveform were used.  Additionally, little or no movement of the sound head is necessary when using the pulsed waveform (impossible with the continuous waveform), allowing the sound to be concentrated over the deposit site.  Clinical experience has shown that the best results (decreases in pain and restoration of function) are produced by relatively high intensity ultrasound, from 1.5 to 2.0 W/cm² (the intensity should be decreased as the subject’s tolerance decreases).

Application:

• The ultrasound unit should be preset to deliver a 1 Mhz, pulsed waveform, at 1.5 to 1.8 W/cm².

• The treatment site should be coated with an appropriate coupling agent (a gel containing ibuprofen or a salt colloidal suspension).

• Treatment should continue for six minutes (time based on a treatment area of 72 cm² or less).  Treatments should occur daily, or every other day until the lesion closes or symptoms disappear.  If improvement is not apparent after the six sessions, treatment should be suspended.

• The sound head should be hygienically cleansed and dried immediately following application and again before its next use.

[See ULTRAHIGH FREQUENCY SOUND, Precautions]

References:

W.T. Coakley, "Biophysical Effects of Ultrasound at Therapeutic Intensities," Physiotherapy, vol. 64

G.T. Haar, "Basic Physics of Therapeutic Ultrasound", Physiotherapy, vol. 64 (4), April 1978. Pp. 100-104

F.E. Miller, J.B. Weaver, "Ultrasound Therapy", Phys Ther Rev, vol. 34 (11), 1954. p. 562

E.M. Oakley, "Application of Continuous Beam Ultrasound at Therapeutic Levels", Physiotherapy, vol. 64 (6), June 1978. Pp. 169-172

H.P. Schwan, E.L. Carstensen, "Advantages and Limitations of Ultrasonics in Medicine", JAMA, 149, May 1952. Pp. 121-125

L.P. Taylor, T. Hui, The Taylor Technique of Soft Tissue Management, Inflammation: Evaluation & Treatment, 2002.  Pp. 50-51

M.C. Ziskin, S.L. Michlovitz, "Therapeutic Ultrasound", Thermal Agents in Rehabilitation, F.A. Davis, Philadelphia, Pa., 1986. Pp. 156-157

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