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therapeutic ultrasound for osteoarthritis: a case study on reduced inflammation

By Sakshi Jethani March 2, 2025

Introduction

Osteoarthritis (OA), a degenerative joint disease, presents significant challenges for millions, causing pain,

stiffness, and limited mobility. As physical therapists, we understand the daily struggles of those living with OA.

This explores the potential of therapeutic ultrasound as a valuable tool in managing OA symptoms.

We'll examine a case study demonstrating how therapeutic ultrasound, specifically using the Tissuewave device,

can reduce inflammation and improve function, ultimately enhancing the lives of those affected by this condition.

We will explore how therapeutic ultrasound, which uses sound waves to generate heat within the tissues, can be

beneficial in treating knee osteoarthritis.

Therapeutic Ultrasound for Osteoarthritis: Pain Relief & Tissue-wave Overview

Therapeutic ultrasound is a physiotherapy treatment that uses sound waves to stimulate tissues beneath the

skin's surface. This stimulation can lead to several beneficial effects, including increased blood flow, reduced

edema, and reducing inflammation. Ultrasound for OA relies on carefully controlled parameters. Research

supports the use of low-intensity ultrasound for OA. A frequency of 1-3 MHz is considered beneficial for healing

and reducing inflammation as it reaches a depth of 5-3 cms, respectively. The Tissuewave device is designed to

deliver these therapeutic benefits in a controlled and targeted manner. Tissuewave allows us to tailor treatment

plans to each patient's specific needs, ensuring a more effective and comfortable experience. The thermal and non-thermal effects are

beneficial when ultrasound is applied at low intensity, i.e. less than 100 mW/cm2 at a frequency of 1.5 MHz.

Case Study: Osteoarthritis Patient Presentation & Physiotherapy Assessment

Our case study focuses on a 65-year-old female patient diagnosed with osteoarthritis in her right knee. She

presented with chronic knee pain, stiffness, and limited range of motion, impacting her ability to perform daily

activities like climbing stairs and walking for extended periods. Her medical history revealed no other significant

conditions that would contraindicate ultrasound therapy. A thorough physiotherapy assessment was conducted,

including a pain assessment using the Visual Analog Scale (VAS), where she rated her pain at an average of 7

out of 10, and a functional assessment using the Timed Up and Go (TUG) test, where she took 18 seconds to

complete the test. These assessments gave us a clear baseline to track the patient's progress. The patient was

also experiencing difficulty sleeping due to the pain.

Tissuewave Treatment Protocol for Osteoarthritis

The patient underwent a course of therapeutic ultrasound treatment using the Tissuewave device. The treatment

protocol involved the application of ultrasound to the affected knee joint three times per week for four weeks.

Key parameters included a frequency of 1 MHz, an intensity of 1.0 W/cm2, and a duration of 10 minutes per

session. Aqua sonic gel was used as a conducting medium for transferring waves through the skin. In some

approaches, therapeutic ultrasound is combined with a topically applied pharmacological agent like diclofenac

(a non-steroidal anti-inflammatory drug (NSAID)) to enhance transdermal drug delivery and improve outcome.

Outcome: Reduced Inflammation & Improved Function with Tissuewave

Following the four-week treatment period, the patient demonstrated significant improvements in both pain and

function. The patient reported a significant reduction in pain, with pain scores decreasing by 60%, with an average

pain score of 3 out of 10. She also experienced improved mobility, completing the TUG test 25% faster, taking

only 13.5 seconds, allowing her to move more freely and confidently. She also reported that she was able to

sleep better. These quantifiable results highlight the effectiveness of Tissuewave in reducing inflammation and

improving function in this OA patient. The reduced inflammation ultrasound results were promising.

Discussion: Tissuewave's Role in Osteoarthritis Management

This case study provides real-world evidence supporting the use of therapeutic ultrasound, specifically the Tis-

suewave device, as a valuable tool in osteoarthritis management. The reduction in inflammation and improvement

in function observed in this patient align with existing research on the benefits of ultrasound therapy for OA.

Therapeutic ultrasound for chronic pain management in joints is a promising approach. While this is a single

case study, it underscores the potential of Tissuewave as a non-invasive, conservative management option for

individuals suffering from osteoarthritis. Further research with larger sample sizes and controlled trials is needed

to confirm these findings and explore the potential of combining Tissuewave with other physiotherapy modalities.

Ultrasound benefits osteoarthritis, transforming physiotherapy, one patient at a time.