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What Is Phonophoresis?

Medically Reviewed by Melinda Ratini, DO, MS on June 08, 2021

Phonophoresis, also known as sonophoresis or ultrasonophoresis, is when an ultrasound is used to maximize the effects of a topical drug. The ultrasound waves push particles of a pain-relieving or anti-inflammatory drug deeper into your skin tissues. When these particles reach the subcutis layer, the deepest layer of skin, the cells absorb the pain reliever.

The Phonophoresis Debate

Phonophoresis is commonly used to treat inflammatory issues and injuries to soft tissues. The effectiveness of phonophoresis is debated in the medical world. While there are studies that vouch for the usefulness of this treatment, some studies find that there is little to no difference in pain relief from a phonophoresis treatment as compared to an ultrasound.

Because of this, there are still contemporary studies that look at the effectiveness of a phonophoresis treatment.

For example, in one study, phonophoresis was compared with ultrasound therapy to treat myofascial pain syndrome. While phonophoresis treatment did help with pain relief of the condition, the results were not significantly better than ultrasound therapy.

However, results from one small study suggested that phonophoresis was significantly more effective for pain relief than ultrasound or pain medication alone.

How Can Phonophoresis Help?

Inflammatory injuries and conditions where phonophoresis has been tried include:

  • Strains
  • Osteoarthritic conditions
  • Tendinitis
  • Lateral epicondylitis
  • Sprains
  • Bursitis 
  • Temporomandibular joint pain 

Usually, anesthetic or anti-inflammatory agents are topically applied during a phonophoresis treatment.

Common drugs used with phonophoresis include:

  • Hydrocortisone
  • Dexamethasone
  • Benzydamine
  • Salicylates 
  • Various anesthetics

Dexamethasone, in particular, may work well with delivering pain relief through phonophoresis. Hydrocortisone is another steroid drug that has been a part of various studies in research on phonophoresis.

True to its heat-loving nature, phonophoresis tends to work better when the skin is heated before treatment. 

Along with heating the skin, phonophoresis may work best when the topical drug being used is left on the skin for an extended time period. Doing this will allow it to sink through your skin properly so that it can work effectively. 

Phonophoresis Allies

Phonophoresis can be used with other treatments. For example, it is sometimes used together with a wrist splint to treat carpal tunnel syndrome.

In addition to supportive equipment, your doctor may prescribe certain exercises and routines that will help to heal your condition or injury. 

One alternative treatment to phonophoresis is iontophoresis. Iontophoresis has a similar goal where it helps a drug to penetrate your skin. The difference is that it does this through electronic transportation where ionized particles will sink into your skin through electric currents. 

Another difference between the two treatments is the depth that a drug can penetrate through your skin. Iontophoresis can reach up to one centimeter into your skin and will take up to 30 minutes. Phonophoresis on the other hand can reach as much as five centimeters deep while taking only 10 minutes. 

Safety Considerations

As with all medical procedures, it’s important to consult your doctor for advice to see if receiving a phonophoresis treatment is suited for you.

You should also be notified of any risks by a health professional before your first phonophoresis treatment. For instance, there is a possibility that scarring might happen over time with regular treatments.

There is a potential for skin discoloration to happen as well if the treatment is continued over a long time period. 

It’s important to note that there’s a slight risk of burning your skin with both phonophoresis and iontophoresis. Although it is rare, it is a risk that comes with receiving a thermal-based therapy.

Because of the risks involved with phonophoresis, it’s advised not to use ultrasound equipment without professional knowledge of how to do so.

Overall, phonophoresis is being investigated by the medical world for its perceived benefits of pain relief. Yet, there is a need for more research to discover both the benefits and risks of undergoing phonophoresis.

WebMD Medical Reference

Sources

SOURCES:

‌ACRM: “Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials.”

‌CONNECTICUT VALLEY HOSPITAL: “Physical Therapy Services.”

International Journal of Pharmaceutics: “Phonophoresis.”

International Journal of Women’s Health and Reproduction Sciences: “Therapeutic Efficacy of Dexamethasone Phonophoresis on Symptomatic Knee Osteoarthritis in Elderly Women.”
JOURNAL OF ATHLETIC TRAINING: “Phonophoresis and the Absorption of Dexamethasone in the Presence of an Occlusive Dressing.”

Journal of Ultrasound in Medicine: “Overview of Therapeutic Ultrasound Applications and Safety Considerations.”

Pharmaceutical Research: “Drug Delivery by Phonophoresis.”

Practical Management of Pain: “Physical Modalities.”

Rheumatology International: “Comparison the efficacy of phonophoresis and ultrasound therapy in myofascial pain syndrome.”

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