At 20:00 08/03/98 -0600, you wrote:
>US is not always "pro-inflammatory" unless you use the continuous mode. If
>you use pulsed (20% or 50%), there will be no thermal effects, but effects
>on a cellular level: stim of macrophages, increased angiogenesis, increased
>enzyme activity, increased cell membrane permeability, etc. These
>would assist in healing more than just allowing the inflammation to
>persist. Also, if there is an inflammatory process due to a
>strain/tendinitis, I don't consider that to be a good or "healing" process,
>but a painful one that I would try to retard with an anti-inflammatory gel.
>
>Just a few thoughts,
>Elizabeth Perez PT
>
>
These cellular events of the process of inflammation, that you have
mentioned, are indeed thought to be stimulated by ultrasound, whether
applied in a continuous or pulsed fashion. Thermal effects are surely not
needed for stimulation of these events? The stimulation of this normal
desirable process was what I was referring to as pro-inflammatory. To me,
to the word anti-inflammatory does not give the understanding of enhancing
the healing effects, but instead implies limiting the process of
inflammation and thereby limiting healing.
Pro-inflammatory to me does not mean the over-stimulation (and hence
painful) of injured tissues. Controlled stimulation with ultrasound need,
and should, not give noxious sensation.
So, does it seem that on one view we use anti-inflammatories to treat the
pain, but possibly retard the healing process. Or alternatively we
encourage the healing process with ultrasound, but respect the pain and
even treat the pain with other numerous methods (pharmacological,
electrotherapeutical, acupuncture etc.).
Wendy Johnson
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