Ultrasound
Therapy
A non-invasive physiotherapy modality that may be used as an adjunct for selected musculoskeletal conditions when clinically appropriate.
Book A Consultation
A therapeutic modality used selectively within rehabilitation.
Therapeutic ultrasound uses high-frequency sound waves delivered through a treatment head placed over the skin. In physiotherapy, it may be used as an adjunctive modality for selected musculoskeletal conditions. Its use depends on the individual's diagnosis, symptoms, treatment goals, contraindications and the quality of evidence available for the condition being treated.
- Symptom Management Some clinical studies and systematic reviews have reported improvements in pain or function for selected conditions, although results are not consistent across all diagnoses.
- Support for Rehabilitation When symptom relief occurs, it may make movement, exercise or functional rehabilitation more comfortable for some patients.
- Adjunctive Use Ultrasound is generally considered alongside active rehabilitation rather than as a replacement for exercise, movement training or other evidence-based physiotherapy interventions.
Current evidence does not support treating therapeutic ultrasound as a universally effective modality. Findings vary substantially according to the diagnosis, treatment parameters and comparator. Recent studies provide useful evidence for selected conditions, but several reviews also report low or very-low certainty and important methodological limitations.
Knee Osteoarthritis 路 2026
A recent assessor-blinded randomized controlled trial compared high-intensity laser therapy with therapeutic ultrasound, with both used as adjuncts to exercise, in adults with knee osteoarthritis. At 12 weeks, the high-intensity laser group showed greater improvements in WOMAC and several secondary outcomes than the ultrasound group. This study suggests that ultrasound can be studied as an exercise adjunct, but it does not establish ultrasound as superior to other physical modalities.
2026 Randomized Controlled Trial 路 PubMedTendinopathy 路 2026
A 2026 systematic review and meta-analysis included randomized controlled trials involving patients with upper- and lower-limb tendinopathies. The review found very-low-certainty evidence that extracorporeal shock wave therapy may reduce pain more than ultrasound therapy in some comparisons, particularly lateral epicondylitis. The included studies had important methodological limitations, limiting confidence in the findings.
Dudo艅 & Stania 路 Journal of Clinical Medicine 路 2026 路 PubMedTemporomandibular Disorders 路 2026
A 2026 network meta-analysis of randomized controlled trials evaluated therapeutic ultrasound alongside manual therapy, exercise, low-level laser therapy and TENS for temporomandibular disorders. Therapeutic ultrasound was associated with significant improvements in pain and maximal mouth opening. These findings are specific to temporomandibular disorders and should not be generalized to other musculoskeletal conditions.
Lin et al. 路 Medicine 路 2026 路 PubMedKnee Osteoarthritis 路 2025
A 2025 network meta-analysis of physical modalities for knee osteoarthritis included randomized controlled trials involving more than 2,000 participants. In this analysis, ultrasonic therapy did not show a significant benefit for the main outcomes evaluated. The findings support individualized treatment rather than assuming that every physical modality provides meaningful benefit in knee osteoarthritis.
Lan et al. 路 Aging Clinical and Experimental Research 路 2025 路 PubMedKnee Osteoarthritis 路 2024
A 2024 systematic review and meta-analysis included 21 randomized controlled trials involving 1,315 patients. Therapeutic ultrasound was associated with improvements in pain and WOMAC total scores. However, the studies showed substantial heterogeneity, and treatment parameters appeared to influence outcomes.
Luo et al. 路 Heliyon 路 2024 路 PubMedMusculoskeletal Disorders 路 2024
A 2024 systematic review and meta-analysis identified eligible trials involving knee and shoulder musculoskeletal disorders. The analysis found a significant pain-related effect for knee disorders, while results for shoulder disorders were not significantly different from other interventions.
Guan et al. 路 Therapeutic Advances in Chronic Disease 路 2024 路 PubMedEvidence Quality 路 2021
A GRADE-based systematic review found small benefits for pain and self-reported function in knee osteoarthritis when therapeutic ultrasound was compared with sham treatment. However, the certainty of evidence was rated very low, and the authors concluded that meaningful clinical recommendations could not be made because of limitations in the available studies.
Dantas et al. 路 Brazilian Journal of Physical Therapy 路 2021 路 PubMedClinical Guidance for Knee Osteoarthritis
NICE guideline NG226 recommends not offering ultrasound therapy for osteoarthritis because the evidence does not show sufficient benefit. This recommendation applies specifically to osteoarthritis management and should not be interpreted as a blanket statement that therapeutic ultrasound has no role in every musculoskeletal condition.
NICE 路 Osteoarthritis in over 16s 路 NG226Therapeutic ultrasound should be considered only after clinical assessment and consideration of the patient's diagnosis, symptoms, goals, contraindications and the available evidence. When used, the treatment head is applied to the selected treatment area with an appropriate coupling medium and suitable treatment parameters. Patient response should be monitored throughout treatment. Ultrasound may be combined with active rehabilitation when clinically appropriate, but it should not replace exercise, movement training, education or functional rehabilitation.
Therapeutic ultrasound should not be described as a guaranteed method for healing tissue, eliminating pain, removing arthritis or restoring damaged cartilage. Evidence varies substantially by condition, and findings from one diagnosis should not automatically be generalized to another. In knee osteoarthritis specifically, current NICE guidance does not recommend routine ultrasound therapy because of insufficient evidence of benefit.
Shockwave or Ultrasound Therapy for Tendinopathy? A Systematic Review and Meta-Analysis.
PubMed 路 PMID 41827423 路 2026
Effectiveness of manual therapy, exercise, low-level laser therapy, ultrasound, and TENS in reducing pain and improving mouth opening in temporomandibular joint disorders.
PubMed 路 PMID 42332459 路 2026
High-intensity laser therapy versus therapeutic ultrasound as adjuncts to exercise for knee osteoarthritis.
PubMed 路 PMID 42709245 路 2026
Physical modalities for the treatment of knee osteoarthritis: a network meta-analysis.
PubMed 路 PMID 40192971 路 2025
Effects of therapeutic ultrasound in patients with knee osteoarthritis: A systematic review and meta-analysis.
PubMed 路 PMID 38803857 路 2024
Ultrasound therapy for pain reduction in musculoskeletal disorders: a systematic review and meta-analysis.
PubMed 路 PMID 39170758 路 2024
Effects of therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis.
PubMed 路 PMID 31382781 路 2019
Therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis with GRADE quality assessment.
PubMed 路 PMID 34535411 路 2021
Find out whether ultrasound therapy is appropriate for your rehabilitation.
Book A Consultation
Ultrasound
Therapy
A non-invasive physiotherapy modality that may be used as an adjunct for selected musculoskeletal conditions when clinically appropriate.
Book A Consultation
A therapeutic modality used selectively within rehabilitation.
Therapeutic ultrasound uses high-frequency sound waves delivered through a treatment head placed over the skin. In physiotherapy, it may be used as an adjunctive modality for selected musculoskeletal conditions. Its use depends on the individual's diagnosis, symptoms, treatment goals, contraindications and the quality of evidence available for the condition being treated.
- Symptom Management Some clinical studies and systematic reviews have reported improvements in pain or function for selected conditions, although results are not consistent across all diagnoses.
- Support for Rehabilitation When symptom relief occurs, it may make movement, exercise or functional rehabilitation more comfortable for some patients.
- Adjunctive Use Ultrasound is generally considered alongside active rehabilitation rather than as a replacement for exercise, movement training or other evidence-based physiotherapy interventions.
Current evidence does not support treating therapeutic ultrasound as a universally effective modality. Findings vary substantially according to the diagnosis, treatment parameters and comparator. Recent studies provide useful evidence for selected conditions, but several reviews also report low or very-low certainty and important methodological limitations.
Knee Osteoarthritis 路 2026
A recent assessor-blinded randomized controlled trial compared high-intensity laser therapy with therapeutic ultrasound, with both used as adjuncts to exercise, in adults with knee osteoarthritis. At 12 weeks, the high-intensity laser group showed greater improvements in WOMAC and several secondary outcomes than the ultrasound group. This study suggests that ultrasound can be studied as an exercise adjunct, but it does not establish ultrasound as superior to other physical modalities.
2026 Randomized Controlled Trial 路 PubMedTendinopathy 路 2026
A 2026 systematic review and meta-analysis included randomized controlled trials involving patients with upper- and lower-limb tendinopathies. The review found very-low-certainty evidence that extracorporeal shock wave therapy may reduce pain more than ultrasound therapy in some comparisons, particularly lateral epicondylitis. The included studies had important methodological limitations, limiting confidence in the findings.
Dudo艅 & Stania 路 Journal of Clinical Medicine 路 2026 路 PubMedTemporomandibular Disorders 路 2026
A 2026 network meta-analysis of randomized controlled trials evaluated therapeutic ultrasound alongside manual therapy, exercise, low-level laser therapy and TENS for temporomandibular disorders. Therapeutic ultrasound was associated with significant improvements in pain and maximal mouth opening. These findings are specific to temporomandibular disorders and should not be generalized to other musculoskeletal conditions.
Lin et al. 路 Medicine 路 2026 路 PubMedKnee Osteoarthritis 路 2025
A 2025 network meta-analysis of physical modalities for knee osteoarthritis included randomized controlled trials involving more than 2,000 participants. In this analysis, ultrasonic therapy did not show a significant benefit for the main outcomes evaluated. The findings support individualized treatment rather than assuming that every physical modality provides meaningful benefit in knee osteoarthritis.
Lan et al. 路 Aging Clinical and Experimental Research 路 2025 路 PubMedKnee Osteoarthritis 路 2024
A 2024 systematic review and meta-analysis included 21 randomized controlled trials involving 1,315 patients. Therapeutic ultrasound was associated with improvements in pain and WOMAC total scores. However, the studies showed substantial heterogeneity, and treatment parameters appeared to influence outcomes.
Luo et al. 路 Heliyon 路 2024 路 PubMedMusculoskeletal Disorders 路 2024
A 2024 systematic review and meta-analysis identified eligible trials involving knee and shoulder musculoskeletal disorders. The analysis found a significant pain-related effect for knee disorders, while results for shoulder disorders were not significantly different from other interventions.
Guan et al. 路 Therapeutic Advances in Chronic Disease 路 2024 路 PubMedEvidence Quality 路 2021
A GRADE-based systematic review found small benefits for pain and self-reported function in knee osteoarthritis when therapeutic ultrasound was compared with sham treatment. However, the certainty of evidence was rated very low, and the authors concluded that meaningful clinical recommendations could not be made because of limitations in the available studies.
Dantas et al. 路 Brazilian Journal of Physical Therapy 路 2021 路 PubMedClinical Guidance for Knee Osteoarthritis
NICE guideline NG226 recommends not offering ultrasound therapy for osteoarthritis because the evidence does not show sufficient benefit. This recommendation applies specifically to osteoarthritis management and should not be interpreted as a blanket statement that therapeutic ultrasound has no role in every musculoskeletal condition.
NICE 路 Osteoarthritis in over 16s 路 NG226Therapeutic ultrasound should be considered only after clinical assessment and consideration of the patient's diagnosis, symptoms, goals, contraindications and the available evidence. When used, the treatment head is applied to the selected treatment area with an appropriate coupling medium and suitable treatment parameters. Patient response should be monitored throughout treatment. Ultrasound may be combined with active rehabilitation when clinically appropriate, but it should not replace exercise, movement training, education or functional rehabilitation.
Therapeutic ultrasound should not be described as a guaranteed method for healing tissue, eliminating pain, removing arthritis or restoring damaged cartilage. Evidence varies substantially by condition, and findings from one diagnosis should not automatically be generalized to another. In knee osteoarthritis specifically, current NICE guidance does not recommend routine ultrasound therapy because of insufficient evidence of benefit.
Shockwave or Ultrasound Therapy for Tendinopathy? A Systematic Review and Meta-Analysis.
PubMed 路 PMID 41827423 路 2026
Effectiveness of manual therapy, exercise, low-level laser therapy, ultrasound, and TENS in reducing pain and improving mouth opening in temporomandibular joint disorders.
PubMed 路 PMID 42332459 路 2026
High-intensity laser therapy versus therapeutic ultrasound as adjuncts to exercise for knee osteoarthritis.
PubMed 路 PMID 42709245 路 2026
Physical modalities for the treatment of knee osteoarthritis: a network meta-analysis.
PubMed 路 PMID 40192971 路 2025
Effects of therapeutic ultrasound in patients with knee osteoarthritis: A systematic review and meta-analysis.
PubMed 路 PMID 38803857 路 2024
Ultrasound therapy for pain reduction in musculoskeletal disorders: a systematic review and meta-analysis.
PubMed 路 PMID 39170758 路 2024
Effects of therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis.
PubMed 路 PMID 31382781 路 2019
Therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis with GRADE quality assessment.
PubMed 路 PMID 34535411 路 2021
Find out whether ultrasound therapy is appropriate for your rehabilitation.
Book A Consultation