This article is about some treatment approaches that I feel do not belong in any therapy room especially physiotherapy. It's part of a larger group of articles where I look at myths of various treatment approaches.

The treatments in question are acupuncture and ultrasound. These once formed large cornerstones of physiotherapy practice however the science has now proven that they have minimal specific effects. People do indeed get results from using their use. However this is likely due to placebo and/or the fact people get better with time anyway.

Acupuncture

Long used with history deep rooted in Eastern medicine. Placing needles in people to cure all manner of ills from back pain to common colds. It is thought to do this through auras, qi and meridien lines. In truth there is very little evidence that it can have any of these effects. Research that has found a positive effect has shown only small benefits and these studies have questionable design / quality.

Most damning there are several studies that look at real acupuncture vs fake acupuncture (pretending to put the needles in). They have found no difference between the two.  Thus the process of putting needles in is not what is having an effect.  The expectation of effect is having more of a say. In addition other studies have shown that it does not matter where the needles are placed. Its effects are therefore unspecific and based on placebo.  Ethically therefore I feel it should not be used.

Ultrasound

Ultrasound is another technique physiotherapists have historically used a lot.   The premise behind ultrasound is that the soundwaves travel through the skin where they can stimulate cells to promote healing. There is evidence that this can occur at a physiological level. However these experiments are often not in living humans and so cannot necessarily carried over. They also often use frequencies and durations that are not practical in the real world.

When studied in humans there is very little, if any effect.  There is conflicting results and lots of poorly designed studies. Similar to acupuncture, there is no difference between ultrasound and sham ultrasound (machine turned off).  Thus there are questions to be raised regarding its use.  You may improve but this will be a placebo effect or you bodies natural resolution. Why waste time doing something that has  no specific effect when you could be spending time doing something that does?

Conclusion

Ultimately in my opinion, treat any passive modalities (e.g. having something done to you) with caution. Question the rationale (i.e. how it works), and the evidence.  Question why it's needed and if anything can be done instead. Active treatment wins hands down time after time in the long run and should be the treatment of choice.  Get in contact to discuss your problem.  We pride ourselves on making sure you only get the treatment you need and you are seen the minimal amount of times.  This will save you time, money and heartbreak in the future as you get life back on track.