Effectiveness of Diathermy in Comparison With Ultrasound or Corticosteroids in Patients With Tendinopathy: A Critically Appraised Topic

Abstract

Clinical Scenario: Many therapeutic modalities have been used to treat the pain and inflammation commonly associated with tendinopathies. One modality that has been used to treat patients with tendinopathies is diathermy. Focused Clinical Question: Is there evidence to suggest that diathermy is more or equally as effective at reducing pain in patients with tendinopathy when compared with ultrasound or corticosteroid treatments? Summary of Search, "Best Evidence" Appraised, and Key Findings: The literature was searched for randomized control trials (RCTs) that investigated the effects of diathermy treatments in comparison with ultrasound or corticosteroid treatments on pain in patients with tendinopathy. Three RCTs were selected from the search results and included in this critically appraised topic. Clinical Bottom Line: There is moderate evidence to support that diathermy is more effective at reducing pain in patients with tendinopathy than ultrasound and equally as effective as corticosteroid treatments. Strength of Recommendation: There is grade B evidence to support that diathermy is more effective at reducing pain in patients with tendinopathy than ultrasound and equally effective at reducing pain as corticosteroid treatments.

Emerging diagnostic and therapeutic applications of non-ionising electromagnetic radiations in Oncology

“…Diathermy is clearly associated with increased local blood flow secondary to heating above 41.5°C. The increase in blood flow increases nutrients, oxygen, elasticity, promotes pH normalization and has analgesic, metabolic-modulating and neurobiological effects [33,34]. Short-wave diathermy has been observed to be more effective than the medium-wave one in determining greater blood flow by means of echo-doppler measurements [30].…”

<p>Emerging medical applications based on non-ionizing electromagnetic fields from 0 Hz to 10 THz</p>

“…Other examples of positive therapeutic effects of diathermy concern tendinopathy-related pain148 (434 MHz; three RCTs), chronic pelvic inflammatory disease148 (one double-blind RCT; SW diathermy), and idiopathic carpal tunnel syndrome148 (27.21 MHz; 15 sessions á 15 mins).…”

“…There seems to be more beneficial effects noted in studies using SW diathermy than MW diathermy, although both modalities show a mixture of results. One mechanistic difference may be at hand though, illustrated by a recent study on blood flow in the lower limbs of female subjects (n=40)148 Both SW (27.12, 240 W) and MW diathermy (2.45 GHz; 200 W) caused sustained skin heating after treatment (albeit longer lasting by SW). However, Doppler measurements of blood flow noted increased blood flow only during SW treatment.…”

Design of an ultrasonic physiotherapy system with pulse wave feedback control

“…The low-intensity pulsed ultrasound (LIPUS) used in this rehabilitation technology transfers energy at an intensity less than 3 W/cm 2 , which is not sufficient to cause a thermal effect, so it avoids the adverse reactions associated with traditional ultrasound treatment. This technique has achieved satisfactory results in rehabilitation from surgical incision, tendon injury, nerve injury and fracture, as well as regeneration or repair after radioactive bone necrosis [11].…”