Evidence-based medicine and therapeutic ultrasound of the musculoskeletal system

The aim of this review is to critically analyze the evidence of therapeutic ultrasound between 0.8 and 3 MHz for treating musculoskeletal diseases. Relevant randomized, controlled, clinical trials and systematic reviews published on this topic have been taken into consideration.There was evidence of effectiveness for the following indications: inflammatory and degenerative diseases of joints and the vertebral column, overuse syndromes of tendons and muscles and the facilitation of bone tissue healing.According to the current knowledge an evidence-based recommendation could be most clearly made for the facilitation of bone fracture healing with ultrasound. For all other indications evidence was based on overly sparse data from low quality randomized controlled trials that would not allow clear recommendations. However, there is also a lack of data from methodologically sound clinical trials that could have proven the inefficacy of this treatment. As beneficial effects with ultrasound are frequently observed in everyday clinical practice, this therapeutic modality should continue to be considered in the future as a treatment option for musculoskeletal diseases.