Therapeutic ultrasound ameliorates hyperalgesia and edema on CFA-induced persistent inflammatory response in mice

Abstract Background: The present study investigated the effects of pulsed and continuous ultrasound (USP and USC) in edema and hyperalgesia after chronic inflammatory process induced by Complete Freund's Adjuvant-CFA and analyzing the relationship of the application frequency of ultrasound, in pro- and anti-inflammatory cytokine production. Methods: Forty-five animals were divided into 9 groups; all animals from groups 2 to 9 were subjected to a persistent inflammation model induced by CFA in mice. We report the effects and the underlying action mechanisms of USP and USC in the animals which were irradiated two, three or five times a week on the left hind paw. The analyses performed in this study were: evaluation of hind paw edema through the plethysmometer, evaluation of thermal hyperalgesia through withdrawal test using a water container at 44.5°C (± 0.5°C), and the plantar region of the left paw which was removed for analysis of cytokines. Results: Our results showed that USP and USC consistently reduced paw edema, and pulsed ultrasound showed a higher significant effect than the continuous mode. Moreover, groups with irradiation frequency of five times a week presented an inhibition of the edema, and groups with frequency of three or two times a week reduced mainly hyperalgesia, in comparison with the control group. The beneficial effects of the US then seem to be associated with upregulation of anti- and pro-inflammatory mediators, such as IL-10 and IL-6, respectively. Conclusion: This study provided evidence that ultrasound constitutes an important non-pharmacological intervention for the management of inflammatory and pain states.

Effectiveness of Electrophysical Modalities in the Management of Temporomandibular Joint Disorders: A Review.

This review was conducted by three investigators to assess the scientific evidence and eff ectiveness of various electro physical modalities in the treatment of temporomandibular joint (TMJ) disorders. This review was conducted by three investigators. The databases of PubMed, Science direct, Cochrane clinical trials register (June 1994-Jan 2013) were electronically searched for the key terms TMJ disorders with low-level laser therapy (LLLT), iontophoresis, phonophoresis, therapeutic ultrasound, transcutaneous electric nerve stimulation, microcurrent electrical nerve stimulation. The retrieved titles were thoroughly evaluated, and full text was obtained. Based on the inclusion and exclusion criteria the selected studies were assessed for the quality evidence of the trails using the Grade Pro 3.6 version software and summary of finding table was generated. Of 1544 titles, 28 full text publications, which were eligible for this review were included, and 15 randomized placebo controlled trials that were fulfilling the set criteria. Out of 15 studies 10 are performed on LLLT, 2 on iontophoresis, 1 on pulsed radiofrequency energy, 1 on cathodal high voltage electric stimulation and 1 on laser acupuncture. LLLT is the extensively practiced electrophysical treatment modality with the moderate quality of evidence. Electrophysical modalities are helpful as adjuvant in the treatment of TMJ symptoms. However, there are no evidences to conclude that a single electrophysical modality is beneficial over the other in the temporomandibular disorders management.