Phonophoresis is a physical therapy technique that combines ultrasound and topical medications. A topical medication is a medication that’s applied directly to your skin. Ultrasound waves then help your skin absorb the medication into the tissues beneath.

Phonophoresis treats inflammation and pain in your muscles, ligaments, and joints. It’s similar to iontophoresis. Iontophoresis delivers topical medications through your skin using electrical currents instead of ultrasound.

Phonophoresis may be used alone or as part of a treatment or therapy plan.

Phonophoresis is commonly used to treat sprains, strains, or injuries. It can be used on:

  • muscles
  • joints
  • ligaments
  • other parts of your musculoskeletal system

Conditions that may respond well to phonophoresis include:

Many other conditions may also be treated with phonophoresis.

Phonophoresis can be done by your doctor, a physical therapist, or an ultrasound specialist. Your doctor may refer you to a facility that specializes in ultrasound treatment.

During the procedure, your doctor or therapist follows three main steps. First, they will apply a medicated ointment or gel to your skin near an injured or inflamed joint or muscle. Medications commonly used in phonophoresis include hydrocortisone, dexamethasone, and lidocaine.

Next, they will apply ultrasound gel to the area where the topical treatment has been applied. This gel helps the ultrasound waves travel through the skin.

Finally, they will use an ultrasound head tool on the area where the topical treatment and gel have been applied. Ultrasound wave frequencies deliver the medication through the skin into the tissue beneath.

Some research suggests that phonophoresis may not be any more effective than typical ultrasound therapy for conditions like myofascial pain syndrome (MPS). Other research shows that phonophoresis is more effective than ultrasound therapy for conditions like knee osteoarthritis.

Phonophoresis is generally thought to be more effective when used with other treatments or therapies. For example, a wrist splint may be used in addition to phonophoresis for carpal tunnel or De Quervain’s tenosynovitis.

One study suggests that phonophoresis is especially effective when used with a wound dressing. Dexamethasone and a type of wound dressing called an occlusive dressing can be applied at least 30 minutes before the ultrasound waves are used for better results.

Your doctor will likely recommend other therapy treatments in addition to phonophoresis. Treatments may involve:

  • RICE method. Rest, ice, compression, and elevation are used to reduce pain and swelling after an injury.
  • Corticosteroid shots. Cortisone drugs are injected into your muscle or joint tissue to help relieve inflammation.
  • Manipulations and exercises. Your doctor or therapist uses directed movements on your affected joints or muscles by hand to help you regain mobility. Your doctor may also recommend exercises you can do at home to get your joints and muscles moving more easily.
  • Medication. You may need medications for pain and discomfort. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used for pain.

There are no known risks associated with phonophoresis. Ultrasound carries a minor risk of burns if the procedure isn’t done correctly.

As with any procedure, it’s important to talk to your doctor about your treatment plan before beginning any new procedure. Some questions you may want to ask include:

  • Will my injury or condition respond well to phonophoresis?
  • Is phonophoresis the best option? Is another treatment, such as regular ultrasound therapy, a better choice?
  • What other treatments might I need along with phonophoresis?
  • Will my pain be relieved or feel less pronounced with phonophoresis?
  • Does my health insurance cover phonophoresis treatments?

Phonophoresis may be a useful intervention to treat pain and inflammation. It’s especially effective for the symptoms of a joint, muscle, or ligament injury.

Phonophoresis is not recommended for long-term or alternative treatment of conditions like arthritis. It can help relieve some discomfort while you undergo other treatments or therapies for musculoskeletal conditions and injuries.