Relative Therapeutic Efficacy of Phonophoresis and Cryotherapy as Combined Therapy in the Management of Musculoskeletal Injuries

Abstract

This study was designed to investigate the efficacy of phonophoresis and cryotherapy as combined therapy (double-modality therapy – DMT) in the management of pain among subjects with musculoskeletal injuries (MSIs).
Subjects were assigned randomly to one of three groups: DMT group  (n=17) received cryotherapy and 15% methyl salicylate phonophoresis, PHONO group (n=14) received 15% methyl salicylate phonophoresis, and
CRYO group (n=19) received cryotherapy and ‘sham’ phonophoresis. Ultrasound at an intensity of 1.5 W/cm² and frequency of 1MHz was used to apply methyl salicylate while intermittent cryotherapy was the mode of
application. The pre- and post-treatment pain perception scores (PPS) of the patients were assessed using the visual analogue scale (VAS), and the sessions of treatment in all groups were recorded. Treatment was administered on alternate days and subjects in all groups were discharged when they were pain free. In total, 233 treatment sessions were recorded – 61(26.2%) in DMT, 77(33.0%) in PHONO and 95(40.8%) in CRYO group respectively, which indicated no significant difference (P > 0.05). In the DMT, CRYO and PHONO groups, 16, 12 and 7 subjects respectively were pain free after 1 to 5 treatments. The difference in the severity of pain was significant (P < 0.05) in each group post-treatment, which suggests that DMT, phonophoresis and cryotherapy were equally effective. The study has demonstrated the therapeutic efficacy of DMT, but it was not superior to the single treatment protocol of phonophoresis or cryotherapy. It might  however, take less treatment sessions to reduce pain among the subjects with the use of DMT compared with other two modalities.

KEYWORDS: cryotherapy, double-modality therapy, musculoskeletal injury, phonophoresis, ultrasound