In 1990 Falconer et al presented a literature review of the therapeutic effectiveness of ultrasound (US) in selected musculosceletal conditions. Analysing 35 studies published 1952 to 1989, Falconer concluded that patients with acute periarticular inflammatory conditions or osteoarthritis may experience relief of pain and immobility following US treatment, but placebo effects and expectations bias cannot be ruled out. Falconer found little justification for the use of US for patients with chronic periarticular inflammatory conditions. A drastic decrease of positive outcome in well designed (controlled and blinded) younger studies has been reported. We analysed 10 controlled and blinded studies on therapeutic effects of US published in the last decade (5 additional to Falconer). Of 7 studies comparing US with placebo-US, 6 revealed clearly negative results. 2 of 3 non-placebo-controlled studies revealed therapeutic effectiveness. More recent experimental investigations question the supposed increase in perfusion and antiinflammatory effects of therapeutic US. There is also no proof for an elevation of the pain threshold by direct influence of US on nociception or by US-induced change of nerve conduction velocity. In accordance with Falconer we conclude that the therapeutic usefulness of US is not sufficiently proved at the present time.

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