In clinical practice, ultrasound is one of the most widely used therapeutic modalities. Ultrasound is applied using a round-headed wand or probe that is put in direct contact with the patients skin. Ultrasound gel is used on all surfaces of the head in order to reduce friction and assist in the transmission of the ultrasound waves. The ultrasound waves are generated by a piezoelectric effect caused by the vibration of crystals within the ultrasound head. The sound waves that pass through the skin cause a vibration of the local tissues. In ultrasound, this vibration can cause a deep heating locally though usually no sensation of heat will be felt by the patient. In situations where a heating effect is not desirable, such as a fresh injury with acute inflammation, the ultrasound can be pulsed rather than continuously transmitted.
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