Phhonophoresis is the movement of the ions or drug molecules into the skin or subcutaneous tissue under the influence of ultrasonic therapy.

1. PHONOPHORESIS

2. Introduction:
• Phonophoresis is defined as the migration of drug
molecules into the skin and subcutaneous tissues
under the influence of the ultrasound.
• This method of drug delivery into the tissues is in use
since early 1950s.
• Also known as sonophoresis or ultrasonophoresis.

3. Method of Treatment:
• The technique for phonophoresis is the same as that
for standard ultrasound administration.
• The ointments massaged into the target area.
• Solutions are not used for phonophoresis.

4. Molecular Substances:
• The selection of molecular substances depends on the
requirements of the condition- not the disease by
name, but the physiologic need of the patients.
Chemicals available for phonophoresis are listed
below:
• Hydrocortisone, lidocaine, iodine, salicylate, zinc

5. Hydrocortisone •An excellent anti- inflammatory agent,
hydrocortisone also provides analgesia in many
instances.
•Hydrocortisone is available over the counter as a
1% ointment.
•Some practitioners prefer 10% ointment.
Lidocaine •Lidocaine is available as 5% ointment.
•It is used primarily as an analgesia/ anaesthetic is
acute conditions or when decreased sensitivity is
desired.

6. Iodine •Available in ointment form, iodine is combined with
methyl salicylate as an over the counter product at local
pharmacies. E.g. 4.8% methyl salicylate, with 4.7%
iodine in a petroleum base.
•Iodine is used as a vasodilating agent, an anti-
inflammatory agent, an as a sclerolytic agent in cases
involving scar tissue, adhesions, calcific deposits, and
adhesive joints (e.g. frozen shoulder).
Salicylate •It is available as a 10% ointment over the counter.
•A basic anti- inflammatory agent, salicylate is also used as a
decongestant, as is chemically related aspirin.

7. Indications:
• Bursitis
• Tendinitis
• Sprain and strain
• Pain
• Inflammatory conditions

8. Contra-indications:
• Those patients who cannot eat sea food should not be
treated with iodine. Should skin irritation and itching
be reported, the usual antidote is an antihistamine. An
alterative chemical should be selected in future
treatments.
• Patients sensitive to metals should not be treated with
zinc. These patients usually cannot wear watchbands,
jewellery etc., without having skin and, at times,
systemic reactions.

9. • Dermatologic consultation should be sought for
specific antidotes for the offending metals. Non-
metallic substances should be substituted.
• Reactions to hydrocortisone are not as common.
• Do not treat patients who are sensitive to aspirin with
salicylates.

10. Precautions:
• Check the patient for sensitivity or allergies to the
agents used.
• Keep the sound head moving continuously on the
skin throughout the treatment or burning may occur
through overheating of tissue.
• Maintain uniform contact between the ultrasound
head and the area being treated, or burns may occur.
• When the unit is on, do not hold the sound head in
the air or break treatment contact, as this could
damage the sound head crystal.

11. • A complaint of sharp pain by the patient indicates the
intensity needs to be reduced, more coupling medium
needs to be added, and/ or move the sound head a
little faster.
• Do not treat over bony prominences to eliminate the
possibility of concentrated energy causing localized
heating.
• Do not treat over or near the heart.

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