Effect of therapeutic ultrasound for neck pain: A systematic review and meta-analysis.

Abstract Objective The study evaluated the effects and safety of therapeutic ultrasound in patients with neck pain. Data sources The PubMed, EMBASE, CENTRAL and Physiotherapy Evidence databases were searched for articles published prior to 1 December 2020. Study selection Randomized controlled trials that compared the effects of therapeutic ultrasound on neck pain were included in this review. The included studies compared therapeutic ultrasound plus other treatments with the other treatments or compared therapeutic ultrasound with sham or no treatment. Outcome measures involved the effects on pain, disability, and quality of life. Other treatments included all nonultrasonic therapies, e.g., various exercises, massage, and electrotherapy. Data extraction Data on the study population, therapeutic ultrasound intervention, combined intervention, outcome measures, and follow-up were extracted. Data synthesis Twelve randomized controlled trials (705 patients) fulfilled the inclusion criteria. Seven studies compared therapeutic ultrasound plus other treatments with the other treatments (449 patients). Therapeutic ultrasound yielded additional benefits for pain, but there was high heterogeneity, and we could not draw a clear conclusion. Ultrasound did not have a better effect on disability or quality of life when it was combined with other treatments. Five studies compared therapeutic ultrasound with sham or no treatment (256 patients), and the pooled data showed that therapeutic ultrasound significantly reduced pain intensity. No adverse events of therapeutic ultrasound were reported in the included studies. Conclusions Therapeutic ultrasound may reduce the intensity of pain more than sham or no treatment, and it is a safe treatment. Whether therapeutic ultrasound in combination with other conventional treatments produced additional benefits on pain intensity, disability or quality of life is not clear. The randomized trials included had different levels of quality and high heterogeneity. A large trial using a valid methodology is warranted.