What is Osteopath?

Osteopathy is an alternative therapy founded by Dr Andrew Taylor Still, an American physician, in the 18th Century.

Osteopathy practice derives its philosophical concept of treatment that body is working as a holistically as a whole unit, body structures and functions is interchangeably important to each other.

There are 3 main key principles that osteopathic treatment is based:

  1. Focus on total body health by treating the whole musculoskeletal system- includes the joints, muscles and spine.
  2. Aims to positively affect body’s nervous, circulatory and lymphatic systems- whole integral system.
  3. Each body has its own self-healing  and regulating mechanism

What are benefits of osteopath treatments?

The goal of Osteopathic manipulative treatment is to:

  1. Relief of pain and reduction of symptoms
  2. Improvement of functions
  3. Increase functional movement
  4. Improved blood supply and nutrition to the affected areas
  5. Sufficient return flow of fluids through the lymphatic and venous systems
  6. Removal of Impediments to return normal nerve transmissions.

How is osteopathy done?

Osteopathic manipulative treatment comprises of gentle hands on techniques which are pain free, safe, proven and very effective against disorders of muscles, bones, joints and nerves. The approach may consists of the following:

  1. Strain counterstrain
  2. Myofascial/Soft tissue release
  3. Muscle energy techniques( to influence the muscle and joint range)
  4. Low amplitude High velocity thrust
  5. Stretching
  6. Exercises
  7. Craniosacral therapy
  8. Visceral manipulation.

Conditions treated on Osteopathic Manipulation are:

  • Generalised aches and pains
  • General, acute and chronic back pain
  • Lumbago
  • Uncomplicated mechanical neck pain
  • Headaches arising from the neck (cervicogenic)
  • Migraine Prevention
  • Joint pains
  • Joint pains, including the hip and knee, from osteoarthritis (OA) as an adjunct to core OA treatments and exercise
  • Arthritic pain
  • Rheumatic pain
  • Shoulder pain (including frozen shoulder) and elbow pain (including tennis elbow) arising from associated musculoskeletal conditions of the neck and back
  • Minor sports injuries and tensions
  • Circulatory problems
  • Digestion problems
  • Cramp
  • Muscle spasms
  • Sciatica
  • Neuralgia
  • Fibromyalgia
  • Inability to relax

Call us at 96390509 to see if we can help your conditions


Spinal Manipulation – Safe or Not?

Joint Manipulation or Spinal manipulation is only done by experienced physiotherapist, chiropractor, or osteopath in Singapore. Commonly heard, some of the massage therapists also crack bones and loosen the joints for clients during massage. Occasionally, a few traditional barbers are also manipulating neck after a haircut! Even some people are imitating on such manipulation acts to perform on their own family, friends or own body. Everyone must be aware that there are DANGERS of untrained person, massage therapist or barbers who do not received proper years of professional medical training and clinical practice. Such people who perform such manipulation techniques which it looks like a very simple fast turning move in just a few seconds. However, in a split second, wrong manipulation move may cause serious complications such as tearing of soft tissues, damage of blood capillaries, muscles fibres strain, overstretching of nerves and damaging the joint surfaces. There are even reported incidences of stroke after a neck manipulation! Test and physical assessment must be done before implement manipulation to determine if there is a risk of injury or if a vertebral artery problem is present.

What exactly happens to the joint during a manipulation?

A manipulation is a passive joint movement technique involving a hard sudden thrust to a joint. The joint is usually pushed towards the end of its joint range of movement, and the manipulation gives an extra stretch and movement to mobilise the joint. Often, a loud audible popping sound may be heard as a pressure is released within the joint. This is similar sound of cracking on your knuckles.  The aim of using manipulation is to restore normal joint movement – which is a mixture of spin, roll and glide. This treatment technique can help to releases endorphins which are natural pain relievers, unlocks stuck joints, and reduces protective muscle spasm. Manipulation only gives a ‘feeling good effect’ as one heard the popping joint noises and felt joints ‘put back in place’.

Spinal manipulations can relieve neck and back pain by taking pressure off sensitive nerves or tissue, increase range of motion, restoring blood flow, adjustment to spinal alignment.

Careful assessment and analysing of patient’s condition is essential before deciding if manipulation is suitable choice of treatment for the pain problem, otherwise problem may become worsen. Especially for condition spondylolisthesis (displacement of vertebral bone causing spinal instability) or spondylolysis (bone defect or stress fractures, tiny cracks in connection between vertebrae), severe or acute bulging/ herniated disc are often contraindicated and implementation of manipulations techniques may be more harm than good.

Some chiropractor uses only spinal manipulation to adjust spine as their main treatment method. During manipulation, the ligaments are passively overstretched. Repeated manipulation of the spine can cause instability of the supporting ligaments. One should be cautious about signing up for chiro spinal manipulation packages for few months or year as frequent manipulation can cause spinal instability, resulting in joints laxity and pain.

Does physiotherapist do manipulation also?

While physiotherapist’s discretion is to use manipulation as the last treatment resort or only used if patient’s condition is required after careful assessment. Other physiotherapy treatment techniques are used first such as ultrasound, electrotherapy, back traction, neck traction, joint mobilisation (safer technique to mobilise joints compared to manipulation), soft tissue massage, taping, and exercises rehabilitation. There is evidence from a high quality study that spinal manipulative therapy combined with exercise is more effective than other procedures like spinal manipulation, exercise or physician consultation alone.

For a long term or lasting effects to relieving pain, manipulation should not be considered as the only source of pain relief treatment. One should not be dependent on such passive treatment methods. Active treatment techniques such as spinal strengthening exercise, clinical. Pilates taught by physiotherapist is utmost important to build a stronger core spine and postural to prevent pain problem reoccur.

Check with a physiotherapist if spinal manipulation is suitable for your condition, call 62244178 /96390509

herniated, ruptured, slipped disc
herniated, ruptured, slipped disc


Alternative Treatment  or Back Surgery for Slipped disc?

Have you seek conservative treatment before considering to go for operation: Physiotherapy, chiropractor, acupuncture, osteopath, back massage, TCM/ Chinese Sinseh? If all conservative therapy have not helped, and your lifestyle is greatly affected by the pain, you can consider a back operation. 

If you ignore the pain, the back pain and weakness/numbness/ tingling in your leg will probably remain as they are or even get worse. 

The aim of the operation is to cure your leg pain. Your back pain may remain unchanged after the operation. If your back pain is more of a problem than your leg pain, you should not have the operation. You may need the operation if: 

  • your leg pain is worse than your back pain
  • you have had leg pain for several months and it is not getting better
  • your leg pain is interfering with your life
  • you have had a MRI scan that shows that you have a disc pressing on the nerve.

If you have all of the above, you may need to see a orthopedics spine specialist to determine if an operation is required. 

Types of Back Operation

Lumbar discectomy is a back surgery to remove part of a problem disc in the low back. The discs are shock absorbers that separate the vertebrae. This procedure is commonly used when a herniated, or ruptured,slipped disc in the low back is putting pressure on a nerve root. Removing the injured portion of the disc also reduces chances of disc herniation again. 

The traditional procedure is called laminotomy and discectomy, which requires a larger incision and tends to require a longer time to heal. 

Newer method is called microdiscectomy, very small incision in the low back. Also known as minimally invasive surgery. This surgery is easier to perform, prevents scarring around the nerves and joints, and helps patients recover more quickly. 

Complications of Back Surgery

As for any types of operation, there are risks involved and complications may happen after operation. 

  • problems with anesthesia
  • thrombophlebitis (blood clots)
  • infection
  • nerve damage
  • ongoing pain

What happens after a Back Surgery?

Patients are usually able to get out of bed within a few hours after surgery, using a back support. Patients are able to return home when their medical condition is stable. 

Bending and lifting should be avoided for four to six weeks. People generally get back to light work in two to four weeks and can do heavier work and sports within three to six months. Workers whose jobs involve strenuous manual labor may be counseled to consider a less strenuous job. This will also be dependent on patient’s condition and condition after surgery. 

Patients usually begin outpatient physiotherapy after the date of surgery. 

What should I expect as I recover?

Many orthopedics surgeons prescribe outpatient physiotherapy after surgery. Although the time required for recovery varies, physiotherapy at Physioclinic after lumbar discectomy is generally only needed for six to eight weeks. You should expect full recovery to take up to six months. 

At first, our physiotherapy sessions will focus on controlling pain and inflammation. Ice and electrical stimulation treatments are commonly used to help with these goals. Our physiotherapist may also use massage to relax tight muscles, hands-on joint mobilisation techniques to ease muscle spasm and pain. 

Active treatments such as strengthening and conditioning spinal muscles, core stability and clinical pilates are essential to your rehabilitation program. Walking and swimming are ideal cardiovascular exercises after this type of surgery. Our physiotherapists also teach specific exercises to help tone and control the muscles that stabilize the low back. 

To find out if physiotherapy can help for your slipped disc, please call 9639 0509

Acupuncture and Physiotherapy are two common treatment seen in Singapore for pain, injury and disease. Let’s understand more:

Acupuncture in Singapore

Acupuncture is a alternative eastern traditional medicine which is carried out by needles poked into the body parts, done mostly by Chinese Sinseh or practitioner. Some may feel painful or discomfort when needles manipulated inside.

Physiotherapy in Singapore

Physiotherapy is an mainstream westernised healthcare profession expertise in human body function and movement.  Physio treats individuals based on a clinical diagnosis. A physiotherapist considers every patient as a different entity, physical examination of each patient, makes a structural and biomechanical analysis and then corrects the dysfunction with the help of non-invasive treatments such as using hands to perform manual joint mobilization or manipulation, pain relief treatment equipment, training to walk and therapeutic exercises.  

A physiotherapist is also involved in prescribing exercise programmes for the professional athletes and sportsmen who suffered from a sports injury. Planning for rehabilitation and optimize sports performance, and fast return to sports. Besides sports physiotherapy, the physiotherapist also carries out exercise testing and prescription for people with medical conditions such as heart and lung problem, hypertension, diabetes, cancer, osteoporosis. A therapist plays a very important responsibility after surgery, such as total knee replacement, total hip replacement, ligament reconstruction, and neurosurgery. The patient undergo different stages of activities and exercises, so as to bring him to a level where he can perform his activities of daily living, back to sports or work.

In neurological conditions like stroke, parkinson’s disease, multiple sclerosis, muscular dystrophy, Guilian Barre Syndrome, the physiotherapist plays a very important role rehabilitating the patient so that he can be less dependent at least in his activities of daily living such as getting up from bed, sitting, bathing, eating. Without physiotherapy treatment these patients would most probably never, regain function to their maximum performance.
A physiotherapist can also help in the hospital intensive care unit (ICU) to prevent secondary complications by chest physiotherapy, change of position, breathing exercises and mobility exercises to prevent muscle stiffness or contractures. Eventually, bringing the patient back to walking out strongly out of the hospital.

Difference between acupuncture and physiotherapy

Acupuncturist works on only one theory that bodily functions are all regulated by the flow of an energy called qi, and acupuncture helps to correct the flow of qi by stimulation of acupuncture  points which lie under the skin. These points are generally joined by what are called meridians. Scientific research has failed to find any correlate between qi, meridian and acupuncture points. The acupuncturists believe that by balancing the flow of qi they can treat all pain, injury or diseases.

Even research proving beneficial effects on these disorders seem to be biased. However, some people still do feel better with acupuncture.

Physiotherapy is in sharp contrast to acupuncture, where evidence is concerned. All treatment and exercises are based on clinical studies. There is strong scientific reseearches which has time and again proven the beneficial effects of physiotherapy, in the treatment of various conditions.

There are clinical physiotherapist in Singapore who are actively involved in research work and clinicians who depend on this research to treat their patients with a logical and scientifically explainable mode of treatment.

Speak to a physiotherapist in Singapore to find out if physiotherapy is suitable for your condition, Call/ SMS 9639 0509

There are many treatments for heel pain and plantar fasciitis in Singapore, including physiotherapy, steriod injections, customised arch support, shockwave therapy and surgery.

Which is the best treatment for fast pain relief and instant result?

About Shockwave Therapy for Heel Pain/ Plantar fasciitis

Shockwaves therapy (also known as ESWT) are loud sound waves that create ‘shocks’ -vibrations and cause controlled injury to the tissue around the heel and plantar fascia. The body responds by speeding it’s natural healing ability and stimulating a repair process

Each session takes about 15 minutes. Patients experience some discomfort during the shockwave therapy and there may be slight redness on the skin after treatment. More rarely, the heel pain becomes slightly worse after treatment before getting better.

How Does Shockwave Therapy for Heel Pain Work?


It is understood that shockwave therapy works in two ways:

  • Shockwaves therapy cause micro- injury to tissue in the affected area and stimulate healing
  • The treatment has a direct effect on the nerve endings which make them less sensitive and therefore less likely to transmit pain

The benefit of shockwave therapy for heel pain is often not felt until after few sessions, depending on severity. The treatment works well for 80 per cent of patients. The effect of the treatment is usually permanent.

To heal your heel pain/ plantar fasciitis, shockwave therapy is the best solution.

Call 96390509 for shockwave therapy now!

Finding effective pain relief treatment for back pain can be difficult, especially you are having pain or aches for a prolonged time.

Should you see a doctor, physiotherapist, chiropractor, osteopath, massage therapist, acupuncture, Chinese tuina or TCM for your back pain? The options to treat back pain can be overwhelming for many people.

How doctors help to relieve back pain?

If you see your doctor for lower back pain treatment, there is a high possibility that you will be prescribed medications to reduce your pain.

Depending on the severity of your back symptoms, you may be prescribed the following medications:

  • Analgesics (pain relievers), such as paracetamol or diclofenac
  • Non-steroidal anti-inflammatory drugs (NSAIDS).
  • Muscle relaxants, such as diazepam (valium).

In the early stages of back injury, medication to relieve pain can be important as it allows you stay relatively active by reducing your pain and inflammation.

Doctor may also referred you for an X-ray or MRI of your spine if your backache is more serious.

How physiotherapists help to treat back pain ?

Physiotherapist is a health care professional who practises the techniques of physical therapy. Physical therapy helps patients with physical limitations that restrict normal activities.

First, physiotherapist will need to understand the history of your back pain and perform a detailed physical assessment. A physiotherapist will choose which treatment modalities are the best to heal up your specific back problem.

Physiotherapy (physical therapy) uses a equipment machines such as ultrasound therapy, electrotherapy, heat therapy, cold therapy to treat back pain. Physiotherapist also use hands-on techniques such as joint mobilisation, spine manipulation, soft tissue massage, back stretching and strengthening exercisesor, clinical pilates for core strengthening.  

Physio also educate patient importance of back care, ergonomics and prevention of back pain reoccurence.

How Does a Physiotherapist and a Doctor Work Together to solve back pain?

In some cases, a doctor’s referral is required to be able to utilize the services of a physiotherapist but this is mostly in cases wherein insurance coverage is needed.

You can directly contact a physiotherapist in Singapore should a need arise. You can simply walk in to a physio clinic and talk with a physiotherapy doctor about your back pain problems.

Looking for an effective way to end persistent pain, manage injury rehabilitation or a non-surgical approach to your condition?

Call our physiotherapist today at 96390509 to discuss your back pain if required to see a doctor or physiotherapist in Singapore

What do Physiotherapists treat?

Physiotherapists. also known as physical therapists are considered a health specialist profession supplementary to medicine, seen in hospitals and private clinic in Singapore.

Physiotherapy works to restore, regain movement and function to the body. Physiotherapists work in a wide variety of settings that may include:

–       Pain Management

–       Musculoskeletal Injury

–       Sport Injury & sport enhancement

–       Stroke rehabilitation

–       Post operation Rehabilitation

–       Elderly Rehab

–       Chest Physiotherapy

What do Osteopath treats?

Osteopaths are complementary, alternative therapy to medical practices.

An osteopath looks at the body holistically, this means that an osteopath does not just treat a back pain problem, they will look at the entire body and the full medical history of the patient.

Osteopathy is a theory of disease and method to treat and cure, based on the assumption that disease is the result of the relationship between anatomical structure of the body and the way the body functions.

Find a Physiotherapist or Osteopath in Singapore?

If you are in pain, you want to be assured that you can find the right health professional who can effectively relieve pain and discomfort.

What is most important when deciding whether find a physiotherapist or a oestopath to treat your pain is who you go to. There are many good physiotherapist and good osteopath in Singapore. Who is the best specialist?

Our physiotherapist approach at the Physioclinic is that we will cross refer to a osteopath if your condition required, to make sure our patients always get the appropriate solution for fastest recovery. A short consultation will first determine whether you are best to see a physiotherapist or a osteopath.

Call us now at 96390509 to discuss your problem if you want to find a physiotherapist or osteopath in Singapore.


When you are suffering from neck or back pain, it can be difficult to know what type of pain relief treatment you need. Understanding the differences between chiropractic and physiotherapy will help you make the best choice.

Basically, chiro and physio can treat spinal joint and muscles problem to reduce pain, increase movement and flexibility.

Both chiropractors & physiotherapists treat a number of different but similar neuromusculoskeletal conditions including headaches, migraines, back and neck pain, sports injuries, sciatica, scoliosis, disc degeneration.

What is a physiotherapist?

Physiotherapy is the most widely recognized health remedy available in hospitals and private clinic in Singapore, focus on treating movement disorder, pain or injury. Physiotherapist uses wide variety of physical therapy such as using equipment (Eg ultrasound, electrotherapy, heat therapy), massage, therapeutic exercises, joint mobilisation, joint manipulation, postural education. Treatments session may be more than 30 minutes or more each session, depending on condition.

Besides treatment of work related musculoskeletal or sport injury, physical therapists also help in stroke recovery, post operation rehabilitation, arthritis, pre-natal, post-natal, ergonomics, walking analysis, weight management, cardiopulmonary rehabilitation

What is a chiropractor?

Chiropractors are not real medical doctors. The degree education for becoming chiropractor is called Doctors of Chiropractic. Chiro practise in private clinics settings in Singapore.

Chiropractors mostly use hands to perform and adjust the spinal- technique called manipulations to align the spine. Chiro can treat spinal joint misalignments or ‘subluxations’ which they believed could interfere with the nervous system and ultimately result in many different conditions of diminished health. Based on this assertion, all health problems could be prevented or treated using adjustments of the spinal joints.

Different chiropractors vary in their approach, while some adhere strictly to the use of spinal adjustments less than 5-minute treatment time per session.

Differences between physiotherapist and chiropractors in Singapore

Almost all chiropractors only use passive care and physiotherapists encourage patients to take a more active role in their care and therefore prevent dependence. Physiotherapists educate and give patient knowledge in how to manage their own neck or back pain effectively.

There has been controversy between the physiotherapy and chiropractic professions, with both claiming to be the more superior health care treatment. There has been much research to suggest that both physiotherapy and chiropractic are equally as good in the treatment of back pain.

Suffering in Pain? Who do I choose?

When faced with a pain or injury, we want to be absolutely confident that we can choose a health professional/ specialist that is correct, who can effectively relieve pain and discomfort.

What is most important when deciding whether to go to a physiotherapist or a chiropractor to treat your pain is who you go to. There are good chiropractors and there are bad chiropractors just as there are good and bad physiotherapists.

Our approach at the Physioclinic is that we will cross refer, to make sure patients always get the right treatment. A short consultation will first determine whether you are best to see a physiotherapist or chiropractor.

Call us now at 96390509 to discuss your problem if you need a physiotherapist or chiropractor in Singapore.

Hot or Cold Treatment? Ask a Physiotherapist
Hot or Cold Treatment? Ask a Physiotherapist


Should you do Ice Therapy or Heat Treatment after an Injury or Pain?

Is cold treatment or heat therapy better in helping to reduce pain? And how long should the ice or heat treatments last?

Both have its advantages, depending on type and stage of injury.

Learn how to tell whether to use ice packs and heating pads for injury or pain.

Ice Treatment

When to do Ice Treatment?
Ice treatment is often used for acute (recent) injuries, last 48 hours. If you have a recent injury with signs of inflammation (swelling, reddness, pain, limited movement, warm), you should be using ice treatment. Ice packs are commonly used after sport injuries such as an ankle sprain, knee pain.

What are benefits of Ice Treatment?

– Reduce swelling

– Decrease pain

– Allows for ease in movement

– Prevent pain or injuries becoming a chronic long term problem.

How long should you apply ice treatment?

Ice packs, applied for 10 to 20 minutes, can help minimize swelling around the injury. If pain is severe, cold treatment can be applied every 2-3hours interval.

Applying an ice pack early and often for the first 48 hours will help minimize swelling.

Ice treatments may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after activity. Never ice a chronic injury before activity.

Heat Treatment

When to do Heat Treatment?
Heat treatments should be used for chronic, long term persistent pain conditions, such as overuse injuries. Hotpacks are commonly used after long day work with tired aching muscles.

What are benefits of Heat Treatment?

– help relax and loosen tissues

– stimulate blood flow to the area

How long should you apply heat treatment?

 Heating tissues can be accomplished using a heating pad, or even a hotpack, applied for 10 to 30 minutes. When using heat treatments, be very careful to use a moderate, comfortable heat. Otherwise, there is a risk of being scalded or burn.

Ice packs and heat pads are among the most commonly used treatments in physiotherapy. If you have tried hot pack or cold packs, and your pain still persist, you should see a physiotherapist to assess your condition to find out the exact cause of problem and physiotherapy treatments to solve your problem.

Speak to a Physiotherapist if ice or heat treatment does not work. Call/SMS 9639 0509 or EMAIL US

The effect of additional therapeutic ultrasound in patients with primary hip osteoarthritis: a randomized placebo-controlled study.  [LINK]

Clin Rheumatol. 2010 May 26.

To the best of our knowledge, there is no study in the English literature about the usefulness of ultrasound therapy in degenerative hip osteoarthritis. The aim of this study was to examine its short- and long-term efficacy in patients with primary hip osteoarthritis with regard to pain, functional status, and quality of life (QoL). Forty-five patients with primary hip osteoarthritis were enrolled into the study. Demographic and clinical characteristics including age, sex, duration of disease, and pain on activity and at rest using visual analogue scale (VAS) were recorded. Functional status was determined by a 15-m timed walking test and Western Ontario McMaster Osteoarthritis Questionnaire. QoL was determined by the Short Form-36 survey (SF-36). Each patient was randomly assigned to either group I (standard physical therapy including hot pack and exercise program), group II (sham ultrasound in addition to standard physical therapy), or group III (ultrasound and standard physical therapy). The main outcome measures of the treatment were pain intensity by VAS; functional status measurements that were evaluated at baseline, at the end of the therapies, and at the first and third month of follow-up; and QoL scores that were determined at baseline and at the end of the first and third months. Twelve male and 33 female patients (mean age, 65.3 +/- 6.7 years; mean disease duration, 2.5 +/- 1.7 years) were included in the study. There were no differences between the groups regarding demographic variables on entry to the study. There were 15 patients in each group. Pain and functional outcome measures were determined to have improved significantly in all of the groups at the end of the therapies, but these improvements continued at the end of the first and third months only in group III (p < 0.001) The physical subscores of SF-36 were improved at the end of the first month and were maintained at the end of the third month only in patients receiving additional ultrasound therapy (group III, p < 0.001), while mental subscores of SF-36 did not change significantly in any group. In conclusion, addition of therapeutic ultrasound to the traditional physical therapy showed a longitudinal positive effect on pain, functional status, and physical QoL in patients with hip osteoarthritis. The use of therapeutic ultrasound in the treatment of hip osteoarthritis should be encouraged, and it seems worthy to continue with large clinical trials on ultrasound in order to standardize the treatment modality in this patient group.

Therapeutic ultrasound for osteoarthritis of the knee or hip.  [LINK]

Cochrane Database Syst Rev. 2010 Jan 20;(1):CD003132

Osteoarthritis is the most common form of joint disease and the leading cause of pain and physical disability in the elderly. Therapeutic ultrasound is one of several physical therapy modalities suggested for the management of pain and loss of function due to osteoarthritis (OA).

To compare therapeutic ultrasound with sham or no specific intervention in terms of effects on pain and function safety outcomes in patients with knee or hip OA. 
Studies were included if they were randomised or quasi-randomised controlled trials that compared therapeutic ultrasound with a sham intervention or no intervention in patients with osteoarthritis of the knee or hip.

MAIN RESULTS: Compared to the previous version of the review, four additional trials were identified resulting in the inclusion of five small sized trials in a total of 341 patients with knee OA. No trial included patients with hip OA. Two evaluated pulsed ultrasound, two continuous and one evaluated both pulsed and continuous ultrasound as the active treatment. The methodological quality and the quality of reporting was poor and a high degree of heterogeneity among the trials was revealed for function (88%). For pain, there was an effect in favour of ultrasound therapy, which corresponded to a difference in pain scores between ultrasound and control of -1.2 cm on a 10-cm VAS (95% CI -1.9 to -0.6 cm). For function, we found a trend in favour of ultrasound, which corresponded to a difference in function scores of -1.3 units on a standardised WOMAC disability scale ranging from 0 to 10 (95% CI -3.0 to 0.3). Safety was evaluated in two trials including up to 136 patients; no adverse event, serious adverse event or withdrawals due to adverse events occurred in either trial.

AUTHORS’ CONCLUSIONS: In contrast to the previous version of this review, our results suggest that therapeutic ultrasound may be beneficial for patients with osteoarthritis of the knee. Because of the low quality of the evidence, we are uncertain about the magnitude of the effects on pain relief and function, however. Therapeutic ultrasound is widely used for its potential benefits on both knee pain and function, which may be clinically relevant. Appropriately designed trials of adequate power are therefore warranted.