What Is Phonophoresis?

A Treatment Method Used in Physical Therapy

Phonophoresis, also called sonophoresis, is a physical therapy treatment that uses ultrasound combined with a medication gel.

The physical therapist applies the medication to your skin, and then ultrasound waves help pass the medicine through the skin and into your injured body part.

In this article, you'll learn the conditions phonophoresis treats, how it works, and what to expect during the procedure. You'll also learn about phonophoresis contraindications and risks, and whether it's safe and effective.

Photo of woman getting ultrasound in physical therapy.
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Conditions Treated by Phonophoresis

Phonophoresis is a treatment your physical therapist may use if you have an injury that causes inflammation. It may help decrease pain and inflammation to improve overall functional mobility.

Inflammation

Phonophoresis is used to treat inflammation in a muscle, tendon, ligament, or other soft tissue. It's considered an anti-inflammatory treatment.

Inflammation is the natural healing process that occurs in the body after an injury. The signs and symptoms of inflammation include pain, swelling, redness, and increased temperature of the inflamed body part.

Delayed Onset Muscle Soreness

Phonophoresis has been used to treat delayed onset muscle soreness (DOMS). DOMS is muscle soreness that occurs after vigorous exercise and usually lasts one to two days after exercise.

Injuries

Phonophoresis is often used to treat injuries and conditions such as:

Phonophoresis vs. Iontophoresis

Iontophoresis is another treatment method used in physical therapy that shares some similarities to phonophoresis, but is still quite different.

Phonophoresis and iontophoresis both administer medication into the body through your skin. They're both used as mostly pain-free alternatives to injections to treat inflammation caused by injuries.

However, the main difference is the mode of transmission. Phonophoresis uses ultrasound waves to apply topical medicine to an injured body area, wheres iontophoresis uses electrical current.

What to Expect

When your physical therapist applies phonophoresis to you, you will likely feel nothing. They will lightly rub the ultrasound wand over your injured tissue. There may be a slight warming sensation as the phonophoresis is applied.

You might feel a sharp burning sensation, especially if the ultrasound head is in one place for too long. If this happens, immediately tell your therapist. They can make changes to the treatment to eliminate this sensation.

Medications Used

The medications often used during phonophoresis treatment are those that help decrease inflammation. These anti-inflammatory medicines help reduce the pain and swelling you may feel after an injury.

Anti-inflammatory topical medications (medicines applied to the skin) used in the application of phonophoresis may include:

  • Hydrocortisone
  • Dexamethasone
  • Salicylates

Lidocaine, a pain medicine, is also sometimes used with phonophoresis.

If you and your physical therapist agree that phonophoresis may be a good treatment option for your specific condition, be sure to understand what medication they will use and its rationale.

Some medications carry risks and side effects, even if applied to the skin.

Contraindications

Phonophoresis is typically a safe and painless procedure. However, there are some instances where phonophoresis may be inappropriate.

Contraindications for phonophoresis include:

  • Open wounds 
  • Infected wounds
  • Eczema
  • Abscesses
  • Cancer 
  • Diabetes
  • Tuberculosis 
  • Deep vein thrombosis 
  • Stomach ulcer 
  • Allergy to the medication being used
  • Prosthesis
  • Implanted medical devices  
  • Sensory disturbances

Does Phonophoresis Work?

Some research indicates phonophoresis may help decrease pain and inflammation. However, many of these studies are poorly designed and are not seriously considered when analyzing the effectiveness of the treatment.

Evidence

A 1967 study demonstrated superior outcomes in patients receiving phonophoresis compared to patients receiving ultrasound alone. But more recent studies have failed to duplicate these results.

Other studies indicate the medication used during the ultrasound treatment doesn't penetrate through the skin and therefore can't help treat pain or inflammation.

One study looked at the effectiveness of phonophoresis in treating DOMS. They found phonophoresis didn't help improve soreness when compared to a placebo treatment of phonophoresis.

A 2006 review in the Physical Therapy Journal concluded no evidence from experimental studies could suggest that adding a drug to the coupling medium (ultrasound gel) produced added benefits compared with using ultrasound alone.

In Practice

Some clinicians argue there's insufficient evidence to support using phonophoresis in physical therapy. Others think the treatments provided with phonophoresis can help decrease pain and inflammation.

Some experts think the placebo effect may lead physical therapists and patients to believe that phonophoresis is an effective treatment.

Is Phonophoresis Right For You?


Any good rehab program should include active involvement between you and your therapist. Exercise and movement should be the core of your rehab program, while therapeutic modalities like phonophoresis should be considered a supplement to your program.

If your physical therapist decides to use phonophoresis for your condition, understand what it's used for, and be sure that active exercises are also used to treat your problem.

A Word from Verywell

Your physical therapy program should include active involvement whenever possible, and phonophoresis is a passive treatment. You cannot take phonophoresis home with you, and you cannot use it to self-manage your problem.

You and your physical therapist should work together to ensure you have an active self-care program to improve your condition and return to optimal function as quickly as possible.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Saliba S, Mistry DJ, Perrin DH, Gieck J, Weltman A. Phonophoresis and the absorption of dexamethasone in the presence of an occlusive dressingJ Athl Train. 2007;42(3):349-354.

  2. Cleveland Clinic. Tendonitis or bursitis? Your best treatments begin at home.

  3. Gurcay E, Unlu E, Gurcay AG, Tuncay R, Cakci A. Assessment of phonophoresis and iontophoresis in the treatment of carpal tunnel syndrome: a randomized controlled trialRheumatol Int. 2012;32(3):717-722. doi:10.1007/s00296-010-1706-9

  4. Hulsey Therapy Services. Phonophoresis.

  5. Cagnie B, Vinck E, Rimbaut S, Vanderstraeten G. Phonophoresis versus topical application of ketoprofen: comparison between tissue and plasma levelsPhys Ther. 2003;83(8):707-712. doi:10.1093/ptj/83.8.707

Additional Reading

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.