Knee pain when undergoing ultrasound heat therapy

Patient

Q: I saw a knee specialist for knee pain, and I was diagnosed with patellar subluxation on my right knee. Since, I have been seeing a physical therapist to strengthen the muscles on the right leg. For the last three visits, the therapist has been using ultrasound heat therapy on the tendon below my kneecap, because it cramped during one of our sessions. The first ultrasound therapy felt really good. During the second ultrasound therapy, my knee cramped once. During the third ultrasound therapy, my knee cramped at least three times, and once I felt an intense burning sensation. When I made the therapist aware of this, she paused each time and gave the knee a little time to recover before resuming. The therapist seems puzzled about it. Should I continue with the ultrasound therapy or ask my therapist to stop it? I do not think this pain is normal, and it has been increasing over the last three visits. Or, should I trust that my therapist is a professional and knows what she is doing with it? Please advise. Thank you!

Doctor

A:   The ultrasound in your case is being used to control pain and inflammation, but in the view that is not working, I strongly recommend that other control pain and inflammation method should be used, meaning TENS, moist warm local compresses before to start the exercise routine. Also you could benefit of taking anti inflammatory medication before the PT session.

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