It can be used effectively to eliminate plantar warts. 

It can reduce inflammatory pain in certain cases of bursitis.

Specificity is Key.

Part of the issue I believe many people deal with is that they expect a miracle out of the device and don't put the device into proper (or even reasonable) context. 

I recently had a patient stumble into my office with an acute low back injury (four days) and a lateral shift, acute spasm, unable to get off toilet, put on socks and shoes.   He couldn't bend much less get dressed normally. 

Was I gonna start "stabilizing" him? 

Pffft.  Come on.

I treated him for a week and a day.  Straight.

I simply gave him some sitting posture education to protect the lumbar spine, some advice and restrictions on work and home ADLs, and coached him on a resting position to alleviate symptoms and gradual restoration of motion.    I also encourage him to use his medications appropriately.

And I did daily ultrasound for one week.  I didn't, however, blast his low back at 1.5 w/cm² every day.  I started around 0.6 to 0.8 and 20% duty cycle for 12 minutes with him resting in a position of alleviation.  Could irritated tissue handle more?  Later in the week, yes.  On day one: no way.  I progressed the intensity and duty as per his symptom progression and lo and behold in seven days time, he was dressing again, performing  nearly full ROM, almost pain-free and his lateral shift had nearly fully reversed.   And he discontinued his meds.

Do I do this with every patient?   No.  The patient's situational context predicated its use. 

It wouldn't have worked with an obese patient.  He was rather mesomorphic, with little adipose in his back.

It may not have worked (likely) if I had seen him 5 weeks after the injury started.  But he came in while still in an acute phase, and lower doses of ultrasound intelligently applied (in his case, daily) work well  to reduce acute irritability, especially if other parts of the patient's program are working properly.  Thus this modality (and others) can be a useful adjunct in the care plan.

Now, before you run back to the office and turn on that ultrasound that hasn't been turned on in seven years, do yourself a favor, have it calibrated.   A recent study suggests a rather notable degree of variability can occur between different devices (manufacturers) and even within a device itself---i.e. just because the meter says it's putting out 1.2 w/cm²   doesn't necessarily mean that's what's coming out of the device.

Bottom line: know what you are doing.  Use it intelligently or don't use it at all.

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