Abstract:
The invention relates to apparatus and method for therapeutically treating reflex sympathetic dystrophy using ultra sound. The apparatus includes at least one ergonomically constructed ultrasonic transducer configured to cooperate with a placement module or strip for placement in proximity to pain receptors of the sympathetic nervous system. The apparatus also utilizes a portable, ergonomically constructed main operating unit constructed to fit within a pouch worn by the patient. In operation, at least one ultrasonic transducer positioned in proximity to the pain receptors of the sympathetic nervous system is excited for a predetermined period of time. To ensure that at least one ultrasonic transducer is properly positioned, and to insure compliance with a treatment protocol, a safety interlock is provided to prevent inadvertent excitation of the at least one ultrasonic transducer. In an alternate embodiment, the apparatus includes a treatment basin having a plurality of ultrasonic transducer assemblies placed on the perimeter thereof. The patient places an injured part of the body therein and the transducer assemblies are excited to impinge ultrasonic waves to the injured part of the body.

Description:
This application claims priority from provisional application No. 60/133,442, filed May 11, 1999. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a method and apparatus for therapeutically treating injuries using ultrasound. More particularly, the present invention relates to a method and apparatus which utilizes an ergonomically constructed ultrasonic transducer configured to cooperate with a placement module for placement in proximity to any part of the body for therapeutically treating reflex sympathetic dystrophy. 
     2. Description of the Related Art 
     The use of ultrasound. to therapeutically treat and evaluate bone injuries is known. Impinging ultrasonic pulses having appropriate parameters; e.g., frequency, pulse repetition, and amplitude, for suitable periods of time and at a proper external location adjacent to a bone injury has been determined to accelerate the natural healing of, for example, bone breaks and fractures. 
     U.S. Pat. No. 4, 530,360 to Duarte describes a basic non-invasive therapeutic technique and apparatus for applying ultrasonic pulses from an operative surface placed on the skin at a location adjacent a bone injury. The applicator described in the Duarte patent has a plastic tube which serves as a grip for the operator, an RF plug attached to the plastic tube for connection to an RF source, and internal cabling connected to an ultrasonic transducer. To apply the ultrasound pulses during treatment. an operator must manually hold the applicator in place until the treatment is complete. As a result, the patient is, in effect, immobilized during treatment. The longer the treatment period, the more the patient is inconvenienced. The Duarte patents as well as U.S. Pat. No. 5,520,612 to Winder et al. describe ranges of RF signal for creating the ultrasound, ultrasound power density levels, ranges of duration for each ultrasound pulse, and ranges of ultrasonic pulse frequencies. 
     U.S. Pat. No. 5,003,965 to Talish et al. relates to an ultrasonic body treatment system having a body-applicator unit connected to a remote control unit by sheathed fiber optic lines. The signal controlling the duration of ultrasonic pulses and the pulse repetition frequency are generated apart from the body-applicator unit. Talish et al. also describes a mounting fixture for attaching the body-applicator unit to a patient so that the operative surface is adjacent the skin location. 
     While the systems described in these patents relate to therapeutic methods and apparatus for ultrasonic treatment there is a need for ergonomically configured signal generators and transducers which permit patient mobility during the treatment of reflex sympathetic dystrophy (RSD). Further, a need exists for an apparatus which optimizes the treatment of RSD while maintaining patient mobility. 
     RSD is a disease of the sympathetic nervous system, which is one of the components of the central nervous system. The sympathetic nervous system responds to an injury by activating the pain receptors in the injured part of the body. These pain receptors are activated by signals sent by the sympathetic nervous system through neurotransmitters which transmit neural impulses from one neuron to another. This pain acts as a warning to the injured person that they have been hurt, and that they need to stop whatever they are doing in order to prevent further injury. RSD prolongs this normal sympathetic response to an injury by causing the sympathetic nervous system to continue to stimulate the pain receptors long after the injury has healed. Unless the RSD patient is successfully treated, the pain continues unabated for the rest of his/her life. 
     Several treatments for RSD include drug therapy; spinal blocks which are administered to the patient by injection into the spine; physical therapy; a transcutaneous electrical nerve stimulator (TENS) that connects to the affected area via electrodes and creates electrical pulses that are supposed to interrupt the pain generation and create serotonin and stimulate the release of endorphins; sympathectomy; and implantable devices, such as a peripheral nerve stimulator. 
     SUMMARY OF THE INVENTION 
     The ultrasonic treatment apparatus of the present invention may be used for therapeutically treating reflex sympathetic dystrophy (RSD) using ultrasound. The apparatus may include an ergonomically constructed placement module configured for mounting at least one ultrasonic transducer assembly with an integral signal generator which provides excitation signals to ultrasonic transducers within the transducer assembly. Timing control circuitry as well as monitoring circuitry for the proper attachment and operation of the transducer assembly are housed within a portable main operating unit constructed to fit within a pouch worn by the patient. In operation, the placement module is positioned against a part of the patient&#39;s body such that at least one transducer is positioned over pain receptors of the sympathetic nervous system. The placement module is preferably placed against the part of the patient&#39;s body where it has been medically determined includes pain receptors which are continuously being stimulated by the sympathetic nervous system long after the injury has healed. At least one transducer is then excited for a predetermined period of time to impinge ultrasonic waves against the pain receptors. A sensor may also be used for sensing stimulation of the pain receptors before the at least one transducer is excited. 
     Accordingly, there is provided a kit suitable for ultrasonically treating reflex sympathetic dystrophy while maintaining patient mobility, which comprises: 
     an ultrasonic transducer assembly having at least one ultrasonic transducer; 
     a placement module configured to be worn by a patient, said placement module being configured to receive said transducer assembly such that when said placement module is worn, said at least one ultrasonic transducer is positioned in proximity to pain receptors of the sympathetic nervous system; 
     an ultrasonic signal generator positioned in said ultrasonic transducer assembly; 
     a main operating unit; and 
     a sensor coupled to said main operating unit for sensing stimulation of said pain receptors. 
     Preferably, the main operating unit has an internal power source for powering the signal generator circuitry, a display coupled to the signal generator circuitry to display treatment sequence data, a keypad coupled to the signal generator circuitry to permit user operation and/or entry of data. The signal generator circuitry includes a processor, means for generating a pulsed control signal, and a switch coupled to the processor for regulating the pulsed control signal. A communication interface may be connected between a communication port and the processor to provide a communication link between the ultrasonic signal generator and an external computer or modem. Preferably, the communication interface is a serial communication interface, however, a parallel interface is also contemplated. An alarm is provided to indicate to the user that the treatment time has expired. The alarm is coupled to the processor such that when ultrasonic treatment is completed the processor activates the alarm and terminates ultrasound generation. 
     The present invention also provides a kit for ultrasonically treating RSD while maintaining patient mobility. The kit includes an ultrasonic transducer assembly, a sensor for sensing the stimulation of the pain receptors, a placement module configured to be worn by a patient and to receive the ultrasonic transducer assembly, an integrated ultrasonic signal generator located in the ultrasonic transducer assembly, a main operating unit (MOU) or controller and a pouch constructed to receive the MOU. Preferably, the MOU has an internal power source and is fitted within a pouch which is releasably secured to a patient during treatment thereby providing patient mobility. A MOU envisioned for use with the present invention is described in U.S. Pat. No. 5,556,372 to Talish et al. which is hereby incorporated by reference. 
     The MOU is electrically coupled to at least one transducer secured to the placement module and at least one sensor. The signal generator corresponding to each transducer is activated when one or more of the sensors sense the pain receptors being stimulated by the sympathetic nervous system. The activation of a signal generator excites at least one ultrasonic transducer for impinging ultrasonic waves to the pain receptors in the injured part of the body. 
     A method for ultrasonically treating RSD while maintaining patient mobility is also provided. Once the location of the pain receptors in the injured part of the body is ascertained, for example, by one or more of the sensors, a placement module containing an ultrasonic transducer assembly having at least one transducer and one signal generator is affixed to the injured part of the body such that at least one transducer is in proximity to the pain receptors for the treatment of RSD. 
     In an alternative embodiment, a series of transducers are attached to a placement module and are controlled by a MOU. In another embodiment, a placement module is provided for securing a plurality of transducers thereto in a plurality of configurations. 
     Further, the present invention also provides a strip having at least one ultrasonic transducer secured thereto for placement on the patient&#39;s body directly above the pain receptors for the treatment of RSD. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     Preferred embodiments of the invention are described below with reference to the drawings, which are described as follows: 
     FIG. 1 is a perspective view with parts separated of a first embodiment of a portable ultrasonic treatment apparatus according to the present invention, illustrating a main operating unit or controller and a placement module; 
     FIG. 2 is a perspective view of a patient wearing the portable treatment apparatus of FIG. 1; 
     FIG. 3 is a cross-sectional view along line  3 — 3  in FIG. 2 illustrating the transducer assembly impinging ultrasonic waves to pain receptors where a gel-like substance is positioned between the transducer assembly and the patient&#39;s body; 
     FIG. 4 is a block diagram of one embodiment of the circuitry for the ultrasonic transducer assembly; 
     FIG. 4A is a block diagram of an alternative embodiment of the circuitry for the ultrasonic transducer assembly; 
     FIG. 5 is a perspective view of a second embodiment of the portable ultrasonic treatment apparatus, illustrating a main operating unit or controller and a placement module having a series of transducers; 
     FIG. 6 is a perspective view of a patient wearing the portable treatment apparatus of FIG. 5; 
     FIG. 7 is a cross-sectional view of the patient wearing the portable treatment apparatus of FIG. 5 taken along line  7 — 7  in FIG. 6; 
     FIG. 8 is a perspective view of a patient wearing a portable treatment apparatus of a third embodiment configured for mounting a plurality of transducers in a plurality of configurations in proximity to pain receptors in the injured part of the body; 
     FIG. 9 is a perspective view of a placement module of the embodiment of FIG. 8 being placed on a patient; 
     FIG. 10 is a cross-sectional view along line  10 — 10  of FIG. 8; 
     FIG. 11 is a perspective view of a portable treatment apparatus of a fourth embodiment configured for treating RSD; 
     FIG. 12 is a perspective view of a patient wearing the portable treatment apparatus of FIG. 11; 
     FIG. 13 is a cross-sectional view taken along line  13 — 13  in FIG. 12; 
     FIG. 14 is a perspective view of a portable treatment apparatus of a fifth embodiment configured for treating RSD; 
     FIG. 15 is a perspective view of a patient wearing. the portable treatment apparatus of FIG. 14; 
     FIG. 16 is a perspective view of a portable treatment apparatus of a sixth embodiment configured for treating RSD; 
     FIG. 17 is a perspective view of a patient wearing the portable treatment apparatus of FIG. 16; 
     FIG. 18 is a perspective view of a treatment apparatus of a seventh embodiment configured for treating RSD; 
     FIG. 19 is a perspective view of a patient using the treatment apparatus of FIG. 18; 
     FIG. 20 is a cross-sectional view of a patient using the treatment apparatus of FIG. 18; 
     FIG. 21 is a perspective, partial cut-away view of a treatment apparatus of an eighth embodiment configured for treating RSD; 
     FIG. 22 is a cross-sectional view of a patient using the treatment apparatus of FIG. 21; 
     FIG. 23 is a perspective view of a treatment apparatus of a ninth embodiment configured for treating RSD; 
     FIG. 24 is a perspective view of a patient using the treatment apparatus of FIG. 23; and 
     FIG. 25 is a perspective view of a treatment apparatus of a tenth embodiment configured for treating RSD. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The ultrasonic treatment apparatus of the present invention is used for the surgically non-invasive utilization of ultra high-frequency acoustic energy in the treatment of reflex sympathetic dystrophy (RSD). Even though this detailed description discusses the treatment of RSD following an injury, the ultrasound treatment apparatus can be used to treat RSD caused by other means, such as surgery, medication, or an infection. The treatment of other musculoskeletal injuries including cranial and venous ulcers are also contemplated with the present invention. 
     The apparatus includes an ergonomically constructed placement module having a strap or other fastening means for being secured to an injured part of a patient&#39;s body. At least one ultrasonic transducer assembly partially fabricated with a conductive plastic material is attached or imbedded within the placement module and properly positioned in proximity to the pain receptors in the injured part of the body. Different types of ultrasonic transducers and signals can be provided, such as those described and schematically depicted in U.S. Pat. No. 5,520,612 to Winder et al. which is hereby incorporated by reference. Particularly, the transducers and arrangements schematically depicted by FIGS. 7-11 of the patent in which at least one transducer is used to provide acoustic energy to the site of the injury. The apparatus also utilizes a portable, ergonomically constructed main operating unit (MOU) which is constructed to fit within a pouch worn by the patient using belt and shoulder strap and provides control signals to the ultrasonic transducers. The MOU which is utilized is preferably the one described in U.S. Pat. No. 5,556,372 to Talish et al. which is hereby incorporated by reference. 
     Turning to the figures, in particular FIG. 1, one embodiment of the portable ultrasonic treatment apparatus  10  of the present invention is shown. The ultrasonic treatment apparatus  10  includes a MOU  12 , a placement module  14 , an ultrasonic transducer assembly  16 , and a pouch  18  for releasably securing the MOU  12  to the patient during treatment for providing patient mobility. The placement module  14  is comprised of placement bands  20  and placement support  22 . The placement support  22  includes a pocket  24  adapted for placement of the ultrasonic transducer assembly  16  therein. The placement support  22  further includes a body rest  26  having slots  30  for connecting the placement support  22  to the placement bands  20 . A sponge-like material  34  lines the inner surface of the placement support  22  for providing comfort to the patient. The placement support  22  may be construed of hard plastics which may be custom molded for a particular patient. 
     The transducer assembly  16  includes circuitry, schematically illustrated by FIGS. 4 and 4A and described below, for exciting at least one transducer therein and is coupled to the MOU by cable  36 . The cable  36  is preferably a multiconductor cable capable of transmitting relatively low frequency RF or optical signals, as well as digital signals. The cable  36  may include coaxial cable or other types of suitable shielded cable. Alternatively, the cable  36  may include fiber optic cable for transmitting optical signals. The signals may be transmitted continuously or as a series of pulses. 
     In operation, the placement module  14  is positioned and secured to the patient&#39;s body as shown by FIG. 2, such that the transducer assembly  16  lies over the pain receptors of the sympathetic nervous system in the injured part of the body. A locating ring such as the one disclosed in U.S. patent application Ser. No. 08/389,148 may be used for determining the location of injured bone in the case of a bone injury before the placement module  14  is secured to the patient. Once the placement module  14  is properly positioned, the transducer within the transducer assembly  16  is excited for a pre-determined amount of time. A gel-like substance  38  may be positioned between the transducer assembly  16  and the injured part of the patient&#39;s body to prevent attenuation of the ultrasonic waves as they travel to the pain receptors  40 , as shown by FIG.  3 . 
     With reference to FIG. 4, a block diagram of one embodiment of the ultrasonic transducer assembly circuitry is shown. The transducer assembly circuitry  17  includes a receiver  50  which receives the signals transferred by a signal generator within MOU  12  via cable  36 . Receiver  50  is connected to transducer driver  52  which excites transducer  54 . 
     An alternative embodiment of the transducer assembly circuitry  17  is shown in FIG.  4 A. In this embodiment, the ultrasonic transducer assembly  16  includes an internal battery  60  which supplies power to the components within the transducer assembly  16 . For example, battery  60  supplies power to signal monitoring circuit  62  and signal driver  66 . The signal monitoring circuit  62  provides, preferably, a digital output signal  68  which represents the waveform characteristics of the output of transducer driver  70 . These characteristics can be displayed on a digital display and may include, for example, the frequency, pulse repetition frequency, the pulse width and the average output power of the transducer  54 . The output signal  68  of signal monitoring circuit  62  is transferred to the signal generator within MOU  12  via driver  66  and cable  36 . The signal generator may include a processor and a switch for regulating the signal characteristics. Control signals from the MOU  12  are received by receiver  72  via cable  36 . Safety or fixture interlock  74 , which may include switches on the outer surface of the placement module  14  or transducer assembly  16 , ensures that the placement module  14  is properly positioned before providing power to the internal components of the transducer assembly  16 . 
     A second embodiment of the portable ultrasonic treatment apparatus of the present invention is illustrated by FIGS. 5-7 and designated generally by numeral  200 . The treatment apparatus  200  includes MOU  12 , pouch  18 , and a series of transducer assemblies  206  on a placement module  208 . At least one sensor  209  is also included and coupled to MOU  12  for sensing the stimulation of the pain receptors by the sympathetic nervous system. 
     The transducer assemblies  206  can be placed within pockets  210  of the placement module  208  such that they lie over the pain receptors at the injury site. Each transducer assembly  206  includes a power transducer  212  connected to the MOU via wires  214  and cable  218 . A gel-like substance  204  may be positioned between the transducer assemblies  206  and the injured part of the patient&#39;s body to prevent attenuation of the ultrasonic waves as they travel to the pain receptors  216 , as shown by FIG.  7 . The circuitry  17  for each transducer assembly may be similar to that disclosed for the first and second embodiments and schematically illustrated by FIGS. 4 and 4A. 
     In operation, the placement module  208  is positioned and firmly secured to the patient&#39;s body as shown by FIGS. 6 and 7, such that the transducer assemblies  206  and at least one sensor  209  lie over the pain receptors in the injured part of the body. Once the placement module  208  is properly positioned the transducers within the transducer assemblies  206  are excited for a pre-determined period of time after the at least one sensor  209  has sensed the stimulation of the pain receptors by the sympathetic nervous system. The sensor  209  may provide a signal to the MOU  12  once the sensor  209  no longer senses the stimulation of the pain receptors to disenable the transducer assemblies  206 . 
     It is envisioned that the placement module  208  be constructed from suitable conductive plastics, such as conductive ABS plastics with either carbon, stainless steel, nickel or aluminum fibers to forego the use of wires  210  for connecting the transducer assemblies  206  to each other. In such an embodiment, the conductive placement module  208  would be used to electrically connect the transducer assemblies  206  to each other. 
     With reference to FIGS. 8-10, a third embodiment of the portable ultrasonic treatment apparatus of the present invention is illustrated. In this embodiment, the treatment apparatus  300  includes a MOU  302 , a placement module  304 , ultrasonic transducer assemblies  306 , and a pouch  308  for providing patient mobility during treatment. The placement module  304  is comprised of a placement band  310  and a placement support  312  having half-sections  312   a  and  312   b . The under-side of each half-section  312   a  and  312   b  includes pockets  314  for placement of transducer assemblies  306  therein. The transducer assemblies  306  may be arranged in a plurality of configurations within pockets  314  such that they lie over the injured part of the body. Each transducer assembly  306  is connected to the MOU  302  via wires  316  and cable  318  to power transducer assembly circuitry  17  within each assembly  306 . The circuitry  17  may be similar to that disclosed for the first and second embodiments and schematically illustrated by FIGS. 4 and 4A. 
     In operation, transducers within transducer assemblies  306  are excited for a pre-determined period of time to impinge ultrasonic waves to the pain receptors in the injured part of the body as shown by FIG.  10 . 
     A fourth embodiment of the portable ultrasonic treatment apparatus of the present invention which is primarily suitable for the treatment of RSD is illustrated by FIGS. 11-13. In this embodiment, the apparatus  400  includes at least one ultrasonic transducer assembly  402  positioned on a conductive strip  404 . The strip  404  is secured to a placement band  405  which is fitted against the injured part of the patient&#39;s body  406 . The conductive strip  404  is connected via a cable  408  to a MOU  410  which contains circuitry for exciting ultrasonic transducer assembly  402  affixed to the conductive strip  404 . The conductive strip  404  is preferably constructed from suitable conductive plastics such as conductive ABS plastics with either carbon, stainless steel, nickel or aluminum fibers to forego the use of wires for electrically connecting more than one ultrasonic transducer to the conductive strip  404 . 
     In operation, the transducer assembly  402  is excited to impinge ultrasonic waves to the pain receptors in the injured part of the body as shown by FIG.  13 . It is contemplated that during treatment a gel-like substance is positioned between the transducer assembly  402  and the patient&#39;s body to prevent attenuation of the ultrasonic waves. 
     A fifth embodiment of the portable ultrasonic treatment apparatus of the present invention which is primarily suitable for the treatment of RSD is illustrated by FIGS. 14 and 15. In this embodiment, the apparatus  500  includes at least one ultrasonic transducer assembly  502  positioned on an inner surface of a first support  504  and a second support  506  having straps  507  for strapping the supports  504 ,  506  to an appendage, such as an arm. A gel-lined tubular muff  508  is also included for being worn by the patient prior to strapping the two supports  504 ,  506  as shown by FIG.  15 . The at least one ultrasonic transducer assembly  502  is connected via a cable  510  to a MOU  512  which contains circuitry for exciting ultrasonic transducer assembly  502 . 
     In operation, the transducer assembly  502  is excited to impinge ultrasonic waves to the pain receptors in the injured part of the body. The gel-lined surface of the tubular muff  508  prevents the attenuation of the ultrasonic waves. 
     A sixth embodiment of the portable ultrasonic treatment apparatus of the present invention which is primarily suitable for the treatment of RSD is illustrated by FIGS. 16 and 17. In this embodiment, the apparatus  550  includes at least one ultrasonic transducer assembly  552  positioned on an inner surface of an outer support layer  554 . The outer support layer  554  wraps around a gel-lined tubular muff  556  and is affixed thereto by an elongated strap  558 . The gel-lined tubular muff  556  is worn by the patient prior to strapping the outer support layer  554  to securely tighten the support layer  554  over the muff  556 , as shown by FIG.  17 . The at least one ultrasonic transducer assembly  552  is connected via a cable  560  to a MOU  562  which contains circuitry for exciting ultrasonic transducer assembly  552 . 
     In operation, the transducer assembly  552  is excited to impinge ultrasonic waves to the pain receptors in the injured part of the body. The gel-lined surface of the tubular muff  556  prevents the attenuation of the ultrasonic waves. 
     A seventh embodiment of the portable ultrasonic treatment apparatus of the present invention which is primarily suitable for the treatment of RSD is illustrated by FIGS. 18-20. In this embodiment, the apparatus  600  includes at least one ultrasonic transducer assembly  602  positioned on an inner surface of a cylindrical support  604  having a closed end  606  and an open end  608 . A bag  610  lines the inner perimeter of the support  604  and is filled with gel  612 . The at least one ultrasonic transducer assembly  602  is connected via a cable  614  to a MOU  616  which contains circuitry for exciting ultrasonic transducer assembly  602 . 
     In operation, the patient places their hand within the cylindrical support  604 , as shown by FIG. 19, and activates the MOU  616  to excite transducer assembly  602  to impinge ultrasonic waves to the pain receptors in the injured part of the body, as shown by FIG.  20 . The gel  612  within the bag  610  prevents the attenuation of the ultrasonic waves. 
     An eighth embodiment of the portable ultrasonic treatment apparatus of the present invention which is primarily suitable for the treatment of RSD is illustrated by FIGS. 21 and 22. In this embodiment, the apparatus  700  includes at least one ultrasonic transducer assembly  702  positioned on an inner surface of a foot-shaped support  704  having a closed end  706  and an open end  708 . A bag  710  lines the inner perimeter of the support  704  and is filled with gel  712 . The at least one ultrasonic transducer assembly  702  is connected via a cable  714  to a MOU  716  which contains circuitry for exciting ultrasonic transducer assembly  702 . 
     In operation, the patient places their foot within the foot-shaped support  704  and activates the MOU  716  to excite transducer assembly  702  to impinge ultrasonic waves to the pain receptors in the injured part of the body, as shown by FIG.  22 . The gel  712  within the bag  710  prevents the attenuation of the ultrasonic waves. 
     A ninth embodiment of the portable ultrasonic treatment apparatus of the present invention which is primarily suitable for the treatment of RSD is illustrated by FIGS. 23 and 24. In this embodiment, the apparatus  800  includes at least one ultrasonic transducer assembly  802  positioned on an inner surface of a circular-disc support or basin  804 . A ring-shaped bag  806  filled with a gel is dimensioned to rest on top of the support  804 . The at least one ultrasonic transducer assembly  802  is connected via a cable  808  to a MOU  810  which contains circuitry for exciting ultrasonic transducer assembly  802 . 
     In operation, the patient sits on the ring-shaped bag  806  and activates the MOU  810  to excite transducer assembly  802  to impinge ultrasonic waves to the pain receptors in the injured part of the body, as shown by FIG.  24 . The bag  806  provides comfort to the patient and the gel within the bag  806  prevents the attenuation of the ultrasonic waves. 
     A tenth embodiment of the ultrasonic treatment apparatus of the present invention which is primarily suitable for the treatment of RSD is illustrated by FIG.  25 . In this embodiment, the apparatus  900  includes a plurality of ultrasonic transducer assemblies  902  positioned along the perimeter of a treatment basin  904 . The treatment basin  904  is filled with a liquid, preferably water, to prevent the attenuation of the ultrasonic waves emitted by the plurality of ultrasonic transducer assemblies  902  during treatment. The ultrasonic transducer assemblies  902  are connected via wires  906  to an operating unit  908  which contains circuitry for exciting the ultrasonic transducer assemblies  902 . 
     In operation, the patient places the injured part of the body within the treatment basin  904 , as shown by FIG.  25 . The transducer assemblies  902  are then excited to impinge ultrasonic waves to the pain receptors in the injured part of the body. A sensor may also be used for sensing stimulation of the pain receptors before the ultrasonic transducer assemblies  902  are excited. 
     It will be understood that various modifications can be made to the various embodiments of the present invention herein disclosed without departing from its spirit and scope. For example, various shapes of the pouch and signal generator are contemplated, as well as various types of construction materials. Also, various modifications may be made in the structural configuration of the placement module and the configuration of the components used to excite the ultrasonic transducer. For example, a sensor may be used with all the embodiments described herein for sensing the stimulation of the pain receptors. Therefore, the above description should not be construed as limiting the invention but merely as presenting preferred embodiments of the invention. Those skilled in the art will envision other modifications within the scope and spirit of the present invention as defined by the claims presented below.