What do the professional say about PEMF helping pain?

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Pulsed Electromagnetic Field Therapy:

A Non-Drug Option for Pain

By Kim Hecht, DO

Interim Medical Director – Susan Samueli

Integrative Health Institute

UCI Susan and Henry Samueli College of Health Sciences

Common over the counter medications used for pain relief, such as ibuprofen (e.g. Advil, Motrin) and acetaminophen (e.g. Tylenol) have potential health risks when used long-term or used inappropriately.  Overuse of ibuprofen or NSAIDS increase the risk of stomach ulcers and kidney problems.

Inappropriate use of acetaminophen increases the risk of liver dysfunction.  In general, the risks of addiction and respiratory depression are associated with chronic opioid use.  Considering these risks seeking complementary pain relief is wise to consider.

One complementary method to reduce pain is pulsed electromagnetic field, or PEMF.  PEMF devices offer a nondrug approach to pain management and a potential decrease of medication use and dependency. There are many pulsed electromagnetic field devices on the market.  The devices vary depending on the magnetic field intensity, waveform, and frequency. A great amount of research has been performed using PEMF for different aspects of healing in animal models, as well as clinical treatment of non-healing fractures, tendon tears, chronic ulcers, post-surgical pain, and acute or chronic pain. Unfortunately, there is no strong consensus on specific intensities, frequencies, or waveforms for particular conditions. It has been difficult to establish an agreement because different magnetic fields applied for different medical issues can cause different results (Markov, 2015).

Despite the challenges of research, there are multiple possible benefits of a therapeutic magnetic field application to healing the body (Jerabek and Pawluk, 1996).  Studies have shown a decrease in:

  • Pain,

  • Swelling

  • Inflammation

Magnetic field application studies have also shown to improve:

  • Circulation

  • Cellular metabolism

  • Energy

Proposed mechanisms of PEMF therapy include activation of voltage-gated calcium channels to increase intracellular calcium and nitric oxide release (Pilla, 2015). Nitric oxide promotes blood vessel production and growth, which is helpful in healing injured tissues (Pilla, 2015).

PEMF has been examined in many painful conditions including: acute injury, arthritis and nerve issues. Researchers found improved healing of soft tissue injuries by decreasing swelling and healing hematoma, while low frequency PEMFs improved edema during treatment and high frequency PEMF improved edema up to several hours after the treatment session (Markov and Pilla, 1995).

In the different conditions investigated:

  • Individuals with neck pain as a consequence of acute whiplash had significant improvement of pain compared to controls when treated with high frequency PEMF at 27.12 MHz (Foley-Nolen et al., 1992).

  • Patients with low back arthritis had improvement of pain for approximately 90-95% of the time with PEMF of 35-40 mT applied (Mitbreit et al., 1996).

  • A research team investigated 83 patients with knee osteoarthritis (OA). Participants were given treatment for 2 hours a day, 5 days/week for 6 weeks.  The study found significantly improved pain, stiffness, and function in the PEMF group (Thamsborg, 2005). There was no improvement in function for the control group at 2 weeks, and only mild improvement at 6 and 12 weeks. Unfortunately, there was no difference between the PEMF group vs. the control group with respect to pain, stiffness or function as the control group also had significant reduction of pain and stiffness.  While function did not improve in participants over 65 in PEMF group, when investigators only examined the patients under the age of 65, there was significant reduction in stiffness between the two groups.

  • In another study on knee OA, a different device utilizing a sinusoidal signal at 6.8MHs in 34 patients with early knee OA found 60% reduction in pain in the first 5 days. These findings continued for 42 days during use of the device compared to no significant change in the sham (nonactive device) group (Nelson et al,. 2013).

  • Other studies for diabetic peripheral neuropathy have shown equivocal results. Two randomized controlled studies did not find significant improvements of pain with PEMF therapy (Wrobel et al., 2008; Weintraub et al., 2009), while 2 studies did find significant improvement in pain in the PEMF group Cieslar et al., 1995; Graak et al., 2009).

As demonstrated by this brief review, all of the studies discussed employed different frequencies, waveforms and strength, which is not helpful in making a uniform recommendation for patients but is helpful to consider as a nondrug option for pain relief and healing as some patients report significant improvements.

 

References:

Cieslar G, Sieron A, Radelli J. (1995) The estimation of therapeutic effect of variable magnetic fields in patients with diabetic neuropathy including vibratory sensibility. Balneol Pol 37(1): 23–27.

Foley-Nolan D, Moore K, Codd M et al. (1992) Low energy high frequency pulsed electromagnetic therapy for acute whiplash injuries. A double blind randomized controlled study. Scand J Rehabil Med 24(1): 51–59.

Graak V, Chaudhary S, Bal BS et al. (April 2009) Evaluation of the efficacy of pulsed electromagnetic field in the management of patients with diabetic polyneuropathy. Int J Diabetes Dev Ctries 29(2): 56–61.

Jerabek J, Pawluck W. Magnetic Therapy in Eastern Europe: A Review of 30 years of Research. Chicago, IL: Advanced Magnetic Research of the Delaware Valley, 1996.

Markov, M ed. (2015) Electromagnetic field in Biology and Medicine. CRC Press Taylor and Francis Group Boca Rotan, Fl.

Markov MS, Pilla AA. (1995) Electromagnetic field stimulation of soft tissue: Pulsed radiofrequency treatment of post-operative pain and edema. Wounds 7(4): 143–151.

Mitbreit IM, Savchenko AG, Volkova LP et al. (1986) Low-frequency magnetic field in the complex treatment of patients with lumbar osteochondrosis. Ortop Travmatol Protez (10): 24–27.

Nelson FR, Zvirbulis R, Pilla AA. (August 2013) Non-invasive electromagnetic field therapy produces rapid and substantial pain reduction in early knee osteoarthritis: A randomized double-blind pilot study. Rheumatol Int 33(8): 2169–2173.

Pilla A.  (2015) “Pulsed Electromagnetic Fields: From Signalling to Healing” in Electromagnetic field in Biology and Medicine. Markov, M ed. CRC Press Taylor and Francis Group Boca Rotan, Fl.

Thamsborg G, Florescu A, Oturai P et al. (July 2005) Treatment of knee osteoarthritis with pulsed elec- tromagnetic fields: A randomized, double-blind, placebo-controlled study. Osteoarthr Cartil 13(7): 575–581.

Weintraub MI, Herrmann DN, Smith AG et al. (July 2009) Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: A randomized controlled trial. Arch Phys Med Rehabil 90(7): 1102–1109.

Wróbel MP, Szymborska-Kajanek A, Wystrychowski G et al. (September 2008) Impact of low frequency pulsed magnetic fields on pain intensity, quality of life and sleep disturbances in patients with painful diabetic polyneuropathy. Diabetes Metab 34(4 Pt 1): 349–354.

Check out these studies from the National Institute of Health about how PEMF has helped with pain.

1st study:

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018371/​

Background/aim

In this study, it was aimed to investigate the effects of pulsed electromagnetic field(PEMF) therapy on pain, disability, psychological state, and quality of life in cervical disc herniation.

Materials and methods

Patients were randomly divided into two groups, including Group 1, which received a therapy consisting of transcutaneous electrical nerve stimulation (TENS), hot pack (HP), and PEMF, and Group 2, which received a magnetic field (sham magnetic field) without current flow in addition to TENS and HP therapy. Pain was assessed by a visual analog scale (VAS, 0–10 cm). The other outcome measures were function (Neck Pain and Disability Scale), anxiety-depressive mood (Hospital Anxiety and Depression Scale), and quality of life (Nottingham Health Profile). All evaluations were performed at baseline, in the 3rd week, and in the 12th week after treatment.

Results

A significant improvement was found in the neck pain, disability, depression, anxiety, and quality of life scores of both groups after treatment when compared to those before treatment. However, in the comparison between changes within groups, significant improvements were determined only in the VAS and Nottingham Health Profile sleep subparameter in the 12th week after treatment compared to those before treatment.

Conclusion

PEMF therapy in cervical disc herniation can be used safely in routine treatment in addition to conventional physical therapy modalities.

2nd Study: 

Source: https://pubmed.ncbi.nlm.nih.gov/32251502/

Abstract

Objective: Pulsed electromagnetic field (PEMF) therapy is a potentially useful treatment for osteoarthritis (OA), but its effectiveness is still controversial. This study aimed to examine the effects of PEMF therapy and PEMF parameters on symptoms and quality of life (QOL) in patients with OA.

Methods: Cochrane Central Register of Controlled Trials, PubMed, CINAHL, EMBASE, PEDro, clinical trial registers, and reference lists were searched until April 2019. This study examined randomized, placebo-controlled trials, patients with OA, symptom and/or QOL related outcomes, and articles published in English. Two authors extracted data and completed quality assessment.

Results: Sixteen studies were included in our systematic review, while 15 studies with complete data were included in the meta-analysis. Our primary outcome was the standardized mean difference, which was equal to the treatment effect in the PEMF group minus the treatment effect in the placebo group divided by the pooled standard deviation. For pain, the standardized mean difference was 1.06 (95% CI = 0.61 to 1.51), for stiffness 0.37 (95% CI = 0.07 to 0.67), for function 0.46 (95% CI = 0.14 to 0.78), and for QOL 1.49 (95% CI = -0.06 to 3.04). PEMF parameters did not influence symptoms.

Conclusions: Compared with placebo, there was a beneficial effect of PEMF therapy on pain, stiffness, and physical function in patients with OA. Duration of treatment may not be a critical factor in pain management. Further studies are required to confirm the effects of PEMF therapy on QOL.

Impact: Our study suggests that PEMF therapy has clinically significant effects on pain in patients with OA. The current evidence was limited to the short-term effects of PEMF therapy.