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.
https://ssihi.uci.edu/tip/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.
https://ssihi.uci.edu/tip/pulsed-electromagnetic-field-therapy-a-non-drug-option-for-pain/
