Pulsed Electromagnetic Field Therapy (PEMF)
PEMF
Many people have heard of pulsed electromagnetic therapy, pulse magnetotherapy, or PEMF. It has been used in orthopedic and physiatric medicine since 2004 for the treatment of congenital pseudoarthrosis (incomplete joint), poorly healing fractures or failed spine surgery fusions. More recently, it has been used by plastic surgeons due to its lack of known side effects for the adjunctive, noninvasive, nonpharmacologic management of postoperative pain and edema in poorly healing wounds and major reconstructive surgeries. It has also been heralded by Spinal Cord Injury physiatrists as contributing to the functional recovery of patients following spinal cord injury, potentially by improving localized inflammation, oxidative stress and shock-proteins related to such injuries. Moreover, an even more recent study investigating the effects of PEMF for peripheral neuropathic pain demonstrated over 80% of participants noting improvements in pain and other symptoms which translated to reductions in medications and wounds due to improvements in what is now understood to be its affects on circulation and nerve regeneration.
PEMF is an invisible and noninvasive therapy which is applied generally (via laying on a mat) or locally with a magnetic “wand” or set of rings which sets up a magnetic field with frequencies between 0.25 and 50 Hz around the sites requiring treatment. Although the mechanism of several of the healing properties of PEMF treatment is still not completely understood, it is still being offered to individuals across several clinical and research sites due to the evidence of its benefits and the fact that is has not demonstrated any adverse effects when provided to the appropriate individuals. The basis of these interventions is similar to ultrasound or TENS therapy, i.e., the infusion of energy into a system to reset pain receptors and facilitate healing and regeneration of structures. These treatments are given frequently, over several weeks, and requires a physician's prescription for use.
Research has confirmed that PEMF directly stimulates the “powerhouse” mitochondria within cells to induce capillary vessel formation and increase synthesis of protein. These two functions then work together to improve circulation, increase cell uptake of nutrients and removal of waste products, which then lead to improved nerve regeneration and reduction of inflammation (through increased nitric oxide and free-radical scavengers).
Today, clinicians are also seeing evidence of comparable pain relief for joint, neck and low back pain where surgery is not indicated. A robust review of retrospective research with neck and back pain with different etiologies (nonspecific LBP, chronic lower back pain, back pain, chronic mechanical neck pain, chronic postoperative pain following lumbar surgery, chronic nonspecific neck pain, cervical disc herniation, lumbar spinal stenosis, and lower back myofascial pain syndrome) over the last 10+ years was recently released which confirmed the positive effects of improved pain scores and function nearly 3 weeks earlier than without using PEMF - although the therapies had historically been trialed on patients under the age of 65 years of age (mean of 45 years) as insurance did not cover the ‘investigational device’.
The clinical applications of PEMF had also demonstrated improvements despite the various protocols used across the globe: from a total of 5 days to 13 weeks of treatment; and a treatment frequency of 5 times a day to twice a week. The 12 most scientifically rigorous studies compared PEMF applications to ‘sham treatments’, physical therapy modalities, exercise protocols, anti-inflammatory medications, and manual therapies.
PEMF For low back pain:
20 minutes daily 3x/week for 4 weeks in addition to several other noninvasive options showed significant improvements in pain and range of motion as compared to just using these other noninvasive options (37+ or -2 yrs of age)
15 minutes 3x/week for 4 weeks in addition to physical therapy significantly improved pain, function and range of motion (37+ or -3 yrs of age)
30 minutes - Q8-12 hours apart daily x 6 weeks, then daily 2-3x/week x 6 weeks (34+or -13 yrs age)
20 minutes daily for 3 weeks significantly reduced disc-related sciatica and weakness in addition to conservative treatment (37+ or - 9 yrs of age)
Mat PEMF 2 hours 2x/day for 5 to 9 days in addition to physical therapy significantly improved pain and function during acute or sub-acute low back pain episode (43+ or - 8 yrs of age)
Mat PEMF 20 minutes plus exercise daily for 6 weeks also improved stress and anxiety levels (41+ or - 10 yrs age participants)
20 minutes 5x/day for 3 weeks in addition to physical therapy showed improvements in pain, mood, disability but not in range of motion (44+ or - 8 yrs of age)
20 minutes 2-3x/week for 6 weeks plus physical therapy options demonstrated 40% improvement low back pain and 45% in leg pain in post-back surgery patients using 42 us pulse duration versus 26% and 25% in sham comparisons (56 + or - 14 yrs of age)
15 minutes daily plus lumbar flexion exercises for 2 weeks significantly improved pain, function and disability due to back or leg pain from spinal stenosis (62+ or - 8 yrs of age)
3x/week x 3 weeks versus only sham/placebo reduced pain and disability (75+ or - 5 yrs age)
PEMF For neck pain:
20 minutes 2x/week for 6 weeks (23+ or -3 yrs of age)
20 minutes 5x/day for 3 weeks in addition to physical therapy showed improvements in pain, mood, disability but not in range of motion (44+ or -8 yrs of age)
20 minutes plus fTENs and exercise program significantly improved pain and sleep versus sham plus fTENS and exercise (43+ or -10 yrs of age)
MICRO-PULSE ICES (THE NEWEST FORM OF PEMF)
North Shore Osteopathic is pleased to offer Micro-Pulse ICES (Inductively Coupled Electrical Stimulation) core technology, which is the newest most efficient form of PEMF used in basic research and clinical practice to increase stem cell growth and differentiation so as to improve inflammation and healing of tissues after severe injury to the spine, nerves, and musculoskeletal system.
Recently, other forms of electromagnetic therapy called transcranial magnetic stimulation (pulsedTMS or tPEMF) has been been FDA-approved for stroke recovery, chronic pain, PTSD, anxiety and depression. Micro-Pulse ICES is also used to address the same issues via low-dose continuous energy as the higher-energy pulsed TMS.