Effects of Pulsed Electromagnetic Fields (PEMFs) on Stress – By William Pawluk, MD, MSc

Pain Management with Pulsed Electromagnetic Field (PEMF) Treatment© William Pawluk M.D., MSc

The very presence of life means that stress is also present. The recognition of and the reaction to stressors is fundamental to physical and emotional existence. Our reactions to stressors are either healthy, that is, adaptive, or unhealthy, that is, maladaptive. Maladaptive reactions to stress create physical and psychological damage, if either too large to withstand or too frequent to recover from. An example of an adaptive physiologic response is perspiring when the body temperature increases. This response becomes maladaptive, or harmful, when the body is not able to perspire or if the stress continues too long and bodily fluids are not replenished. Stressors may also be psychological or mental. Again, the reaction may be helpful or harmful. For most of us, the use of the term «stress» refers most often to the negative psychological or physiological responses to life’s stimuli.

The original human need for a stress response was adaptive, called the «fight or flight» response. Typically, this response allowed us to engage a threat, such as an attacking animal. In modern Western society, the most common daily stressors are minor psychological events, such as an angry client on the telephone or the tension of driving in heavy traffic. Even these seemingly minor occurrences produce a low-level «fight or flight» reaction in the body. The cumulative or chronic occurrence of these mild stressors may not allow adequate or full recovery and results in many of modern society’s health problems.

The stress response causes the brain to release chemicals that stimulate the nervous system. Adrenalin is pumped into the bloodstream along with extra sugar and fat, from body stores, for energy to fuel muscles. Mental activity is focused; some organs slow their activity, while others are accelerated. The muscles tense up, the breathing rate increases, there may be tightness in the chest and queasiness in the stomach. In a high stress state, most of these reactions will be present. In a lower stress state only one or several may be present and in varying degrees.

Many believe that a healthy human body could be able to live as long as 120 years before organs gradually slow down and stop. Stress accelerates the decline by actually damaging some organs and accelerating the wear and tear on others. Stress may accelerate aging and cause heart disease, atherosclerosis, diabetes, arthritis, fatigue, immune problems, adjustment disorders and anxiety and depression, and many other problems, including cancer. Close to 70-80% of the problems seen by doctors are most likely caused by stress.

Some of the physiologic reactions to stress are: muscle tension, rapid heartbeat, sweaty palms, diarrhea or constipation, increased gastric acid, high blood pressure, increased adrenal hormones, exaggerated mental alertness, increased blood sugar, increased blood lipids, dry mouth, increased insulin, increased thyroid hormone and immune changes.

The physical problems that can result from stress are: insomnia, nervous irritability, headaches, atherosclerosis, hypertension, irritable bowel, gastritis, arrhythmias, panic attacks, anxiety, depression, fatigue, substance abuse, immune deficiencies, asthma, skin problems, allergies, muscle spasms, neuralgias, vision changes, hyperventilation, dehydration, sudden cardiac death, vasospasm, increased cholesterol, increased platelets, decreased oxygen, appetite problems, accelerated auto immune problems increased actually, miscarriages decreased libido, impotence, menstrual changes, disturbed memory, among others.

Clearly not all of these problems happen to everybody under stress. They happen to varying degrees depending on genetics, life and environmental experiences and the level and duration of the stress. Most of us throughout our lifetimes will develop at least some of the above problems.

Once a stress reaction is initiated it is difficult to turn off immediately. The reaction is immediate but the recovery takes hours to days. Since the effects of stress are cumulative, a daily routine of reducing the physiologic response becomes necessary to ward off long-term damage. Many approaches are used to reduce the effects of stress, including relaxation, meditation, yoga and stress avoidance. A new, simple, easily useable approach to reducing the physical response to the effects of daily stress is whole body, pulsed electromagnetic field (PEMF) therapy.

The body is very sensitive to magnetic fields (MFs). The Earth is a large magnet. We are also bombarded by electromagnetic activity from outside the planet. Physiologic changes are seen during solar storms in healthy humans, in patients with cardiovascular diseases and in cosmonauts in SOYUZ spacecraft and the MIR space station. They had nonspecific adaptive stress reactions, with increased cortisol secretion, activation of the sympathoadrenal system (SAS) and suppressed melatonin.

There is much experimental evidence that almost all biological systems are highly sensitive to weak PEMFs, with a wide range of biologic effects. Research, on humans and animals, has shown that PEMFs alter stress responses by action directly on the nervous system, glands, cells, tissues and organs.

The SAS is activated by stress. PEMFs inhibit activation of the SAS and prevent decreases in nonspecific stress resistance. Through PEMFs, the plasma catecholamines, adrenalin and noradrenalin, chemical messengers associated with increased sympathetic nervous system arousal, decrease. PEMFs do this by acting on the hypothalamus and increasing urine excretion of adrenalin. Generally, the excitability of the nervous system also decreases and emotional reactions accompanying stress are corrected. Long-term use of weak PEMFs may be able to help the body remodel tissues that tend to be hyper-reactive to chronic or acute stress so that over time they will become less and less reactive.

Environmental stressors, such as heat or sunlight, affect cellular homeostasis. Thermal stressors and electromagnetic fields (EMFs) interact to induce intracellular heat stress proteins (HSP), protective proteins in the cell. PEMFs can be used preventively prior to anticipated heat, toxicity or surgical injury to prevent cellular harm and thus increase cellular stress resistance and reduce damaging cellular stress responses. This phenomenon could be exploited as a protective presurgical cardiovascular treatment. Other potential uses include protection against viral infections, autoimmune diseases, inflammatory diseases and to enhance the normal stress response in the elderly, by counteracting the normal loss of a healthy stress response during aging.

PEMFs not only activate metabolic processes in the immediate tissues exposed but also act indirectly through the endocrine system and control centers of the nervous system. For example, exposing the thyroid area produces a similar response with a lower field dose vs. the higher dose required by local area exposure, e.g., to the heart in ischemia. In experimental hepatitis, microwave PEMFs to the thyroid were more effective in restoring liver function than exposing the liver itself. Exposure of the adrenals in patients with rheumatoid arthritis activated the body’s own natural cortisone and made lymphocytes function normally. Again, controlled exposure to short-term, weak PEMFs increases the resistivity of the organism to other more severe stressors, including low temperatures, physical load, ischemic heart damage, ionizing radiation, etc.

Stress causes a very quick and significant decrease in white blood cell counts, creating a sudden state of immune vulnerability, such as may be caused by lack of sleep or travel. It also increases serum cortisol two to three-fold, a useful indicator of the level of stress. PEMFs increase host resistance by enhancing some immune functions. After exposure, neutrophils increase gradually and neutrophil metabolism and superoxide production are increased significantly. The cortisol level decreases.

Ascorbic acid (AA) is key to the antioxidant, neuroendocrine and immune mechanisms of stress adaptation (34). PEMFs cause ascorbic acid and serotonin to increase nearly two-fold by the 30th day of exposure. By the 90th day, ascorbic acid concentration returns to the initial (pre-exposure) value, while serotonin still remains significantly increased. This indicates that PEMFs may be useful in acute stress situations as well, by enhancing ascorbic acid function.

In athletes, PEMF therapy of the adrenal glands, thyroid gland or collarbone areas augments immune status and production of hormones, specifically, T-lymphocytes, testosterone and growth hormone and decreases circulating B-lymphocytes, cortisol and initially elevated levels of thyroid hormones. The athletes therefore have higher resistance to disease and higher work capacity.

In rabbits, emotional stress increases risk of sudden death. PEMFs increase resistance of the rabbits to stress. Death risk is lowered almost two-fold.

Pain is a major stressor. Pain inhibition has been consistently found by exposure to PEMFs in various species of animals, including: land snails, laboratory mice, deer mice, pigeons, as well as humans.

Heart rate variability (HRV) results from a complex interplay of neural and hormonal control mechanisms. Changes in HRV have been associated with increased risk of severe arrhythmia and sudden cardiac death in patients with recent myocardial infarction. Heart-rates (HR) are slowed. Some individuals may be more sensitive to or more consistent in having these PEMF-induced changes in HR and HRV. This effect appears to be due to changes to the cardiac pacemaker, the sino-atrial node, giving rise to a more normal beat-to-beat variability. Intermittent exposure daily is more effective than continuous exposure, e.g., overnight.

PEMFs and static magnetic fields (SMFs) act on carotid baroreceptors to reduce blood pressure by causing vasodilation and lowering heart rate. The stimulated baroreceptors reset sympathetic tone. The effects are thought to be due to changes in cell membrane calcium ion (Ca++) transport since they were abolished by verapamil, a potent Ca++ channel blocker. The effects may be of minimal clinical significance in healthy individuals but could be very significant in individuals with cardiovascular disease with abnormal HRV. In other words, strong SMFs had a parasympathetic or vagotonic action. Parasympathetic or vagotonic stimulation is stress reducing.

One group compared the effects of PEMFs and constant (static) magnetic fields on stress. Both weak PEMFs and SMFs (up to 100 gauss) were antitumorigenic, protective against toxic agents and X-ray radiation and produced rejuvenation effects in states of stress..

Soft tissue may also respond negatively to stress and high lipid levels. Stress and high lipid levels can lead to breakdown of elastin and collagen fibers of heart muscle and other tissues. PEMFs directed from the front to the back of the head reduce this tissue breakdown by inhibiting the enzyme that causes it and by anti-oxidant action.

PEMFs result in the several apparently related long-lasting effects, that reduce stress: an increase in blood volume, increase in tissue oxygen, increased pH (reduced acidity), increased depth of respiration, decreased heart rate and improved blood pressure. The magnitude of these effects in humans shows significant inter-individual variability. The benefits appear to be caused by lowered blood acidity, as indicated by measurements of lactic acid and pyruvic acid concentration, blood carbon dioxide levels and hydrogen ion (H+) concentration.

To summarize, mild chronic daily stress causes untold damage to humans. Research has shown that PEMFs produce a number of anti-stress changes in the body, both to ward off stress, that is, create stress resistance, and to decrease the hormonal, immune, neurologic, soft tissue, cardiac, vascular, low pH and low-oxygen damage caused by stress. From this perspective, very low-level PEMFs used regularly should be able to prevent or reverse many of the effects of stress that all of us experience daily. By William Pawluk, MD, MSc

Pain Management with Pulsed Electromagnetic Fields – by William Pawluk, M.D., MSc

The issue of pain treatment is an extremely urgent health and socio-economic problem. Pain, in acute, recurrent and chronic forms, is prevalent across age, cultural background, and sex, and costs North American adults an estimated $10,000 to $15,000 per person annually. Estimates of the cost of pain do not include the nearly 30,000 people that die in North America each year due to non-steroidal anti-inflammatory drug-induced gastric lesions. 17% of people over 15 years of age suffer from chronic pain that interferes with their normal daily activities. Studies suggest that at least 1 in 4 adults in North America is suffering from some form of pain at any given moment. This large population of people in pain relies heavily upon the medical community for the provision of pharmacological treatment. Many physicians are now referring chronic pain sufferers to non-drug based therapies, that is, «Complementary and Alternative Medicine,» in order to reduce drug dependencies, invasive procedures and/or side effects. The challenge is to find the least invasive, toxic, difficult and expensive approach possible.
The ability to relieve pain is very variable and unpredictable, depending on the source or location of pain and whether it is acute or chronic. Pain mechanisms are complex and have peripheral and central nervous system aspects. Therapies should be tailored to the specifics of the pain process in the individual patient. Psychological issues have a very strong influence on whether and how pain is experienced and whether it will become chronic. Most effective pain management strategies require multiple concurrent approaches, especially for chronic pain. It is rare that a single modality solves the problem.
Static or electromagnetic fields have been used for centuries to control pain and other biologic problems, but scientific evidence of their effect had not been gathered until recently. This review explores the value of magnetic therapy in rehabilitation medicine in terms of static magnetic fields and time varying magnetic fields (electromagnetic). A historical review is given and the discussion covers the areas of scientific criteria, modalities of magnetic therapy, mechanisms of the biologic effects of magnetic fields, and perspectives on the future of magnetic therapy.
In the past few years a new and fundamentally different approach has been increasingly investigated. This includes the use of magnetic fields (MF), produced by both static (permanent) and time-varied (most commonly, pulsed) magnetic fields (PEMFs). Fields of various strengths and frequencies have been evaluated. There is as yet no “gold standard”. The fields selected will vary based on experience, confidence, convenience and cost. Since there does not appear to be any major advantage to any one MF application, largely because of the unpredictability of ascertaining the true underlying source of the pain, regardless of the pathology, any approach may be used empirically and treatment adjusted based on the response. After thousands of patient-years of use globally, there very little risk has been found to be associated with MF therapies.
Magnetic fields affect pain perception in many different ways. These actions are both direct and indirect. Direct effects of magnetic fields are: neuron firing, calcium ion movement, membrane potentials, endorphin levels, nitric oxide, dopamine levels, acupuncture actions and nerve regeneration. Indirect benefits of magnetic fields on physiologic function are on: circulation, muscle, edema, tissue oxygen, inflammation, healing, prostaglandins, cellular metabolism and cell energy levels.
Most studies on pain use subjective measures to quantitate baseline and outcome values. Subjective perception of pain using a visual analogue scale (VAS) and pain drawings is 95% sensitive and 88% specific for current pain in the neck and shoulders and thoracic spine.
Measured pain intensity (PI) changes with pain relief and satisfaction with pain management. A 5%, 30%, and 57% reduction in PI correlated with «no,» «some/partial,» and «significant/complete» relief. If initial PI scores were moderate/severe pain (NDS > 5), PI had to be reduced by 35% and 84%, to achieve «some/partial» and «significant/complete» relief, respectively. Patients in less pain (NDS < or = 5) needed 25% and 29% reductions in PI. However, relief of pain appears to only partially contribute to overall satisfaction with pain management.
Several authors have reviewed the experience with PEMFs in Eastern Europe and the West. PEMFs have been used extensively in many conditions and medical disciplines. They have been most effective in treating rheumatic disorders. PEMFs produced significant reduction of pain, improvement of spinal functions and reduction of paravertebral spasms.
Since the turn of this century, a number of electrotherapeutic, magneto therapeutic and electromagnetic medical devices have emerged for treating a broad spectrum of trauma, tumors and infections with static and PEMFs. Their acceptance in clinical practice has been very slow in the medical community. Practitioner resistance seems largely based on confusion of the different modalities, the wide variety of frequencies employed (from ELF to microwave) and the general lack of understanding of the biomechanics involved. The current scientific literature indicates that short, periodic exposure to pulsed electromagnetic fields (PEMF) has emerged as the most effective form of electromagnetic therapy.
The ability of PEMFs to affect pain is dependent on the ability of PEMFs to positively affect human physiologic or anatomic systems. Research is showing that the human nervous system is strongly affected by therapeutic PEMFs.
One of the most reproducible results of weak, extremely low-frequency (ELF) magnetic field (MF) exposure is an effect upon neurologic pain signal processing. PEMFs have been designed for use as a therapeutic agent for the treatment of chronic pain in humans. Recent evidence suggests that PEMFs would also be an effective complement for treating patients suffering from acute pain. Static magnetic field devices with strong gradients have also been shown to have therapeutic potential. Specifically placed static magnets reduce neural action potentials and alleviate spinal mediated pain.
PEMFtherapy is accompanied by an increase in the threshold of pain sensitivity and activation of the anticoagulation system. PEMF treatment stimulates production of opioid peptides; activates mast cells and increases electric capacity of muscular fibers. Long bone fractures that did not unite over 4 months to 4 years are repaired in 87% of cases with daily PEMF treatment. . PEMF of 1.5- or 5-mT field strength, proved helpful edema and pain before or after a surgical operation.
PEMF for 15 minutes daily increases amino acid uptake about 45%. PEMF for 2 hour induces changes in transmembrane energy transport enzymes, allowing energy coupling and increased biologic chemical transport work.
The density of pigeons’ brain mu opiate receptors decreases by about 30% and therefore their pain perception. A 2 hr exposure of healthy humans was found to reduce pain perception and decreased pain-related brain signals. Biochemical changes were found in the blood of treated patients that supported the pain reduction benefit.
Normal standing balance is subject to control by the vestibular area of the brain. PEMF couple with muscular processing or upper body nervous tissue functions. 200-uT PEMFs cause a significant improvement in normal standing balance in adult (18-34 year old) humans. Further evidence of the sensitivity of the nervous system on MFs.
Various MFs with different characteristics reduce pain inhibition in various species of animals  as well as humans. 0.5 Hz rotating MF, 60 Hz ELF magnetic fields and even MRI reduces analgesia induced by both exogenous opiates (i.e. morphine) and endogenous opioids (i.e. stress-induced). Reduction in stress-induced analgesia can be obtained not only by exposing animals to a variety of different magnetic fields, but also after a short-term stay in a near-zero magnetic field. This suggests that even for magnetic field, as for other environmental factors (i.e. temperature or gravity), alterations in the normal conditions in which the species has evolved can induce alterations in physiology as well as in behavior.
The benefits of PEMF use may last considerably longer than the time of use. In rats, a single exposure produces pain reduction both immediately after treatment and at 24 hrs after treatment. The analgesic effect is still observed at 7th and 14th day of repeated treatment and even up to 14 days after the last treatment.
PEMFs promote healing of soft tissue injuries by reducing edema and increasing reabsorption of hematomas. Low frequency PEMFs reduce edema primarily during treatment sessions. PEMFs at very high frequencies (PRFs) for 20-30 minutes cause edema decreases lasting several hours. PRFs induce vasoconstriction at the injury site. They displace negatively charged plasma proteins found in traumatized tissue. This increases lymphatic flow, an additional factor in reducing edema.
In rats exposed for 20 min daily on 3 successive days to PEMFs of 50 mG, the pain threshold increased progressively over the 3 days. The pain threshold following the third magnetic field exposure was significantly greater than those associated with morphine and other treatments. Brain injured and normal rats both showed a 63% increase in mean pain. PEMFs may be very helpful in patients with closed head injuries. The mechanism probably involves the longer acting endorphins rather than encephalin.
Pain relief mechanisms vary by the type of stimulus used. For example, needling to the pain-producing muscle, application of a static magnetic field or external qigong or needling to an acupuncture point all reduce pain but by different mechanisms. Pain could be induced by reduction of circulation in muscle and reduced by recovery of circulation. Pain mediating substances are accumulated in a muscle under reduced circulation and reversed with restoration of circulation. This is why chronic muscle tension is a frequent cause of chronic pain. The effect of a static magnetic field or external qigong is mediated by enhanced release of acetylcholine as a result of activation of the cholinergic vasodilator nerve endings in a muscle artery. Needling an acupuncture point is probably induced by a somato-autonomic reflex through the brain, in the anterior hypothalamus.
In normal subjects, a magnetic stimulus over the cerebellum reduces the size of responses evoked by cortical stimulation. Suppression of motor cortical excitability is reduced or absent in patients with a lesion in the cerebellum or cerebellar nerve pathways. Magnetic stimulation over the cerebellum produces the same effect as electrical stimulation, even in ataxic patients and may be useful for the pain associated with muscle spasticity.
Clinical benefits
In diabetic neuropathy, PEMF treatment every day for about 12 minutes, improves pain, paresthesias and vibration sensation and increases muscular strength in 85% of patients compared to controls.
One author reported that, of treated patients followed for 2-60 months, better results happened in patients with post-herpetic pain and those simultaneously suffering from neck and low back pain.
Chronic pain is often accompanied with or results from decreased circulation or perfusion to the affected tissues, for example, cardiac angina or intermittent claudication. PEMFs have been shown to improve circulation. Skin infrared radiation increases due to immediate vasodilation with low frequency fields and increased cerebral blood perfusion in animals. Pain syndromes due to muscle tension and neuralgias improve.
The results of the treatment depend not only on the parameters of the fields but also on the individual sensitivity of the person. The most effective results in clinical use were found with extremely ultra low frequency PEMFs.
Back, neck and shoulder pain
Chronic low back pain affects approximately 15% of the United States (US) population during their lifetime, with 93 million lost work days and a cost of more than $5 billion per year. Lumbar arthritis is a very common cause of back pain. PEMFs, for 20 minutes daily for 20-25 days for back pain gives relief or elimination of pain, improves results from other rehabilitation and improves secondary neurologic symptoms. Continuous use over the treatment episode works best, in about 90-95% of the time.  Some patients remain pain free 6 months after treatment. Some return to jobs they had been unable to perform. Short term effects are thought due to decrease in cortisol and noradrenaline and an increase serotonin, endorphins and enkephalins. Longer term effects may be due to CNS and/or peripheral nervous system biochemical and neuronal effects in which correction of pain messages occurs and the pain is not just masked as in the case of medication. Back pain or whiplash syndrome treated PEMF twice a day for two weeks along with usual pain medications relieves pain in 8 days vs. 12 days in the controls. Headache is halved in the PEMF group and neck and shoulder/arm pain improved by one third versus just medications alone.  This has been effective for herniated lumbar discs, spondylosis, radiculopathy, sciatica and arthritis. Pain relief is sometimes experienced as early as 10 minutes or in some cases takes as long as 14 days.
For neck pain, PEMFs may have more benefit, compared to physical therapy, for both pain and mobility.
Other pain applications
High frequency PEMF of 10-15 single treatments every other day either eliminates or improves, even at 2 weeks following therapy, 80% of patients with pelvic inflammatory disease, 89% with back pain, 40% with endometriosis, 80% with postoperative pain, and 83% with lower abdominal pain of unknown cause.
In dentistry, PEMFs have also been found useful in treating dental pain, jaw muscle spasms and swelling during wisdom tooth extraction with a high frequency system. As is often seen in pain studies, a placebo response is high, 30-40% of the time. In periodontal disease bone reabsorption may be severe enough to require bone grafting. Grafting is followed by moderate pain peaking several hours afterwards. Repeated PEMF exposure for two weeks eliminates pain within a week. Even single PEMF exposure produces much lower pain scores vs. controls.
Pelvic pain of gynecological origin was also found to be benefited by a different high voltage, high frequency system. This includes ruptured ovarian cysts, postoperative pelvic hematomas, chronic urinary tract infection, uterine fibrosis, dyspareunia, endometriosis and dysmenorrhea. Treatment times vary from 15 to 30 minutes on subsequent or alternate days. 90% of patients experience marked, rapid relief from pain with pain subsiding within 1-3 days. Most of these patients don’t require supplementary analgesics.
Patients suffering from headache treated with a PEMF after failing acupuncture and medications, applied  20 min/day for 15 days get effective relief of migraine, tension and cervical headaches at about one month after treatment. They have at least a 50% reduction in frequency or intensity of the headaches and reduction in analgesic drug use.
Orthopedic or musculoskeletal uses
The use of PEMFs is rapidly increasing and extending to soft tissue from its first applications to hard tissue. PEMF in current orthopedic clinical practice is used to treat delayed and non-union fractures, rotator cuff tendinitis, spinal fusions and avascular necrosis, all of which can be very painful. Clinically relevant response to the PEMF is generally not always immediate, requiring daily treatment for several months in the case of non-union fractures. Specific diagnoses were painful shoulder with abnormal supraspinatus tendon, tennis elbow, ulnar compression syndrome, carpal tunnel syndrome, semilunar bone injury, traumatic amputation neuroma of the median nerve, persistent muscle spasm of the upper and lower back, inner hamstring tendinitis, patellofemoral arthrosis, osteochondral lesion of the heel and posterior tibial tendinitis patients report pain intensity is 59% lower  Those with upper back muscle spasms, rotator cuff injury and osteochondral heel lesions showed more than 85% decrease in pain, even after a single  session. Pain relief persists for several days. None have worsening of their pain.
Post-traumatic Sudeck-Leriche syndrome (late stage reflex sympathetic dystrophy – RSD) is very painful pain and largely untreatable by other approaches. Ten 30-minute PEMF sessions  plus physiotherapy and medication reduced edema and pain at 10 days.
Even small,  PEMF devices with very weak field strengths have been benefit musculoskeletal disorders. Because of the low strength used treatment at the site of pain may need to last between 11 to 32 days, between 2 times per week, 4 hours each or, if needed, continuous use.  Pain scale scores are significantly better in the majority of cases. Conditions that can be considered are arthritis, lupus erythematosus, chronic neck pain, epicondylitis, femoropatellar degeneration, fracture of the lower leg and Sudeck’s atrophy.
Musculoskeletal ailments may be also be treated.  Diagnoses may include intervertebral disc prolapse, spinal stenosis and osteoporosis. Only 20 sessions of 8 minutes, twice daily for two weeks help. Pain and forward bending ability improve. Longer term use would be expected to give even greater benefit.
240 patients treated with PEMFs in a conservative orthopedic practice had decreased pain, increased functionality and increased point pressure thresholds, disappearance of swelling and pathological skin coloration, less need for orthopedic devices and less reaction to changes in the weather. Conditions treated are: rheumatic illnesses, delayed healing process in bones and pseudo-arthritis, including those with infections, fractures, aseptic necrosis, loosened protheses, venous and arterial circulation, reflex sympathetic dystrophy all stages, osteo-chondritis dissecans, osteomyelitis and sprains and strains and bruises. The success rate approaches 80%. Even X-rays may show improvement. cartilage/bone tissue may reform, including the joint margin. About 60% of loosened hip protheses have subjective relief of pain and walk better, without a cane.
Summary
PEMFs of various kinds and strengths have been found to have good results in a wide array of painful conditions. There is little risk when compared to the potential invasiveness of other therapies and the risk of toxicity, addiction and complications from medications. Clearly more research is needed to elaborate mechanisms and optimal treatment parameters. Many studies that have been reported here have been controlled trials and many have been double blind placebo. Medical practitioners are becoming gradually aware of the potential of PEMFs to successfully treat or significantly benefit the myriad of problems presented to them.
Dr. Pawluk is an Asssistant Professor at Johns Hopkins Medical School. He is a board certified family physician with training in acupuncture, nutritional/herbal medicine, homeopathy, hypnosis and body work. He has used magnetic therapies as part of his practice for over 10 years. He has published a book, Magnetic Therapy in Eastern Europe: a Review of 30 years of Research. He uses a holistic approach to treating the individual and applies the modality or modalities most likely to help, whether individually or combined.

Bone density changes in osteoporosis-prone women exposed to pulsed electromagnetic fields (PEMFs).

Tabrah F, Hoffmeier M, Gilbert F Jr, Batkin S, Bassett CA.

University of Hawaii School of Medicine, Straub Clinic and Hospital, Honolulu.

To determine the effect of a 72 Hz pulsating electromagnetic field (PEMF) on bone density of the radii of osteoporosis-prone women, the nondominant forearms of 20 subjects were exposed to PEMF 10 h daily for a period of 12 weeks. Bone density before, during, and after the exposure period was determined by use of a Norland-Cameron bone mineral analyzer. Bone mineral densities of the treated radii measured by single-photon densitometry increased significantly in the immediate area of the field during the exposure period and decreased during the following 36 weeks. A similar but weaker response occurred in the opposite arm, suggesting a «cross-talk» effect on the nontreated radii, from either possible arm proximity during sleep or very weak general field effects. The data suggest that properly applied PEMFs, if scaled for whole-body use, may have clinical application in the prevention and treatment of osteoporosis.

J Bone Miner Res. 1990 May;5(5):437-42.

Prevention of osteoporosis by pulsed electromagnetic fields.

Rubin CT, McLeod KJ, Lanyon LE.

Musculo-Skeletal Research Laboratory, Department of Orthopaedics, State University of New York, Stony Brook 11794.

Using an animal model, we examined the use of pulsed electromagnetic fields, induced at a physiological frequency and intensity, to prevent the osteoporosis that is concomitant with disuse. By protecting the left ulnae of turkeys from functional loading, we noted a loss of bone of 13.0 per cent compared with the intact contralateral control ulnae over an eight-week experimental period. Using a treatment regimen of one hour per day of pulsed electromagnetic fields, we observed an osteogenic dose-response to induced electrical power, with a maximum osteogenic effect between 0.01 and 0.04 tesla per second. Pulse power levels of more or less than these levels were less effective. The maximum osteogenic response was obtained by a decrease in the level of intracortical remodeling, inhibition of endosteal resorption, and stimulation of both periosteal and endosteal new-bone formation. These data suggest that short daily periods of exposure to appropriate electromagnetic fields can beneficially influence the behavior of the cell populations that are responsible for bone-remodeling, and that there is an effective window of induced electrical power in which bone mass can be controlled in the absence of mechanical loading.

J Bone Joint Surg Am. 1989 Mar;71(3):411-7.

Pulsed electromagnetic fields prevent osteoporosis in an ovariectomized female rat model: a prostaglandin E2-associated process.

Chang K, Chang WH.

Department of Biomedical Engineering, Chung-Yuan Christian University, Chung-Li, Taiwan, Republic of China.

With the use of Helmholtz coils and pulsed electromagnetic field (PEMF) stimulators to generate uniform time varying electromagnetic fields, the effects of extremely low frequency electromagnetic fields on osteoporosis and serum prostaglandin E(2) (PGE(2)) concentration were investigated in bilaterally ovariectomized rats. Thirty-five 3 month old female Sprague-Dawley rats were randomly divided into five different groups: intact (INT), ovariectomy (OVX), aspirin treated (ASP), PEMF stimulation (PEMF + OVX), and PEMF stimulation with aspirin (PEMF + ASP) groups. All rats were subjected to bilateral ovariectomy except those in INT group. Histomorphometric analyses showed that PEMF stimulation augmented and restored proximal tibial metaphyseal trabecular bone mass (increased hard tissue percentage, bone volume percentage, and trabecular number) and architecture (increased trabecular perimeter, trabecular thickness, and decreased trabecular separation) in both PEMF + OVX and PEMF + ASP. Trabecular bone mass of PEMF + OVX rats after PEMF stimulation for 30 days was restored to levels of age matched INT rats. PEMF exposure also attenuated the higher serum PGE(2) concentrations of OVX rats and restored it to levels of INT rats. These experiments demonstrated that extremely low intensity, low frequency, single pulse electromagnetic fields significantly suppressed the trabecular bone loss and restored the trabecular bone structure in bilateral ovariectomized rats. We, therefore, conclude that PEMF may be useful in the prevention of osteoporosis resulting from ovariectomy and that PGE(2) might relate to these preventive effects. Copyright 2003 Wiley-Liss, Inc.

Bioelectromagnetics. 2003 Apr;24(3):189-98.

Hip Problems
Electromagnetic fields on loosened hip prostheses. Results showed an increase of bone density in all patients receiving PEMF treatment compared to only 60 percent of controls. The authors argue such findings suggest PEMF elicits early bone reconstruction, which enhances early weight bearing.
Pulsed electromagnetic fields (50 Hz, 50 G) in treating aseptic loosening of total hip prostheses. PEMF therapy consisted of 20 minutes per day for 6 days per week over a total of 20 such sessions and was begun, on average, a year and a half following the start of loosening. Results showed PEMF to have some beneficial effects with respect to loosened hip arthroplasties, although it was not effective in patients suffering severe pain due to extreme loosening.

1. Gualtieri, et al., «The Effect Pulsed Electromagnetic Field Stimulation on Patients Treated of Hip Revesions with Trans-Femoral Approach,» Second World Congress for Electricity and Magnetism in Biology and Medicine, 8-13 June 1997, «Therapy with Pulsed Electromagnetic Fields in Aseptic Loosening of Total Hip Protheses: A Prospective Study,»

Joint Disease
3014 patients found pulsed magnetic field treatment at low frequencies and intensities to be a highly effective, side-effect-free therapy for joint disease. E. Riva Sanseverino, et al., «Therapeutic Effects of Pulsed Magnetic Fields on Joint Diseases,» Panminerva Med, 34(4), October-December 1992, p.187-196.

By Dr. D. C. Laycock, Ph.D. Med. Eng. MBES, MIPEM

By Dr. D. C. Laycock, Ph.D. Med. Eng. MBES, MIPEM

Pulsed Magnetic Field Therapy …… How does it work?

All living cells within the body possess potentials between the inner and outer membrane of the cell, which, under normal healthy circumstances, are fixed. Different cells, e.g. Muscle cells and Nerve cells, have different potentials of about -70 mV respectively. When cells are damaged, these potentials change such that the balance across the membrane changes, causing the attraction of positive sodium ions into the cell and negative trace elements and proteins out of the cell. The net result is that liquid is attracted into the interstitial area and swelling or edema ensues. The application of pulsed magnetic fields has, through research findings, been shown to help the body to restore normal potentials at an accelerated rate, thus aiding the healing of most wounds and reducing swelling faster. The most effective frequencies found by researchers so far, are very low frequency pulses of a 50Hz base. These, if gradually increased to 25 pulses per second for time periods of 600 seconds (10 minutes), condition the damaged tissue to aid the natural healing process.

PAIN REDUCTION is another area in which pulsed electromagnetic therapy has been shown to be very effective. Pain signals are transmitted along nerve cells to pre-synaptic terminals. At these terminals, channels in the cell alter due to a movement of ions. The membrane potential changes, causing the release of a chemical transmitter from a synaptic vesicle contained within the membrane. The pain signal is chemically transferred across the synaptic gap to chemical receptors on the post synaptic nerve cell. This all happens in about 1/2000th of a second, as the synaptic gap is only 20 to 50 n.-meter wide. As the pain signal, in chemical form, approaches the post synaptic cell, the membrane changes and the signal is transferred. If we look at the voltages across the synaptic membrane then, under no pain conditions, the level is about -70 mV. When the pain signal approaches, the membrane potential increases to approximately +30 mV, allowing a sodium flow. This in turn triggers the synaptic vesicle to release the chemical transmitter and so transfer the pain signal across the synaptic gap or cleft. After the transmission, the voltage reduces back to its normal quiescent level until the next pain signal arrives.

The application of pulsed magnetism to painful sites causes the membrane to be lowered to a hyper-polarization level of about -90 mV. When a pain signal is detected, the voltage must now be raised to a relatively higher level in order to fire the synaptic vesicles.

Since the average change of potential required to reach the trigger voltage of nearly +30 mV is +100 mV, the required change is too great and only +10 mV is attained. This voltage is generally too low to cause the synaptic vesicle to release the chemical transmitter and hence the pain signal is blocked. The most effective frequencies that have been observed from research in order to cause the above changes to membrane potentials, are a base frequency of 200Hz and pulse rate settings of between 5 and 25Hz.

Source: Lecture abstract of 28-01-1995, Dr. D. C. Laycock, Ph.D. Med. Eng. MBES, MIPEM, B.Ed. (Hons Phys. Sc.). Consultant Clinical Engineer, Westville Associates and Consultants (UK).