Pulsed Electromagnetic Fields (PEMF)

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Category: Allied Health Options

Injury Type: Acute

What is it?

An alternating or pulsed electromagnetic field passed through the tissue (i.e. muscle) between electrodes placed on or near the skin. It must be applied by a qualified professional using a machine based in their clinic.

How does it work?

Alternating or pulsed electromagnetic fields (PEMF) induce electric current within the tissue. Even though these currents are extremely small, there main therapeutic purpose is thought to enhance bone and/or tissue healing. Human tissue contains charged molecules that can respond to the charge of magnetic fields. It is thought that magnetic field passes through the skin into the underlying tissue (i.e. muscle) and may relax capillary walls, thereby boosting blood flow to the painful area. They can also help prevent the muscle spasms that underlie many forms of pain apparently by interfering with muscle contractions. Also, they may interfere with the electrochemical reactions that take place within nerve cells, impeding their ability to transmit pain messages to the brain.

Is it effective?

There is limited evidence from two studies on people with chronic neck pain or osteoarthritis that PEMF may reduce pain in the short term. Two additional studies have examined the effect of PEMF on people with whiplash. The first study (reported within a review) provided PEMF in conjunction with other treatments (iontophoresis, TENS and ultrasound) hence it was difficult to determine whether PEMF contributed to any of the observed effects. In this study, the comparison group receiving relaxation training, neck school, psychological and manual treatment had better improvement in pain, return to work and self-rated outcomes. The other study on whiplash patients found that PEMF combined with usual medication therapy was more beneficial for pain reduction and improved mobility than usual medication therapy on its own. A recent systematic review concluded that PEMF may be effective in the short term but not in the long term.

Are there any disadvantages?

There has been no research on the disadvantages associated with PEMF. It must be applied by a trained professional, therefore there may be considerable costs involved, especially if multiple treatments are required. The treatment may not be suitable for everyone.

Where do you get it?

PEMF may be provided by therapists (i.e. physiotherapist) involved in facilitating recovery from whiplash.

Recommendations

PEMF may be beneficial following whiplash; however more high quality research is required to substantiate current evidence.

Key References

  • Hurwitz, E, Carragee, E, Van der Velde, G, Carroll, L, Nordin, M, Guzman, J, Peloso, P, Holm, L, Coˆte, P, Hogg-Johnson, S, Cassidy, D & Haldeman, S 2008, 'Treatment of neck pain: noninvasive interventions; results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders', European Spine Journal, vol. 17, no. 1, pp. 123-152.
  • Kroeling, P, Gross, A, Goldsmith, CH, Cervical Overview Group, 'Electrotherapy for neck disorders', Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD004251. DOI: 10.1002/14651858.CD004251.pub3.
  • Thuile, C & Walzl, M 2002, 'Evaluation of electromagnetic fields in the treatment of pain in patients with lumbar radiculopathy or the whiplash syndrome', Neurorehabilitation, vol. 17, no. 1, pp. 63-7.
  • Verhagen, A, Scholten-Peeters, G, Van Wijngaarden, S, De Bie, R & Bierma-Zeinstra, S 2007, 'Conservative treatments for whiplash', Cochrane Database of Systematic Reviews, Issue 2, Art. No.: CD003338. DOI: 10.1002/14651858.CD003338.pub3.
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