Effect of pulsed electromagnetic field on pain, functionality and quality of life in the treatment of chronic non-specific low back pain: a randomized controlled trial
DOI:
https://doi.org/10.18203/2320-6012.ijrms20232851Keywords:
Pulsed electromagnetic field, Chronic low back pain, DisabilityAbstract
Background: Pulsed electromagnetic field therapy is a new device and its efficiency on pain treatment needs to be clarified. Our aim is to investigate the effects of PEMF therapy in combination with conventional physical therapy modalities in patients with chronic non-specific low back pain.
Methods: Prospective, randomized, patient-blinded, controlled trial with twenty-nine subjects having chronic nonspecific LBP were randomized into experimental and control groups.
The experimental group received PEMF in addition to conventional physical therapy, whereas the control group received a sham electromagnetic field with conventional physical therapy for ten sessions over a four-week period. Pain intensity, functional disability and lumbar range of motion measures were collected.
Results: Twenty-seven participants with chronic non-specific LBP completed the study (Experimental group N=13, control group N=14). There were significant within-subject effects and treatment*time effects for pain intensity, ODI, and lumbar ROM results. The change in pain intensity (p=0.004), ODI (p=0.012) and lumbar ROM (p<0.001) were significantly higher in the PEMF group compared to the control group.
Conclusions: Compared to conventional physical therapy, combining PEMF therapy with conventional physical therapy provides greater clinical improvement in terms of pain intensity, functional disability and lumbar ROM in subjects with non-specific LBP.
References
Deyo RA, Tsui-Wu Y-J. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987;12:264-8.
Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet. 2012;379:482-91.
Schofield DJ, Shrestha RN, Passey ME, Earnest A, Fletcher SL. Chronic disease and labour force participation among older Australians. Med J Australia. 2008;189:447-50.
van Tulder M, Becker A, Bekkering T. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2006; 15(2):S169-91.
Amirdelfan K, McRoberts P, Deer TR. The differential diagnosis of low back pain: a primer on the evolving paradigm. Neuromodulation: Technol Neural Interface. 2014;17:11-7.
Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389:736-47.
van Tulder M, Hayden J, van Tulder M, Malmivaara A, Koes B. Exercise therapy for treatment of non-specific low back pain. Cochrane Database System Rev. 2005;20:CD000335.
Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low‐back pain. Cochrane Database System Rev. 2011.
Funk RH. Coupling of pulsed electromagnetic fields (PEMF) therapy to molecular grounds of the cell. Am J Translat Res. 2018;10:1260-72.
Wang T, Yang L, Jiang J, Liu Y, Fan Z, Zhong C. Pulsed electromagnetic fields: promising treatment for osteoporosis. Osteopor Int. 2019;30:267-76.
Hazlewood C, Markov M, Kostarakis P. Magnetic fields for relief of myofascial and/or low back pain through trigger points. Proceed Int Workshop Biol Effects Electromagnet Field. 2006;3:475-83.
Markov MS. Pulsed electromagnetic field therapy history, state of the art and future. Environmentalist. 2007;27:465-75.
Fini M, Giavaresi G, Carpi A, Nicolini A, Setti S, Giardino DR. Effects of pulsed electromagnetic fields on articular hyaline cartilage: review of experimental and clinical studies. Biomed Pharmacother. 2005;59:388-94.
Andrade R, Duarte H, Pereira R, Lopes I, Pereira H, Rocha R, et al. Pulsed electromagnetic field therapy effectiveness in low back pain: A systematic review of randomized controlled trials. Porto Biomed J. 2016;1:156-63.
Zarkovic D, Kazalakova K Repetitive peripheral magnetic stimulation as pain management solutıon ın musculoskeletal and neurological disorders - a pilot study. Int J Physiother. 2016;6:671-5.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine. 2000;25:2940-52.
Verma Y, Goyal M, Narkeesh D. Pain, range of motion and back strength in chronic mechanical low back pain before & after lumbar mobilisation. Int J Physioth Res. 2013;3:48-57.
Saidu IA, Maduagwu SM, Abbas AD, Adetunji OO, Jajere AM. Lumbar spinal mobility changes among adults with advancing age. J Midlife Health. 2011;2(2):65-71.
Harden RN, Remble T, Houle T, Long J, Markov M, Gallizzi M. Prospective, randomized, single‐blind, sham treatment‐controlled study of the safety and efficacy of an electromagnetic field device for the treatment of chronic low back pain: A Pilot Study. Pain Pract. 2007;7:248-55.
Park W, Sun S, Lee S, Kang B, Lee J, Hwang D. Effect of Pulsed Electromagnetic Field Treatment on Alleviation of Lumbar Myalgia: A Single Center, Randomized, Double-blind, Sham-controlled Pilot Trial Study. J Magnet. 2014;19:161-9.
Lee PB, Kim YC, Lim YJ, Lee C, Choi SS, Park SH, et al. Efficacy of pulsed electromagnetic therapy for chronic lower back pain: a randomized, double-blind, placebo-controlled study. J Int Med Res. 2006;34:160-7.
Omar AS, Awadalla MA, El-Latif MA. Evaluation of pulsed electromagnetic field therapy in the management of patients with discogenic lumbar radiculopathy. Int J Rheumat Dis. 2012;15:e101-8.
Krammer A, Horton S ,Tumilty S. Pulsed electromagnetic energy as an adjunct to physiotherapy for the treatment of acute low back pain: a randomised controlled trial. New Zealand J Physiother. 2015;43:16.
Harden RN, Remble TA, Houle TT, Long JF, Markov MS, Gallizzi MA. Prospective, randomized, single-blind, sham treatment-controlled study of the safety and efficacy of an electromagnetic field device for the treatment of chronic low back pain: a pilot study. Pain Pract. 2007;7:248-55.
Lee PB, Kim YC, Lim YJ, Lee CJ, Choi SS, Park SH, et al. Efficacy of pulsed electromagnetic therapy for chronic lower back pain: a randomized, double-blind, placebo-controlled study. J Int Med Res. 2006;34:160-7.
Elshiwi AM, Hamada HA, Mosaad D, Ragab IMA, Koura GM, Alrawaili SM. Effect of pulsed electromagnetic field on nonspecific low back pain patients: a randomized controlled trial. Braz J Physical Ther. 2019;23:244-9.
Trock DH, Bollet AJ, Markoll R. The effect of pulsed electromagnetic fields in the treatment of osteoarthritis of the knee and cervical spine, Report of randomized, double blind, placebo controlled trials. Int J Rheumat Dis. 1994.
Vallbona C, Richards T. Evolution of magnetic therapy from alternative to traditional medicine. Physical Med Rehab Clin. 1999;10:729-54.
Pilla A, Muehsam D, Markov M. A dynamical systems/Larmor precession model for weak magnetic field bioeffects: Ion binding and orientation of bound water molecules. Bioelectrochem Bioenerget. 1997;43:239-49.
