Back Pain

Future Sci OA. 2016 Feb 11;2(1):FSO105. doi: 10.4155/fsoa-2015-0019. eCollection 2016.

Electromagnetic fields in the treatment of chronic lower back pain in patients with degenerative disc disease.

Arneja AS1, Kotowich A2, Staley D3, Summers R4, Tappia PS5.

Author information

  • 1Rehabilitation Hospital, Internal Medicine, Winnipeg, Manitoba, Canada; Rehabilitation Hospital, Internal Medicine, Winnipeg, Manitoba, Canada.
  • 2BioResonance Technology Inc., Winnipeg, Manitoba, Canada; BioResonance Technology Inc., Winnipeg, Manitoba, Canada.
  • 3St. Boniface Hospital Research, Office of Clinical Research, Winnipeg, Manitoba, Canada; St. Boniface Hospital Research, Office of Clinical Research, Winnipeg, Manitoba, Canada.
  • 4National Research Council, Institute for Biodiagnostics, Winnipeg, Manitoba, Canada; National Research Council, Institute for Biodiagnostics, Winnipeg, Manitoba, Canada.
  • 5St. Boniface Hospital Research, Asper Clinical Research Institute, CR3129-369 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada; St. Boniface Hospital Research, Asper Clinical Research Institute, CR3129-369 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada.

Abstract

AIM:

To examine the effects of low-amplitude, low frequency electromagnetic field therapy (EMF) therapy in patients with persistent chronic lower back pain associated with degenerative disc disease.

DESIGN:

Double-blind, randomized and placebo controlled.

INTERVENTION:

EMF using a medical device resonator; control group underwent same procedures, except the device was turned off.

OUTCOME MEASURES:

Pain reduction and mobility.

RESULTS:

Improvements in overall physical health, social functioning and reduction in bodily pain were observed in the EMF group. The pain relief rating scale showed a higher level of pain relief at the target area in the EMF group. An increase in left lateral mobility was seen only in the EMF group.

CONCLUSION:

EMF treatment may be of benefit to patients with chronic nonresponsive lower back pain associated with degenerative disc disease.

Int Med Case Rep J. 2014 Dec 31;8:13-22.

An open-label pilot study of pulsed electromagnetic field therapy in the treatment of failed back surgery syndrome pain.

Harper WL1, Schmidt WK2, Kubat NJ3, Isenberg RA4.

Author information

  • 1Tarheel Clinical Research, LLC, Raleigh, NC, USA.
  • 2NorthStar Consulting, LLC, Davis, CA, USA.
  • 3Nicole Kubat Consulting, Pasadena, CA, USA.
  • 4Regenesis Biomedical, Inc., Scottsdale, AZ, USA.

Abstract

Persistent pain following back surgery remains a major treatment challenge. The primary objective of this open-label exploratory study was to investigate the analgesic effectiveness of pulsed electromagnetic field therapy administered twice daily over a 45-day period in 34 subjects (68% female) with persistent or recurrent pain following back surgery. A secondary goal was to guide the design of future randomized controlled trials that could target responsive subpopulations. All predefined primary and secondary outcomes, including change in pain intensity (PI), physical function (Oswestry Disability Index), analgesic consumption, and overall well-being (Patient Global Impression of Change), are reported. A responder analysis (?30% reduction in PI versus baseline) was added as a post hoc evaluation. Safety outcomes, as well as results of a cost-avoidance survey, are also summarized. Of the 30 per-protocol subjects who completed the study, 33% reported a clinically meaningful (?30%) reduction in PI. A higher response rate (60%) was reported for subjects who had undergone discectomy prior to the trial compared to subjects who had undergone other types of surgical interventions (decompression or fusion) without discectomy. Improvements in PI were paralleled by improvements in secondary outcomes. Relative to baseline, responders reported an average 44% and 55% reduction in back PI and leg PI (respectively), and an average 13% improvement in Oswestry Disability Index scores. In the per-protocol population, 50% of responders and 12% of nonresponders reported less analgesia consumption at the end of treatment versus baseline. Sixty-seven percent of per-protocol responders and 0% of nonresponders reported clinically meaningful improvement in overall well-being on the Patient Global Impression of Change scale.

West Indian Med J.  2013 Mar;62(3):205-9.

Evaluation of the efficacy of pulsed electromagnetic therapy in the treatment of back pain: a randomized controlled trial in a tertiary hospital in Nigeria.

Oke KI1, Umebese PF2.
  • 1Department of Physiotherapy, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. kayodeoke2001@yahoo.com
  • 2Department of Orthopaedics and Traumatology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.

Abstract

Musculoskeletal system disorders (MSDs) are amongst the most commonly encountered problems in orthopaedics and physiotherapy practice all over the world and back pain is amongst the most prevalent of musculoskeletal presentations encountered in clinical practice. The attendant deformities, huge economic loss among many other sequelae on the affected individuals have always informed the search for cost-effective treatment modalities that are non-invasive and are devoid of or at least have minimal side effects. This randomized controlled trial was conducted to assess the therapeutic efficacy of the use of a non-pharmacological device [pulsed electromagnetic field (PEMF)] modality in the treatment of back pain. A total of 16 patients (mean age: 42.82 +/- 8.63 years) with back pain without radiculopathy who met the inclusion criteria were purposively enrolled in the study. Patients were randomly assigned into two groups. Group A had eight patients treated with PEMF plus medications (analgesics, nonsteroidal anti-inflammatory – diclofenac sodium) while the eight patients in group B were treated with only standard medications. The PEMF device was applied in group A four times a day for the period the patients were admitted (maximum of nine days). Measured outcome parameters were reduction in pain as assessed with numeric pain rating scale (NPRS) and improvement in functional ability status as assessed with functional activity scale (FAS). Obtained data were analysed with paired and independent t-test to test the significant efficacy of the treatment outcomes in the two groups. There was a statistically significant faster pain relief and resumption of active functions in patients treated with PEMF plus analgesic compared with the rates exhibited by patients treated with standard analgesics alone. These results suggest that PEMF therapy is beneficial in reducing pain and disability in patients with back pain and should be made part of holistic cape for back pain. Further studies using PEMF on larger patient populations are advocated to further confirm the efficacy of PEMF therapy in back pain management.

 

Pain Pract. 2007 Sep;7(3):248-55.

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.

Harden RN, Remble TA, Houle TT, Long JF, Markov MS, Gallizzi MA.

Center for Pain Studies, Chicago, Illinois 60611, USA. nharden@ric.org

Abstract

OBJECTIVES: To evaluate the efficacy and safety of therapeutic electromagnetic fields (TEMF) on chronic low back pain. Secondary objectives included the investigation of the effects of TEMF on psychometric measures.

SETTING: Pain Research center in an Urban Academic Rehabilitation Facility.

DESIGN: Prospective, randomized, single-blind, placebo (sham) treatment-controlled design in which participants were evaluated over a 6-week period. A total of 40 subjects were randomly assigned: 20 subjects to 15 milliTESLA (mT) treatment using a prototype electromagnetic field device and 20 to sham treatment.

INTERVENTIONS: After a 2-week baseline period, eligible individuals were randomized to one of the treatment groups (sham or 15 mT) for six 30-minute treatments over 2 weeks, then a 2-week follow-up period.

OUTCOME MEASURES: The primary outcome measure was the self-report of pain severity using a 100 mm visual analog scale collected using a twice daily McGill Pain Questionnaire-Short Form. Several secondary measures were assessed.

RESULTS: Both groups (15 mT and sham) improved over time (P < 0.05). Although groups were similar during the treatment period, treated subjects (TEMF of 15 mT) improved significantly over sham treatment during the 2-week follow-up period (20.5% reduction in pain; F(1,34) = 10.62, P = 0.003). There were no reported serious adverse events.

CONCLUSIONS: This study demonstrates that TEMF may be an effective and safe modality for the treatment of chronic low back pain disorders. More studies are needed to test this hypothesis.

Electromagn Biol Med. 2007;26(4):311-3.

Utilization of extremely low frequency (ELF) magnetic fields in chronic disease; five years experience: three case reports.

Mancuso M, Ghezzi V, Di Fede G.

Institute of Biological Medicine, Milano, Italy.

Abstract

We present three examples of the use of ELF magnetic therapy, two cases of multiple sclerosis and one of chronic pulmonary disease. In each of the two MS cases the Seqex device was applied as an adjunct to antioxidant medication two times a week for six weeks. Radiological and MRI examination indicated improvement in the two MS patients and stabilization in the patient with obstructive pulmonary disease following merely five treatments.

Complement Ther Clin Pract. 2007 Feb;13(1):4-14. Epub 2006 Oct 18.

An experimental study comparing the effects of combined transcutaneous acupoint electrical stimulation and electromagnetic millimeter waves for spinal pain in Hong Kong.

Yip YB, Tse HM, Wu KK.

School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China. yipvera@gmail.com

Abstract

OBJECTIVES: To compare the efficacy of combined transcutaneous acupoint electrical stimulation (TAES) and electromagnetic millimeter wave (EMMW) therapy as an add-on treatment for pain relief and physical functional activity enhancement among adults with sub-acute non-specific spinal pain in either the low back or neck.

DESIGN: A non-blinded study with data obtained before, immediate, one week and three months after intervention.

SETTING: The Telehealth Clinic and Community Centre, Hong Kong.

PARTICIPANTS: Forty-seven subjects with either sub-acute neck or low back pain.

INTERVENTION: Subjects were randomly allocated to either an intervention group (n=23) or a control group (n=24). These groups were then divided into subgroups according to the site of their spinal pain-neck or back. The intervention group had eight treatments over a three-week period of TAES and EMMW.

OUTCOME MEASURES: Changes from baseline to the end of treatment were assessed at intervals of one week and three months on either neck or low back pain intensity [by Visual Analogue Scale (VAS)]; stiffness level; stress level; neck or low back lateral flexion and forward flexion in cm, and interference with daily activities.

RESULTS: The baseline VAS scores for the intervention and control groups were 5.34 and 5.18 out of 10, respectively (P value=0.77). At the one week and three month assessments, there were no significant differences between the groups-VAS (P value=0.09 and 0.27, respectively). A further subgroup of chronic pain sufferers (n=31) was identified and these had significantly reduced pain intensity at the one week assessment (P value=0.04) but this was not sustained at post three months after treatment (P value=0.15). Improvements in stiffness level, stress level, and functional disability level in the intervention group were not significant.

CONCLUSIONS: Our study shows that there was a reduction in pain intensity, stress and stiffness level immediately after the eight sessions of treatment (TAES and EMMW), though the effect is not sustained after a week. No pain relief was found with the neck pain subgroup. However, the reduction in subjective average pain intensity among the chronic pain subgroup was sustained at the post one week assessment for the intervention group but not at the post three month assessment.

J Int Med Res. 2006 Mar-Apr;34(2):160-7.

Efficacy of pulsed electromagnetic therapy for chronic lower back pain: a randomized, double-blind, placebo-controlled study.

Lee PB, Kim YC, Lim YJ, Lee CJ, Choi SS, Park SH, Lee JG, Lee SC.

Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.

Abstract

This randomized, double-blind, placebo-controlled clinical trial studied the effectiveness of pulsed electromagnetic therapy (PEMT) in patients with chronic lower back pain. Active PEMT (n = 17) or placebo treatment (n = 19) was performed three times a week for 3 weeks. Patients were assessed using a numerical rating scale (NRS) and revised Oswestry disability scores for 4 weeks after therapy. PEMT produced significant pain reduction throughout the observation period compared with baseline values. The percentage change in the NRS score from baseline was significantly greater in the PEMT group than the placebo group at all three time-points measured. The mean revised Oswestry disability percentage after 4 weeks was significantly improved from the baseline value in the PEMT group, whereas there were no significant differences in the placebo group. In conclusion, PEMT reduced pain and disability and appears to be a potentially useful therapeutic tool for the conservative management of chronic lower back pain.

Neurorehabilitation. Volume 17, Number 1 / 2002: 63 – 67

Evaluation of electromagnetic fields in the treatment of pain in patients with lumbar radiculopathy or the whiplash syndrome

Ch. Thuile A1 and M. Walzl A2

A1 International Society of Energy Medicine, Vienna, Austria
A2 State Clinic of Neurology and Psychiatry, Graz, Austria

Abstract:

Back pain and the whiplash syndrome are very common diseases involving tremendous costs and extensive medical effort. A quick and effective reduction of symptoms, especially pain, is required. In two prospective randomized studies, patients with either lumbar radiculopathy in the segments L5/S1 or the whiplash syndrome were investigated. Inclusion criteria were as follows: either clinically verified painful lumbar radiculopathy in the segments L5/S1 and a Laségue’s sign of 30 degrees (or more), or typical signs of the whiplash syndrome such as painful restriction of rotation and flexion/extension. Exclusion criteria were prolapsed intervertebral discs, systemic neurological diseases, epilepsy, and pregnancy. A total of 100 patients with lumbar radiculopathy and 92 with the whiplash syndrome were selected and entered in the study following a 1:1 ratio. Both groups (magnetic field treatment and controls) received standard medication consisting of diclofenac and tizanidine, while the magnetic field was only applied in group 1, twice a day, for a period of two weeks. In patients suffering from radiculopathy, the average time until pain relief and painless walking was 8.2 – 0.5 days in the magnetic field group, and 11.7 – 0.5 days in controls p < 0.04). In patients with the whiplash syndrome, pain was measured on a ten-point scale. Pain in the head was on average 4.6 before and 2.1 after treatment in those receiving magnetic field treatment, and 4.2/3.5 in controls. Neck pain was on average 6.3/1.9 as opposed to 5.3/4.6, and pain in the shoulder/arm was 2.4/0.8 as opposed to 2.8/2.2 (p < 0.03 for all regions). Hence, magnetic fields appear to have a considerable and statistically significant potential for reducing pain in cases of lumbar radiculopathy and the whiplash syndrome.

References:

  1. G.B.J. Andersson, The Epidemiology of Spinal Disorder, in: The Adult Spine: Principles and Practice, J.W. Frymoyer, ed., Raven Press, New York, 1991.
  2. V. Grosser, K. Seide and D. Wolter, Berufliche Belastungen und bandscheibenbedingte Erkrankungen der LWS: Derzeit-iger Kausalwissenstand in der Literatur? in: Berufskrankheit 2108: Kausalit¨at und Abgrenzungskriterien, D. Wolter and K. Seide, eds., Springer, Berlin, 1995, pp. 26-38.
Med Pr. 2003;54(6):503-9.

Disorders of locomotor system and effectiveness of physiotherapy in coal miners.

[Article in Polish]

Bilski B, Bednarek A.

Katedry Profilaktyki Zdrowotnej, Akademii Medycznej im. K. Marcinkowskiego w Poznaniu. bilskib@polbox.com

BACKGROUND: The aim of the survey was to analyze the efficacy of physiotherapy applied in coal miners as well as to assess their locomotor system load and the effects of working conditions in mines.

MATERIALS AND METHODS: The questionnaire survey covered a group of 51 miners, aged 28-76 years (mean, 54 years), undergoing physiotherapeutic procedures in the mine out-patient clinic during the first quarter of 2003.

RESULTS: The survey revealed that lumbosacral disorders were the most frequent locomotor system complaints reported by miners, especially those who work in a bending down position. According to the clinical data, spondylosis and allied disorders were the main reasons for pain in this part of the body. Having analyzed the relationship between age and occurrence of back pains, the majority of complaints were found in the 46-55 age group (two complaints per one respondent). The analysis of the association between back pains and duration of employment revealed that the complaints for the locomotor system occurred already after a five-year employment.

CONCLUSIONS: The survey showed that the application of physiotherapeutic procedures diminished the back pain in the study group by 2.83 on average on the 0-10 scale. It was also found that magnetotherapy proved to be the most effective method in treating the spinal degenerative changes.

Adv Ther. 2000 Mar-Apr;17(2):57-67.

Spine fusion for discogenic low back pain: outcomes in patients treated with or without pulsed electromagnetic field stimulation.

Marks RA.

Richardson Orthopaedic Surgery, Texas 75080, USA.

Sixty-one randomly selected patients who underwent lumbar fusion surgeries for discogenic low back pain between 1987 and 1994 were retrospectively studied. All patients had failed to respond to preoperative conservative treatments. Forty-two patients received adjunctive therapy with pulsed electromagnetic field (PEMF) stimulation, and 19 patients received no electrical stimulation of any kind. Average follow-up time was 15.6 months postoperatively. Fusion succeeded in 97.6% of the PEMF group and in 52.6% of the unstimulated group (P < .001). The observed agreement between clinical and radiographic outcome was 75%. The use of PEMF stimulation enhances bony bridging in lumbar spinal fusions. Successful fusion underlies a good clinical outcome in patients with discogenic low back pain.

Bratisl Lek Listy. 1999 Dec;100(12):678-81.

Personal experience in the use of magnetotherapy in diseases of the musculoskeletal system.

[Article in Slovak]

Sadlonova J, Korpas J.

Ist Dpt of Internal Medicine, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia. bll@fmed.uniba.sk

Therapeutic application of pulsatile electromagnetic field in disorders of motility is recently becoming more frequent. Despite this fact information about the effectiveness of this therapy in the literature are rare. The aim of this study was therefore the treatment of 576 patients who suffered from vertebral syndrome, gonarthritis and coxarthritis. For application of pulsatile electromagnetic field MTU 500H Therapy System was used. Pulsatile electromagnetic field had a frequency valve of 4.5 mT in all studied groups and magnetic induction valve 12.5-18.75 mT in the 1st group. In the 2nd group the intensity was 5.8-7.3 mT and in the 3rd group it was 7.6-11.4 mT. The time of inclination/declination in the 1st group was 20/60 ms, in the 2nd group 40/80 ms and in the 3rd group 40/90 ms. The electromagnetic field was applied during 10 days. In the 1st-3rd day during 20 minutes and in the 4th-10th day during 30 minutes. The therapy was repeated in every patient after 3 months with values of intensity higher by 50%. In the time of pulsatile electro-magnetotherapy the patients were without pharmacotherapy or other physiotherapy. The application of pulsatile electromagnetic field is a very effective therapy of vertebral syndrome, gonarthritis and coxarthritis. The results have shown that the therapy was more effective in patients suffering from gonarthrosis, than in patients with vertebral syndrome and least effective in patients with coxarthosis. Owing to regression of oedema and pain relieve the motility of patients improved. (Tab. 3, Ref. 19.)

Minerva Anestesiol. 1989 Jul-Aug;55(7-8):295-9.

Pulsed magnetic fields.  Observations in 353 patients suffering from chronic pain.

[Article in Italian]

Di Massa A, Misuriello I, Olivieri MC, Rigato M.

Three hundred-fifty-three patients with chronic pain have been treated with pulsed electromagnetic fields. In this work the Authors show the result obtained in the unsteady follow-up (2-60 months). The eventual progressive reduction of benefits is valued by Spearman’s test. We noted the better results in the group of patients with post-herpetic pain (deafferentation) and in patients simultaneously suffering from neck and low back pain.