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Stop Depending on Drugs for Pain Relief. PEMF is a Drug-free, Safe, and Non-invasive Option

Stop Depending on Drugs for Pain Relief. PEMF is a Drug-free, Safe, and Non-invasive Option

Author: Dr. Faisal Hayat, MBBS

Musculoskeletal disorders (MSD) are the injuries or disorders of the muscles, nerves, tendons, joints, cartilages, and spinal discs. It can be of acute or chronic types. Musculoskeletal conditions are typically characterized by pain, limitations in mobility, and affecting the overall quality of life.

Introduction

According to the International Association for the Study of Pain (IASP), pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.[1]

Musculoskeletal disorders comprise a range of conditions. The most common and disabling musculoskeletal disorders are back pain, osteoarthritis, fibromyalgia, neck pain, tendinopathy, and myofascial pain.

World Health Organization (WHO) has presented that approximately 1.71 billion people have musculoskeletal conditions worldwide. Of these 1.71 billion people, 568 million people have low back pain (LBP). [2]

According to a report published in 2001, annually, almost 70 million physician office visits in the United States are due to musculoskeletal disorders, including an estimated 130 million total health care encounters including outpatient, hospital, and emergency room visits. [3]

Treatment modalities

Musculoskeletal pain is long-lasting and categorized as chronic if it lasts for three months or more. Treatment is mainly classified into pharmacological and non-pharmacological modalities to relieve musculoskeletal pain. The pharmacological treatment measures include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and the newer cyclooxygenase-2 inhibitors. Non-pharmacologic treatment modalities are recommended as first-line therapy.

Non-pharmacological treatment options include PEMF, TENS, physical modalities, etc. Because of having severe side effects, PEMF is a better modality than TENS and should be preferred to manage musculoskeletal pain.

Pharmacological Options

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective and usually considered first-line therapy in managing musculoskeletal disorders. But these are commonly associated with gastrointestinal (GI) and renal side effects. That’s why NSAIDs’ use is contraindicated in many individuals.

Acetaminophen (Paracetamol)

Paracetamol is generally effective in managing the pain of mild to moderate intensity. Still, its chronic use may affect the liver and has long been associated with potential liver toxicity even in therapeutic doses. Hepatotoxicity can be fatal.

Muscle relaxants

These effectively relieve acute pain and are generally not prescribed for chronic use because of their sedating effects.  Muscle relaxants are typically more effective in alleviating the pain of mild to moderate intensity.

Opioid analgesics

Opioid analgesics comprise a class of drugs that have the most potency for pain relief than most other drugs and can be used as an alternative treatment option to relieve more severe pain or in patients who are intolerant to other pharmacological means. But almost all opioid analgesics are associated with gastrointestinal side effects and may produce physical and psychological dependence.

Antidepressants

Antidepressants, such as amitriptyline, have been prescribed chronically to relieve musculoskeletal pain, especially for the generalized pain of fibromyalgia (FM). But these are associated with significant side effects and produce a modest, transient benefit.

Non-pharmacological Options

It is stated that pharmacological treatment options are adequate to relieve musculoskeletal pain but have common side effects. Advancements and recent clinical trials in bio-magnetic technology have introduced Pulsed electromagnetic field (PEMF) therapy as an excellent therapeutic option to relieve musculoskeletal pain. The use of pulsed electromagnetic field (PEMF) therapy to treat nonunion fractures was approved by US Food and Drug Administration (FDA) in 1979.

Physical modalities

Physical modalities like hot packs, massage, and home exercises are appropriate for a short time. These modalities may be helpful in both acute and chronic types of pain. But physical modalities can always be used as adjunctive therapy.

PEMF therapy

Low-frequency PEMF therapy is effective and clinically proven treatment option to relieve musculoskeletal pain. It is a non-invasive bio-magnetic technology that has not shown any side effects in clinical trials. The FDA has approved PEMF therapy to be clinically used to fuse broken bones, reduce joint pain, tissue pain, and support muscle function.

Unlike TENS, pulsed electromagnetic field (PEMF) devices are not associated with currents. These use low voltage magnetic fields that can be applied to the brain to generate more global pain relief.

TENS therapy

The Transcutaneous Electrical Nerve Stimulation (TENS) unit is associated with currents. Electrons pass through the tissues to which the device is being applied, thereby only providing localized pain relief to the patients. It may manage acute or chronic pain but has few side effects.

The possible side effects of TENS are skin irritation, burn marks, local skin reaction, contact dermatitis, and muscular spasm.

Clinical trials

Following clinical trials have shown that PEMF therapy is an effective and safe treatment option to relieve musculoskeletal pain.

  • In 2020, a clinical study was published titled “Electromagnetic Field Therapy: A Rehabilitative Perspective in the Management of Musculoskeletal Pain – A Systematic Review.” This systemic review of the literature was performed on the articles published between January 1, 2009, and December 31, 2018, and the age limit was >18 years. This systemic review concluded that pulsed electromagnetic field (PEMF) therapy relieves pain and improves function in patients with various musculoskeletal diseases. The treatment was well tolerated, with no reported adverse side effects in the analyzed studies.[4]
  • A randomized, double-blind, sham-controlled clinical trial was conducted in patients with either chronic generalized pain from fibromyalgia (FM) or chronic localized musculoskeletal or inflammatory pain. Patients were exposed to a PEMF (400 μT) therapy through a portable device fitted to their head during twice-daily 40 min treatments over seven days. The effect of PEMF therapy on pain was recorded. The study concluded that PEMF therapy might be a novel, safe and effective therapeutic tool for use in at least certain subsets of patients with chronic, nonmalignant pain.[5]

DCcure, pain-relieving PEMF device

DCcure is a non-invasive, non-drug, safe, and FDA Class 1 listed pulsed electromagnetic field (PEMF) therapeutic device. A clinical trial was conducted on 42 patients 18-75 years of age. This study has proven its efficacy and safety for non-specific low back pain (NLBP) patients.

  • In 2019, a Randomized Controlled clinical trial was conducted by Anthony J Lisi et al. They published this study with the title “A Pulsed Electromagnetic Field Therapy Device for Non-Specific Low Back Pain.” The PEMF device used in the study was “MDcure®, Aerotel Ltd., Holon, Israel, and Aerotel Inc. USA, New York, NY, USA.” They concluded that the device is safe and provides preliminary evidence of effectiveness in improving non-specific low back pain (NLBP). Clinical study has not shown adverse or severe effects.[6]

Conclusion

The common problems associated with musculoskeletal pain are overuse of imaging, opioids and other analgesics, and overuse of surgery. That’s why most clinicians recommend a combination of pharmacological and non-pharmacological interventions to be used together to manage patients’ pain.

The rapidly expanding field of bio magnetics potentially offers a variety of therapeutic modalities that can relieve chronic pain. These modalities are even more valuable in patients resistant to more traditional therapies. The pulsed electromagnetic field (PEMF) is unique among these bio-magnetic modalities.

The PEMF therapeutic modality we use exclusively is lower power and frequency than virtually all other bio-magnetic modalities. Clinical trials have shown that the patients’ dependency on pharmacological treatment options has been minimized by using a pulsed electromagnetic field (PEMF) therapy.

Chronic use of pain-relieving medications like opioids may produce dependence, toxicity, and side effects in patients with chronic musculoskeletal pain. That’s why clinicians recommend using PEMF devices as adjunctive therapy along with analgesics to relieve musculoskeletal pain. Due to its non-invasiveness, safety, and efficacy, PEMF therapy has gained much trust and popularity among clinicians and researchers. And because of providing safe, long-term, and repairing effects, PEMF is better than TENS.

References

  1. IASP announces revised definition of pain. International Association for the Study of Pain (IASP). (2021, July 20). Retrieved March 4, 2022, from https://www.iasp-pain.org/publications/iasp-news/iasp-announces-revised-definition-of-pain/
  2. World Health Organization. (n.d.). Musculoskeletal conditions. World Health Organization. Retrieved March 4, 2022, from https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
  3. National Research Council and the Institute of Medicine (2001). Musculoskeletal disorders and the workplace: low back and upper extremities. Panel on Musculoskeletal Disorders and the Workplace. Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academy Press. Available from:https://www.nap.edu/read/10032/chapter/1external icon
  4. Paolucci, Teresa, Letizia Pezzi, Antonello Marco Centra, Niki Giannandrea, Rosa Grazia Bellomo, and Raoul Saggini. “Electromagnetic field therapy: a rehabilitative perspective in the management of musculoskeletal pain–a systematic review.” Journal of Pain Research 13 (2020): 1385.
  5. Thomas AW, Graham K, Prato FS, et al. A randomized, double-blind, placebo-controlled clinical trial using a low-frequency magnetic field in treating musculoskeletal chronic pain. Pain Res Manag. 2007;12(4):249-258. doi:10.1155/2007/626072
  6. Lisi, A. J., Scheinowitz, M., Saporito, R., &Onorato, A. (2019). A Pulsed Electromagnetic Field Therapy Device for Non-Specific Low Back Pain: A Pilot Randomized Controlled Trial. Pain and Therapy, 8(1), 133–140.

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