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Why do you feel pain? What is its origin? How PEMF therapy heals pain

Why do you feel pain? What is its origin? How PEMF therapy heals pain

Why do you feel pain? What is its origin? How PEMF therapy heals pain

Author: Dr. Faisal Hayat, MBBS

What is pain?

International Association for the Study of Pain (IASP) defines pain as; “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”  Pain is usually described as both; sensation and emotion. Both aspects of pain should be kept in mind when treating a patient.

Pain is universally accepted as a signal of disease and the most common symptom that brings a patient to a clinician’s attention. It protects the body and maintains homeostasis. It localizes and identifies the actual tissue-damaging process. The difference in the quality, time course, and location of pain helps diagnose the disease.

Pain may happen in any part of the body, lasting for days, months, or even years. Consistent pain even of mild intensity can interfere with your routine life activities. It may disturb the quality of life along with anxiety, sleep disturbances, and depression.

Pain is not always a result of underlying pathology. A lot of routine physical activities, exercises, and office work for a more extended period may produce an unpleasant, painful sensation. Working in a sedentary office job can develop low back pain (LBP) because of an incorrect body posture or a poorly designed workplace. Sometimes your posture is acceptable, but sitting for an extended period without standing or stretching may contribute to office back pain.

According to the World Health Organization (WHO), approximately 1.71 billion people have musculoskeletal conditions worldwide. Among these musculoskeletal disorders, low back pain (LBP) causes the highest-burden, with a prevalence of 568 million people.

Categories of pain

  • Based on the duration

Pain can last for days, months, and even years. It is usually classified as acute and chronic. Acute pain is typically short-lived and of severe intensity. Chronic pain is generally mild to moderate intensity and for a more extended period.

  • Based on the severity

It is categorized as mild, moderate, and severe intensity.

  • Others

Pain may happen in any part of the body. It may be referred, radiating, neuropathic, or inflammatory types.

What causes the feeling of pain?

The four main stages of nociceptive pain comprise transduction (i.e., action at receptors in the periphery), transmission (i.e., action potentials along axons), perception (i.e., cortical processing of nociceptive input), and modulation (i.e., engagement of descending circuits). The mechanism of pain can be further described as follows.

Peripheral mechanisms

  • Everybody tissue has special nerve receptors, called ‘nociceptors.’
  • Primary afferent nociceptors (pain receptors) respond to different types of noxious stimuli. The stimuli can be of different types like; heat, intense cold, pitch and other types of mechanical distortion, changes in pH, and application of chemical irritants.
  • Intense, repeated, or prolonged stimulation of the damaged tissue leads to sensitization.
  • Mostly primary afferent nociceptors contain polypeptide mediators like substance P, released from their peripheral terminals.

Central mechanisms

  • Noxious stimuli activate the sensitive peripheral ending of the primary afferent nociceptor by transduction.
  • The axons of primary afferent nociceptors enter the spinal cord, synapsing with cells of origin of the major ascending pain pathway, the spinothalamic tract.
  • Pain signals are transmitted to the brain sites involved in pain perception. The message is relayed in the thalamus to the anterior cingulate, frontal insular, and somatosensory cortex.
  • Most spinal neurons contacted by primary afferent nociceptors send their axons to the contralateral thalamus.
  • Interruption of this pathway produces permanent deficits in the discrimination of pain and temperature.
  • Pain-modulating circuits can enhance as well as suppress pain.
  • The pain produced by injuries of similar magnitude is remarkably variable in different individuals and different situations. For example, athletes may have serious fractures with only minor pain.
  • Sometimes, an expectation of pain can induce pain even without a noxious stimulus.

What is PEMF therapy?

Advancements and recent clinical research in the field of bio-magnetic technology have introduced Pulsed electromagnetic field (PEMF) therapy as a good therapeutic option for relieving chronic pain. PEMF therapy is a non-invasive bio-magnetic technology that means it doesn’t penetrate or pierce the skin or mucous membranes of the body. Because of its safety, effectiveness, and other advantages, FDA has approved it to be clinically used for broken bones fusion, reduce joint pain tissue pain, and support muscle function.

Pulsed electromagnetic field (PEMF) devices have a range of clinical uses. These have proven their effectiveness to relieve low back pain, chronic pain, pelvic pain, musculoskeletal pain, and diabetic neuropathy. These are easy to use and have no side effects. Recent clinical studies have concluded that pulsed electromagnetic field (PEMF) therapy has long-term benefits without disturbing the body’s ionizing or thermal balance.

The pulsed electromagnetic field (PEMF) therapy and PEMF devices effectively treat patients with anxiety, panic, and post-traumatic stress disorders. These are also useful in managing Parkison’s disease, osteoarthritis, and malignant disorders.

The patient’s dependency on pharmacological treatment options has been minimized by using pulsed electromagnetic field (PEMF) devices. Chronic pain-relieving drugs like opioids may produce dependence, toxicity, and side effects. That’s why clinicians recommend using pain-relieving devices as adjunctive therapy along with analgesics.

How does it relieve pain?

Pulsed electromagnetic field (PEMF) therapy is an electromagnetic device that successfully relieves pain and stiffness in patients with chronic pain. It stimulates low-intensity magnetic fields to repair cellular dysfunction. PEMF devices act at a cellular level and target the specific injured tissues of the body.

The exact mechanism of pulsed electromagnetic field (PEMF) therapy is unknown so far. The published clinical studies have proposed some theories to help understand the process behind relieving pain.

  • The blood supply to the damaged tissues increases and helps to enhance electrolytes and ions movement. The increased blood supply further increases oxygen flow to the injured tissues, relieving pain, swelling, and inflammation.[1]
  • According to one hypothesis, pulsed electromagnetic field (PEMF) therapy may induce eddy currents in biological tissue, which could, in turn, mediate downstream biological effects.[2]
  • PEMF therapy may alter the gene aspect that comprises genes of pain courses like endogenous opioids and eicosanoid enzyme courses.[3]
  • PEMF may help in the detoxification and regeneration of damaged cells.
  • PEMF therapy may inhibit pain by directly modulating the nervous system, perhaps by stimulating inhibitory sensory neurons as proposed in gate control theory. It may mediate local electrochemical changes, which may, in turn, have downstream effects on gene expression.[2]
  • PEMF therapy has a low-frequency electromagnetic current with an extended range of frequencies that may increase the permeability of the cell membrane and stimulate many intracellular functions.[4]
  • Numerous cellular studies have addressed the effects of electromagnetic frequency on signal transduction pathways. And the magnetic fields are capable of affecting the signal transaction pathways via alteration of ion binding and transport.[5]

DcCure, pain-relieving PEMF device

DcCure is a non-invasive, safe, and FDA Class 1 listed pulsed electromagnetic field (PEMF) therapeutic device. It has proven its efficacy and safety in a randomized clinical study conducted on 42 patients 18-75 years of age with non-specific low back pain (NLBP). The device is affordable and convenient for patients with chronic pain.

  • A Randomized Controlled clinical trial was conducted in 2019 by Anthony J Lisi et al. It was published with the title “A Pulsed Electromagnetic Field Therapy Device for Non-Specific Low Back Pain.” In this trial, 42 people of 18-75 years of age were randomized. The PEMF device used in the trial was “MDcure®, Aerotel Ltd., Holon, Israel, and Aerotel Inc. USA, New York, NY, USA.” The authors concluded that the device is safe and provides preliminary evidence of effectiveness in improving function in the patients experiencing non-specific low back pain (NLBP). No adverse or severe effects were seen in the trial.[6]

Reference

  1. Dr. Garry F. Gordon, The Science of PEMF, Gordon Research Institute, October 27, 2012, The Woodland of Van Buren Wayne, Michigan.
  2. Sorrell, Robert Gordon et al. “Evaluation of pulsed electromagnetic field therapy for the treatment of chronic postoperative pain following lumbar surgery: a pilot, double-blind, randomized, sham-controlled clinical trial.” Journal of pain research vol. 11 1209-1222. 22 Jun. 2018, doi:10.2147/JPR.S164303.
  3. Moffett J, Fray LM, Kubat NJ. Activation of endogenous opioid gene expression in human keratinocytes and fibroblasts by pulsed radiofrequency energy fields. J Pain Res. 2012;5:347–357.
  4. Takamoto K, Bito I, Urakawa S, Sakai S, Kigawa M, Ono T, et al. Effects of compression at myofascial trigger points in patients with acute low back pain: A randomized controlled trial. Eur J Pain. 2015;19(8):1186–96.
  5. Marko S. Markov (2007) Expanding Use of Pulsed Electromagnetic Field Therapies, Electromagnetic Biology, and Medicine, 26:3, 257-274.
  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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