A Review of Pulsed Electromagnetic Field (PEMF) Mechanisms at a Cellular Level: A Rationale for Clinical Use
American Journal of Health Research
Volume 1, Issue 3, November 2013, Pages: 51-55
Received: Sep. 20, 2013;
Published: Oct. 20, 2013
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Brett Wade, Therapist Assistant Program, Okanagan College, Kelowna, British Columbia, Canada
Delivery of health care demands evidence-based practice. Evidence-based practice helps to ensure that all facets of health care delivery are subject to a higher level of accountability. This helps to assure that the patient is receiving treatment that has some proof of efficacy. In recent years, physiotherapy practice has been influenced by a swell of research which, in many cases, supports current practice and, in some cases, influences change of practice. Despite the fact that there is a significant increase in the numbers of clinical trials and reviews in Physiotherapy, including research in electromagnetic modalities and mechanical modalities, it is not uncommon for a practitioner to feel at a loss to answer, “Exactly how does this treatment work?” This paper will review the mechanisms of action of the most common electromagnetic modalities and provide a rationale as to why “pulsed” fields seem to produce more significant effects compared with continuous applications. It will be shown that significant tissue healing effects, particularly with the modality PEMF, are likely the result of increased activity in non-excitable cells. The reputation of electromagnetic modalities has suffered in recent years, likely due to a lack of understanding of mechanisms for action. In the literature, the understanding in this area has made considerable progress over the past ten years. This review will explain the science at a cellular level and suggest the potential mechanisms for action for the modalities with specific focus on PEMF.
A Review of Pulsed Electromagnetic Field (PEMF) Mechanisms at a Cellular Level: A Rationale for Clinical Use, American Journal of Health Research.
Vol. 1, No. 3,
2013, pp. 51-55.
Behrens B, Michlovitz S. Physical Agents Theory and Practice. Second ed. Philadelphia: F.A. Davis; 2006. p. 145
Panagopoulos DJ, Karabarbounis A, Margaritis LH. Mechanism for action of electromagnetic fields on cells. Biochemical and Biophysical Research Communications. 2002;298(1):95-102.
Ganesan K, Gengadharan AC, Balachandran C, Manohar BM, Puvanakrishnan R. Low frequency pulsed electromagnetic field--a viable alternative therapy for arthritis. Indian J Exp Biol. 2009;47(12):939-48.
Chang WH-S, Chen L-T, Sun J-S, Lin F-H. Effect of pulse-burst electromagnetic field stimulation on osteoblast cell activities. Bioelectromagnetics. 2004;25(6):457-65.
Mattei MD, Caruso A, Pezzetti F, Pellati A, Stabellini G, Sollazzo V, et al. Effects of Pulsed Electromagnetic Fields on Human Articular Chondrocyte Proliferation. Connective Tissue Research. 2001;42(4):269-79.
Richards TL, Lappin MS, Acosta-Urquidi J, Kraft GH, Heide AC, Lawrie FW, et al. Double-blind study of pulsing magnetic field effects on multiple sclerosis. J Altern Complement Med. 1997;3(1):21-9.
Sandyk R. Role of the pineal gland in multiple sclerosis: a hypothesis. Journal of Alternative & Complementary Medicine. 1997;3(3):267-90.
Markov M. Pulsed electromagnetic field therapy history, state of the art and future. The Environmentalist. 2007;27(4):465-75.
Varani K, Gessi S, Merighi S, Iannotta V, Cattabriga E, Spisani S, et al. Effect of low frequency electromagnetic fields on A2A adenosine receptors in human neutrophils. British Journal of Pharmacology. 2002;136(1):57-66.
Gómez-Ochoa I, Gómez-Ochoa P, Gómez-Casal F, Cativiela E, Larrad-Mur L. Pulsed electromagnetic fields decrease proinflammatory cytokine secretion (IL-1β and TNF-α) on human fibroblast-like cell culture. Rheumatology International. 2011;31(10):1283-9.
Farndale R, Murray J. Pulsed electromagnetic fields promote collagen production in bone marrow fibroblasts via athermal mechanisms. Calcified Tissue International. 1985;37(2):178-82.
Delle Monache S, Alessandro R, Iorio R, Gualtieri G, Colonna R. Extremely low frequency electromagnetic fields (ELF-EMFs) induce in vitro angiogenesis process in human endothelial cells. Bioelectromagnetics. 2008;29(8):640-8.
Pipitone N, Scott DL. Magnetic pulse treatment for knee osteoarthritis: a randomised, double-blind, placebo-controlled study. Curr Med Res Opin. 2001;17(3):190-6.
Sutbeyaz ST, Sezer N, Koseoglu F, Kibar S. Low-frequency pulsed electromagnetic field therapy in fibromyalgia: a randomized, double-blind, sham-controlled clinical study. Clin J Pain. 2009;25(8):722-8.
Kennedy WF, Roberts CG, Zuege RC, Dicus WT. Use of pulsed electromagnetic fields in treatment of loosened cemented hip prostheses. A double-blind trial. Clin Orthop Relat Res. 1993;286(286):198-205.
Sutbeyaz ST, Sezer N, Koseoglu BF. The effect of pulsed electromagnetic fields in the treatment of cervical osteoarthritis: a randomized, double-blind, sham-controlled trial. Rheumatol Int. 2006;26(4):320-4.
Uzunca K, Birtane M, Tastekin N. Effectiveness of pulsed electromagnetic field therapy in lateral epicondylitis. Clin Rheumatol. 2007;26(1):69-74.
Shupak NM, McKay JC, Nielson WR, Rollman GB, Prato FS, Thomas AW. Exposure to a specific pulsed low-frequency magnetic field: a double-blind placebo-controlled study of effects on pain ratings in rheumatoid arthritis and fibromyalgia patients. Pain Res Manag. 2006;11(2):85-90.
Bassett C, Schink-Ascani M. Long-term pulsed electromagnetic field (PEMF) results in congenital pseudarthrosis. Calcified Tissue International. 1991;49(3):216-20.
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. J Rheumatol. 1994;21(10):1903-11.
Sharrard W. A double-blind trial of pulsed electromagnetic fields for delayed union of tibial fractures. Journal of Bone & Joint Surgery, British Volume. 1990 May 1, 1990;72-B(3):347-55.
Binder A, Parr G, Hazleman B, Fitton-Jackson S. PULSED ELECTROMAGNETIC FIELD THERAPY OF PERSISTENT ROTATOR CUFF TENDINITIS: A Double-blind Controlled Assessment. The Lancet. 1984;323(8379):695-8.
Huang LQ, He HC, He CQ, Chen J, Yang L. Clinical update of pulsed electromagnetic fields on osteoporosis. Chin Med J. 2008;121(20):2095-9.
Yoo M, Cho Y, Kim K, Chun Y, Chung C. PULSED ELECTROMAGNETIC FIELDS TREATMENT FOR THE EARLY STAGES OF OSTEONECROSIS OF THE FEMORAL HEAD. Journal of Bone & Joint Surgery, British Volume. 2004 February 1, 2004;86-B(SUPP II):148-9.
Stiller MJ, Pak GH, Shupack JL, Thaler S, Kenny C, Jondreau L. A portable pulsed electromagnetic field (PEMF) device to enhance healing of recalcitrant venous ulcers: a double-blind, placebo-controlled clinical trial. British Journal of Dermatology. 1992;127(2):147-54.
Gordon GA. Designed electromagnetic pulsed therapy: Clinical applications. Journal of Cellular Physiology. 2007;212(3):579-82.