11/11/2019 Pulsed electromagnetic field therapy - Wikipedia

Pulsed electromagnetic field therapy

Pulsed electromagnetic field therapy (PEMFT), also known
Pulsed electromagnetic field
as low field magnetic stimulation (LFMS) uses
therapy
electromagnetic fields in an attempt to heal non-union fractures
and depression.[1] By 2007 the FDA had cleared several such
stimulation devices.[2]

In 2013 the U.S. Food and Drug Administration (FDA) warned a

manufacturer for promoting the device for unapproved uses such
as cerebral palsy and spinal cord injury.[3]

Contents
Use Drolet's 1990 Rhumart system, a PEMF
Delayed- and non-union fractures
device.
History
Other pulsed magnetic therapy, pulse
Wellness devices names magnetotherapy (PEMF)
Research
Knee osteoarthritis
Depression
Postoperative Pain
See also
References
Further reading

Use

Delayed- and non-union fractures

While PEMF therapy is claimed to offer some benefit in the treatment of fractures, the evidence is inconclusive and is
insufficient to inform current clinical practice.[4]

History
Electromagnetic field therapy has been in use since the invention of electricity. Veterinarians became the first health
professionals to use PEMF therapy, usually to attempt to heal broken legs in racehorses.[5] In 2004, a pulsed
electromagnetic field system was approved by the FDA as an adjunct to cervical fusion surgery in patients at high risk
for non-fusion.[5] On 13 October 2015 the FDA reclassified PEMF wellness devices from the Class 3 category to a Class
2 status. PEMF devices that have been FDA cleared are able to make health claims that require a doctor's prescription
for use.[6]

Although claims that electricity might aid bone healing was reported as early as 1841, it was not until the mid-1950s
that scientists seriously studied the subject. During the 1970s, Bassett and his team introduced a new approach which
attempted to treat delayed fractures; a technique that employed a very specific biphasic low frequency signal to be

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applied for non-union/delayed fractures.[7][8][9][10] The use of electrical

stimulation in the lumbosacral region was first attempted by Alan Dwyer of
Australia.[11][12]

Wellness devices
The original PEMF devices consisted of a Helmholtz coil which generated a
magnetic field. The patient's body was placed inside the magnetic field to
deliver treatment. Today, the majority of PEMF wellness devices resemble
a typical yoga mat in dimensions but are slightly thicker to house several
flat spiral coils to produce an even electromagnetic field. A frequency
generator is then used to energize the coils to create a pulsed
electromagnetic field. A wide variety of professional and consumer PEMF
devices are sold and marketed as FDA registered wellness devices.[6] The
majority are manufactured in Germany, Austria and Switzerland and are
imported into North America as electric massagers or full body electric An old fracture with nonunion of the
fracture fragments.
yoga mats. They are either placed on a massage table for clinical use or
directly on the floor in the home to practice simple yoga postures. The
companies that sell and manufacture them as "general wellness products" are not permitted to make medical claims of
effectiveness in treating disease.[6]

Research

Knee osteoarthritis
A 2013 review found that evidence was of very low quality, there might be a benefit for improved function, and there
was no evidence for benefit for pain.[13]

In 2017 the wearable ActiPatch PEMF Device was FDA 510k Cleared, Application # K152432, for "Adjunctive
treatment of musculoskeletal pain related to: (1) plantar fasciitis of the heel; and (2) osteoarthritis of the knee". This
Clearance was for Over the Counter use.[14]

Depression
Use of pulsed electromagnetic field therapy has been studied for depression.[15]

Postoperative Pain
In 2019 the wearable RecoveryRx PEMF Device was FDA Cleared, Application K190251, for "Adjunctive treatment of
postoperative pain".[16]

See also
Radionics
Pulsed radiofrequency#Therapeutic uses

References
1. Martiny, K; Lunde, M; Bech, P (15 July 2010). "Transcranial low voltage pulsed electromagnetic fields in patients
with treatment-resistant depression". Biological Psychiatry. 68 (2): 163–9. doi:10.1016/j.biopsych.2010.02.017 (htt
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11/11/2019 Pulsed electromagnetic field therapy - Wikipedia

ps://doi.org/10.1016%2Fj.biopsych.2010.02.017). PMID 20385376 (https://www.ncbi.nlm.nih.gov/pubmed/203853

76).
2. Markov, Marko S (2007). "Expanding Use of Pulsed Electromagnetic Field Therapies". Electromagnetic Biology &
Medicine. 26 (3): 257–274. doi:10.1080/15368370701580806 (https://doi.org/10.1080%2F15368370701580806).
PMID 17886012 (https://www.ncbi.nlm.nih.gov/pubmed/17886012).
3. "Warning Letters - Curatronic Ltd. 1/9/13" (https://wayback.archive-it.org/7993/20180726055205/https://www.fda.g
ov/ICECI/EnforcementActions/WarningLetters/2013/ucm335343.htm). www.fda.gov. Archived from the original (ht
tps://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm335343.htm) on 26 July 2018. Retrieved
7 January 2018.
4. Griffin, XL; Costa, ML; Parsons, N; Smith, N (13 April 2011). "Electromagnetic field stimulation for treating delayed
union or non-union of long bone fractures in adults". The Cochrane Database of Systematic Reviews (4):
CD008471. doi:10.1002/14651858.CD008471.pub2 (https://doi.org/10.1002%2F14651858.CD008471.pub2).
PMID 21491410 (https://www.ncbi.nlm.nih.gov/pubmed/21491410).
5. "Electrical stimulation of the spine as an adjunct to spinal fusion procedures" (https://web.archive.org/web/201504
02122818/http://www.bcbsms.com/index.php/index.php?id=200&action=viewPolicy&path=%2Fpolicy%2Femed%
2FElectrical+Stimulation+of+the+Spine+as+an+Adjunct+to+Spinal+Fusion+Procedures.html&source=emed).
Blue Cross & Blue Shield of Mississippi. Archived from the original (http://bcbsms.com/index.php/index.php?id=20
0&action=viewPolicy&path=%2Fpolicy%2Femed%2FElectrical+Stimulation+of+the+Spine+as+an+Adjunct+to+Sp
inal+Fusion+Procedures.html&source=emed) on 2015-04-02. "Pulsed electromagnetic field systems with FDA
PMA include the EBI Bone Healing System from Electrobiology, Inc., which was first approved in 1979 and
indicated for nonunions, failed fusions, and congenital pseudarthroses; and the Cervical-Stim from Orthofix, which
was approved in 2004 as an adjunct to cervical fusion surgery in patients at high risk for non-fusion."
6. "General Wellness: Policy for Low Risk Devices - Guidance for Industry and Food and Drug Administration Staff"
(http://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm429674.pd
f) (PDF). U.S. Food and Drug Administration. 29 July 2016. Retrieved 16 February 2016.
7. Bassett CA, Pawluk RJ, Pilla AA; Pawluk; Pilla (1974). "Acceleration of fracture repair by electromagnetic fields. A
surgically noninvasive method". Ann N Y Acad Sci. 238 (1): 242–62. Bibcode:1974NYASA.238..242B (https://ui.a
dsabs.harvard.edu/abs/1974NYASA.238..242B). doi:10.1111/j.1749-6632.1974.tb26794.x (https://doi.org/10.111
1%2Fj.1749-6632.1974.tb26794.x). PMID 4548330 (https://www.ncbi.nlm.nih.gov/pubmed/4548330).
8. Bassett CA, Pawluk RJ, Pilla AA; Pawluk; Pilla (1974). "Augmentation of Bone Repair by Inductively Coupled
Electromagnetic Fields". Science. 184 (4136): 575–7. Bibcode:1974Sci...184..575B (https://ui.adsabs.harvard.ed
u/abs/1974Sci...184..575B). doi:10.1126/science.184.4136.575 (https://doi.org/10.1126%2Fscience.184.4136.57
5). PMID 4821958 (https://www.ncbi.nlm.nih.gov/pubmed/4821958).
9. Bassett CA, Pilla AA, Pawluk RJ; Pilla; Pawluk (1977). "A non-operative salvage of surgically-resistant
pseudarthroses and non-unions by pulsing electromagnetic fields. A preliminary report". Clin Orthop. 124 (124):
128–43. doi:10.1097/00003086-197705000-00017 (https://doi.org/10.1097%2F00003086-197705000-00017).
PMID 598067 (https://www.ncbi.nlm.nih.gov/pubmed/598067).
10. Bassett CA, Mitchell SN, Norton L, Pilla A; Mitchell; Norton; Pilla (1978). "Repair of non-unions by pulsing
electromagnetic fields". Acta Orthop Belg. 44 (5): 706–24. PMID 380258 (https://www.ncbi.nlm.nih.gov/pubmed/3
80258).
11. Mackenzie, Donald, Francis D Veninga; Veninga (2004). "Reversal of delayed union of anterior cervical fusion
treated with pulsed electromagnetic field stimulation: case report". Southern Medical Journal. 97 (5): 519–524.
doi:10.1097/00007611-200405000-00021 (https://doi.org/10.1097%2F00007611-200405000-00021).
PMID 15180031 (https://www.ncbi.nlm.nih.gov/pubmed/15180031).
12. Bose, B (2001). "Outcomes after posterolateral lumbar fusion with instrumentation in patients treated with
adjunctive pulsed electromagnetic field stimulation". Advances in Therapy. 18 (1): 12–20.
doi:10.1007/BF02850247 (https://doi.org/10.1007%2FBF02850247). PMID 11512529 (https://www.ncbi.nlm.nih.go
v/pubmed/11512529).
13. Negm, A; Lorbergs, A; Macintyre, NJ (September 2013). "Efficacy of low frequency pulsed subsensory threshold
electrical stimulation vs placebo on pain and physical function in people with knee osteoarthritis: systematic
review with meta-analysis". Osteoarthritis and Cartilage. 21 (9): 1281–9. doi:10.1016/j.joca.2013.06.015 (https://d
oi.org/10.1016%2Fj.joca.2013.06.015). PMID 23973142 (https://www.ncbi.nlm.nih.gov/pubmed/23973142).
14. https://www.accessdata.fda.gov/cdrh_docs/pdf15/K152432.pdf

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15. van Belkum, SM; Bosker, FJ; Kortekaas, R; Beersma, DG; Schoevers, RA (3 November 2016). "Treatment of
depression with low-strength transcranial pulsed electromagnetic fields: A mechanistic point of view". Progress in
Neuro-Psychopharmacology & Biological Psychiatry. 71: 137–43. doi:10.1016/j.pnpbp.2016.07.006 (https://doi.or
g/10.1016%2Fj.pnpbp.2016.07.006). PMID 27449361 (https://www.ncbi.nlm.nih.gov/pubmed/27449361).
16. https://www.accessdata.fda.gov/cdrh_docs/pdf19/K190251.pdf

Further reading
Vavken, Patrick; Arrich, Ferdi; Schuhfried, Othmar; Dorotka, Ronald (2009-05-01). "Effectiveness of pulsed
electromagnetic field therapy in the management of osteoarthritis of the knee: a meta-analysis of randomized
controlled trials" (https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0027512/). Journal of Rehabilitation Medicine.
41 (6): 406–411. doi:10.2340/16501977-0374 (https://doi.org/10.2340%2F16501977-0374). ISSN 1651-2081 (http
s://www.worldcat.org/issn/1651-2081). PMID 19479151 (https://www.ncbi.nlm.nih.gov/pubmed/19479151).

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