What is Back Pain ?
The human back is a complex structure consisting of bone, joints, nerves, muscle, tendons and ligaments surrounding the spinal cord. In itself back pain is not a disease. It is a symptom of a range of medical issues concerning one or more of the many parts that constitute the upper and lower back. Back pain is one of the more common complaints people of all ages endure. It is something most people experience in their lives, but its likelihood does increase with age. It affects women and men in equal numbers and most experience back pain for relatively short time periods, alleviating from 3-6 weeks with care. However, some people will develop ongoing pain that lasts for more than 3 months. When it strikes it can restrict all aspects of your life – family, social, work, and recreation. Without successful treatment, persistent back pain can have detrimental effects on the state of mind and mental wellbeing.
Types of Back Pain
Back pain is a broader term concerning discomfort anywhere along the spine, and in some cases extending down one or both legs.
Case Studies supporting PEMF benefits for Back Pain
CHRONIC PELVIC PAIN SYNDROME
A PROSPECTIVE, RANDOMIZED, PLACEBO CONTROLLED, DOUBLEBLIND STUDY OF PELVIC ELECTROMAGNETIC THERAPY FOR THE TREATMENT OF CHRONIC PELVIC PAIN SYNDROME WITH 1 YEAR OF FOLLOWUP
Purpose:Male chronic pelvic pain syndrome is a condition of uncertain etiology and treatment is often unsatisfactory. There is evidence that the symptom complex may result from pelvic floor muscular dysfunction and/or neural hypersensitivity /inflammation. We hypothesized that the application of electromagnetic therapy may have a neuromodulating effect on pelvic floor spasm and neural hypersensitivity.
Materials and Methods:
Following full Stamey localization men with National Institute of Diabetes and Digestive and Kidney Diseases category III prostatitis were prospectively randomized to receive active electromagnetic or placebo therapy. Active therapy consisted of 15minutes of pelvic floor stimulation at a frequency of 10 Hz, followed by a further 15 minutes at 50 Hz, twice weekly for 4 weeks. Patients were evaluated at baseline, 3 months and 1 year after treatment using validated visual analog scores.
A total of 21 men with a mean age of 47.8 years (range 25 to 67) were analyzed. Mean symptom scores decreased significantly in the actively treated group at 3 months and 1 year (p _0.05), unlike the placebo group, which showed no significant change (p _0.05). Subanalysis of those receiving active treatment showed that the greatest improvement was in pain related symptoms.
The novel use of pelvic floor electromagnetic therapy may be a promising new noninvasive option for chronic pelvic pain syndrome in men.
Effect of PEMF
Effect of Pulsed Electromagnetic Fields on Human Tenocyte Cultures From Supraspinatus and Quadriceps Tendons
Denaro V, Ruzzini L, Barnaba SA, Longo UG, Campi S, Maffulli N, Sgambato A: Effect of pulsed electromagnetic fields on human tenocyte cultures from supraspinatus and quadriceps tendons. Am J Phys Med Rehabil 2010;89:000–000.
To investigate the effects of pulsed electromagnetic fields (PEMFs) on human tenocyte cultures and to assess whether PEMFs could represent a viable therapeutic option in tendon pathologies.
Controlled laboratory study in which primary human tenocytes were isolated from healthy supraspinatus and quadriceps tendons and were exposed to the electromagnetic field stimulation. Cell growth and cell cycle were evaluated after 72 hrs, 5 days, and 7 days of continuous PEMF exposure
Tenocyte growth analysis, cell cycle analysis, and total collagen accumulation did not show statistically significant differences between exposed and control groups. Exposure to PEMF significantly accelerated cut closure 12 and 24 hrs after the injury.
PEMFs comparable with the ones used for the management of pseudoarthrosis stimulate closure of an in vitro laceration of a tenocyte monolayer. Our results provide the preliminary in vitro work and the basis to support the study of the in vivo effects of PEMFs on tendinopathies
Effect of Pulsed Electromagnetic Field Treatment on Alleviation of Lumbar Myalgia; A Single Center, Randomized, Double-blind, Sham-controlled Pilot Trial Study
Lumbago refers to the pain in the lumbar area, the most common type of back pain
- It is reported that 70-80% of adults will complain of lumbago at some point in their lives
- And chronic lumbago is known to be one of the key factors that limit the activities of the population over the age of 45
- Among these, myalgia refers to the symptoms of pain in the muscles. Clinically the state in which there is sharp pain in soft tissues other than joints with unknown cause without objective sign and abnormal test findings. Lumbago is classified into 4 types, namely, muscle tension, muscular spasm, muscle deficiency and myofascial pain syndrome according to cause of myalgia and its clinical characteristics
- Therefore, lumbar myalgia refers to the pain in the lumbar with the characteristics described above. Among the diverse treatments for the pain, electrical treatment (electrotherapy) is used the most frequently. Electrotherapy is used to induce muscular contraction by stimulating motor nerves or to control pain by stimulating afferent nerve fibers with large diameters
- However, it has the disadvantages: it cannot be applied to the parts of the body where an electrode cannot be attached; can damage the skin or tissues because it requires the use of electrodes; and is inconvenient for patients, who have to take their clothes off for preliminary measures before the fixation of the electrodes. Pulsed electromagnetic field (PEMF) therapy depolarizes muscles by inducing eddy currents in tissues through a pulsed magnetic field
- It can be applied to areas where electrodes are difficult to attach. It has been applied to various diseases since the confirmation of its efficacy in treatment of bone fracture mal-unions
- Therefore, this study carried out a comparative analysis of the indices related to the extent of discomfort and pain before and after treatment, daily life disabilities and depression. These indices were obtained from a placebo device comparison clinical test that applied pulsed electromagnetic therapy on lumbar myalgia.
Efficacy of Pulsed Electromagnetic Therapy for Chronic Lower Back Pain: a Randomized, Double-blind, Placebo-controlled Study
This randomized, double-blind, placebocontrolled 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.
Since obtaining approval from the United States Food and Drug Administration in 1979, pulsed electromagnetic therapy (PEMT) has been widely used to counteract pain resulting from various conditions such as arthritis of the knee joint, 1 – 3 ligament and muscle injuries, 1,4,5 delayed union fracture, 6 whiplash injury, 7 chronic pelvic pain, 8 headache, 9 complex regional pain syndrome type, 10 and multiple sclerosis. 11 In addition, PEMT has also been used to prevent osteoporosis 12, 13 and enhance scar healing. 14,15 However, its efficacy and the optimal modes of magnetic field administration remain intensely controversial.
A small number of randomized, doubleblind clinical studies 1 – 3 have suggested that PEMT is a promising therapy for knee osteoarthritis, but double-blind, placebo-controlled studies have not been conducted on its efficacy in patients with lower back pain. Back pain is one of the most common reasons for seeking medical treatment and the development of effective symptomatic treatment is vital. If PEMT can be shown in placebo-controlled studies to have a positive effect on lower back pain, it offers a useful treatment modality. We therefore studied the efficacy of PEMT in a randomized, doubleblind, placebo-controlled clinical trial in patients with chronic lower back pain.
Proto Bimedical journal
Pulsed electromagnetic field therapy effectiveness in low back pain: A systematic review of randomized controlled trials
Background: Lower back pain is a worldwide prevalent musculoskeletal condition in the general population. In this sense, the pulsed electromagnetic fields (PEMF) therapy has shown significant clinical benefits in several musculoskeletal conditions.
To assess the effectiveness of the PEMF therapy in reducing pain and clinical symptomatology in patients with low back pathological conditions.
It was performed a comprehensive database search using Pubmed, Scopus, Cochrane Library and PEDro databases to assess the effectiveness of the PEMF therapy in reducing pain and clinical symptomatology in patients with low back pathological conditions. More
Six studies were eligible inclusion on the qualitative analysis and five into the quantitative analysis, scoring an overall 6.8 points according the PEDro scale. The studies showed heterogeneity concerning the intervention protocols. More
PEMF therapy seems to be able to relieve the pain intensity and improve functionality in individuals with low back pain conditions. Further research is needed regarding PEMF effects on the different conditions of low back pain, with standardized protocols, More
Evaluation of the Efficacy of Pulsed Electromagnetic Therapy in the Treatment of Back Pain: A Randomized Controlled Trial in a Tertiary Hospital in Nigeria
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 care 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.
Case Study Reference Source:
1. A PROSPECTIVE, RANDOMIZED, PLACEBO CONTROLLED, DOUBLEBLIND STUDY OF PELVIC ELECTROMAGNETIC THERAPY FOR THE TREATMENT OF CHRONIC PELVIC PAIN SYNDROME WITH 1 YEAR OF FOLLOWUP
(Authors: E. ROWE, C. SMITH, L. LAVERICK, J. ELKABIR, R. O’N WITHEROW AND A. PATEL)
2. Effect of Pulsed Electromagnetic Fields on Human Tenocyte Cultures From Supraspinatus and Quadriceps Tendons
(Authors: "Vincenzo Denaro, MD", "Laura Ruzzini, MD", "Simona Angela Barnaba, MD", "Umile Giuseppe Longo, MD", "Stefano Campi, MD", "Nicola Maffulli, MD, MS, PhD, FRCS(Orth)", "Alessandro Sgambato, MD")
3. Effect of Pulsed Electromagnetic Field Treatment on Alleviation of Lumbar Myalgia; A Single Center, Randomized, Double-blind, Sham-controlled Pilot Trial Study
(Authors: Won-hyung Park, Seung-ho Sun, Sun-gu Lee, Byoung-kab Kang, Jong-soo Lee, Do-guwn Hwang and Yun-yeop Cha1)
4. Efficacy of Pulsed Electromagnetic Therapy for Chronic Lower Back Pain: a Randomized, Double-blind, Placebo-controlled Study
(Authors: PB LEE, YC KIM, YJ LIM, CJ LEE, SS CHOI, SH PARK, JG LEE AND SC LEE)
5. Evaluation of the Efficacy of Pulsed Electromagnetic Therapy in the Treatment of Back Pain: A Randomized Controlled Trial in a Tertiary Hospital in Nigeria
(Authors: KI Oke, PFA Umebese)
6. Pulsed electromagnetic field therapy effectiveness in low back pain: A systematic review of randomized controlled trials
(Authors: Renato Andradea, Hugo Duarted, Rogério Pereirae, Isabel Lopesf, Hélder Pereirag, Rui Rochak, João Espregueira-Mendes)