Case Studies supporting PEMF benefits for Carpal Tunnel
Pulsed Magnetic Field Therapy In Refractory Carpal Tunnel Syndrome: Electrodiagnostic Parameters – Pilot Study
Context: Neuropathic pain arises from ectopic firing of nociceptors. Since pulsed electromagnetic fields (PEMF) generate extremely low frequency (ELF) quasi-rectangular currents which influence biological activity, it was hypothesized that directing this energy into the carpal tunnel region could influence neuronal firing patterns and lower VAS scores of neuropathic pain.
Objective: To determine if nine consecutive one-hour treatments (excluding weekends) of a pulsed signal therapy can reduce neuropathic pain scores in refractory hands with carpal tunnel syndrome.
Design/setting/patients: 35 consecutive hands were enrolled in this non-placebo pilot study between July and November 2002. All subjects had to be constantly symptomatic and a failure to therapy. Primary endpoints were comparison of visual analog scores (VAS 0–10) at the end of 9 days of treatment and the end of 30 days follow-up compared to baseline pain scores. Additionally, at the end of study, patients responded to a questionnaire (PGIC) describing their response to treatment. Secondary endpoints were comparison of sensory and motor distal latencies of median nerve after treatment with baseline. Additionally, clinical examination changes were tabulated with baseline. Five hands were surgical failures.
Intervention/device: Non-invasive pulsed signal therapy generated a patented unidirectional quasi-rectangular waveform with strength less than 20 gauss and frequency less than 30 Hz into the carpal tunnel region for nine consecutive one-hour treatments (excluding weekends). The specific amount of energy directed at the target site was unknown.
Results: Statistical reduction (ANOVA) of pain scores at end of treatment (23%) and also end of follow-up (37%) were noted in the 33 hands that completed the study. The PGIC questionnaire revealed 67% improvement. Clinical and electrodiagnostic examination data did not change from baseline to end of study. There were no adverse events or safety issues.
Conclusion: Our pilot data suggests that directing PEMF to the carpal tunnel region can provide modest, short-term relief for a majority of individuals. The precise mechanism is unclear in the absence of electrophysiological changes. This provocative data requires confirmation with randomized, placebo-controlled, double-blind trials and additional electrophysiological markers.
Pulsed magnetic field versus ultrasound in the treatment of postnatal carpal tunnel syndrome: A randomized controlled trial in the women of an Egyptian population
The aim of this study was to compare the effects of pulsed electromagnetic field versus pulsed ultrasound in treating patients with postnatal carpal tunnel syndrome. The study was a randomized, double-blinded trial. Forty postnatal female patients with idiopathic carpal tunnel syndrome were divided randomly into two equal groups. One group received pulsed electromagnetic field, with nerve and tendon gliding exercises for the wrist, three times per week for four weeks. The other group received pulsed ultrasound and the same wrist exercises. Pain level, sensory and motor distal latencies and conduction velocities of the median nerve, functional status scale and hand grip strength were assessed pre- and post-treatment. There was a significant decrease (P<0.05) in pain level, sensory and motor distal latencies of the median nerve, and significant increase (P<0.05) in sensory and motor conduction velocities of the median nerve and hand grip strength in both groups, with a significant difference between the two groups in favour of pulsed electromagnetic field treatment. However, the functional status scale showed intergroup no significant difference (P>0.05). In conclusion, while the symptoms were alleviated in both groups, pulsed electromagnetic field was more effective than pulsed ultrasound in treating postnatal carpal tunnel syndrome.
Case Study Reference Source:
1. Pulsed magnetic field therapy in refractory carpal tunnel syndrome: Electrodiagnostic parameters – pilot study
(Authors: Michael I. Weintrauba, and Steven P. Coleb)
2. Pulsed magnetic field versus ultrasound in the treatment of postnatal carpal tunnel syndrome: A randomized controlled trial in the women of an Egyptian population
(Authors: Dalia M. Kamel, Nashwa S. Hamed, Neveen A. Abdel Raoof, Sayed A. Tantawy)