Neuropathic Pain

Case Studies supporting PEMF benefits for Neuropathic Pain

Effect of Magnetic Therapy on Balance Deficits in Patients with Diabetic Polyneuropathy: Randomized Controlled Trial

Abstract

Background: Diabetes mellitus (DM) is one of the most common chronic diseases all over the world. Incidence of and complications of DM has been increased over the last decade. Diabetic polyneuropathy (DPN) plays a significant role in falling among elderly patients because of significantly impaired sensation in the feet and reduced ability to properly control balance during daily activities. The aim of this study was to evaluate the effect of low frequency pulsed magnetic therapy (LFPMT) on balance in patients with DPN.

Methods: Thirty male patient with DPN were randomly assigned into two groups G1 (Study group) and G2 (Control group). Balance was evaluated pre and post-study using the Biodex Stability System and Short Form of Berg Balance Scale (SFBBS). G1 was treated with LFPMT for 30 min in session, 3 sessions in a week, for six weeks, while G2 received identical sham sessions.

The results: Pre-study (between groups) comparison revealed that the mean values of the overall stability indices (OSI) were (1.75 ± 0.75, 2.12 ± 0.45) for G1 and G2 respectively (P=0.11), the mean values of the SFBBS were (18.8 ± 3.61, 19.8 ± 1.93) for G1 and G2 respectively (P=0.35). At the end of the study (within groups) comparison revealed that the mean values of the OSI were (1.41 ± 0.78, 2.16 ± 0.7) for G1 (P=0.02) and G2 (P= 0.77) respectively, the mean values of the SFBBS were (23.07 ± 3.61, 19.6 ± 1.18) for G1 (P=0.00002) and G2 (P= 0.68) respectively. Post-study (between groups) comparison revealed that there were significant differences in SFBBS (P= 0.002) and OSI (P = 0.01), but in favor of G1.

Conclusions: LFPMT is an effective therapeutic modality in improving balance in patients with DPN.

Interactions of Low-Frequency, Pulsed Electromagnetic Fields with Living Tissue: Biochemical Responses and Clinical Results

Abstract

In recent years many studies have demonstrated stimulatory effects of pulsed electromagnetic fields (PEMF) on biological tissue. However, controversies have also surrounded the research often due to the lack of knowledge of the different physical consequences of static versus pulsed electromagnetic fields. PEMF is widely used for treating fractures and non-unions as well as for treating diseases of the joints. Furthermore, new research has suggested that the technology can be used for nerve regeneration and wound healing although conclusive clinical trials, besides those for fracture healing, are still lacking. Despite the apparent success of the PEMF technology very little is known regarding the coupling between pulsed electrical fields and biochemical events leading to cellular responses. Insight into this research area is therefore of great importance. In this review we describe the physical properties of PEMF-activated electrical fields and explain the typical set up for coils and pulse patterns. Furthermore, we discuss possible models that can account for mechanisms by which induced electric fields are able to enhance cellular signaling. We have emphasized the currently well-documented effects of PEMF on cell function from tissue culture and animal studies as well as from studies describing clinical effects on bone growth, nerve growth and angiogenesis. We believe this relatively new technology can become relevant for treating a variety of physiological conditions demanding enhanced cellular activity.

Pulsed Magnetic Field Therapy in Refractory Neuropathic Pain Secondary to Peripheral Neuropathy: Electrodiagnostic Parameters—Pilot Study

Abstract

Context: Neuropathic pain (NP) from peripheral neuropathy (PN) arises from ectopic firing of unmyelinated C-fibers with accumulation of sodium and calcium channels. Because pulsed electromagnetic fields (PEMF) safely induce extremely low frequency (ELF) quasirectangular currents that can depolarize, repolarize, and hyperpolarize neurons, it was hypothesized that directing this energy into the sole of one foot could potentially modulate neuropathic pain.

Objective: To determine if 9 consecutive 1-h treatments in physician’s office (excluding weekends) of a pulsed signal therapy can reduce NP scores in refractory feet with PN.

Design/setting/patients: : 24 consecutive patients with refractory and symptomatic PN from diabetes, chronic inflammatory demyelinating polyneuropathy (CIDP), pernicious anemia, mercury poisoning, paraneoplastic syndrome, tarsal tunnel, and idiopathic sensory neuropathy were enrolled in this nonplacebo pilot study. The most symptomatic foot received therapy. Primary endpoints were comparison of VAS scores at the end of 9 days and the end of 30 days followup compared to baseline pain scores. Additionally, Patients’ Global Impression of Change (PGIC) questionnaire was tabulated describing response to treatment. Subgroup analysis of nerve conduction scores, quantified sensory testing (QST), and serial examination changes were also tabulated. Subgroup classification of pain (Serlin) was utilized to determine if there were disproportionate responses.

Intervention: Noninvasive pulsed signal therapy generates a unidirectional quasirectangular waveform with strength about 20 gauss and a frequency about 30 Hz into the soles of the feet for 9 consecutive 1-h treatments (excluding weekends). The most symptomatic foot of each patient was treated.

Results: All 24 feet completed 9 days of treatment. 15/24 completed follow-up (62%) with mean pain scores decreasing 21% from baseline to end of treatment (P = 0.19) but with 49% reduction of pain scores from baseline to end of follow-up (P < 0.01). Of this group, self-reported PGIC was improved 67% (n = 10) and no change was 33% (n = 5). An intent to treat analysis based on all 24 feet demonstrated a 19% reduction in pain scores from baseline to end of treatment (P = 0.10) and a 37% decrease from baseline to end of follow-up (P < 0.01). Subgroup analysis revealed 5 patients with mild pain with nonsignificant reduction at end of follow-up. Of the 19 feet with moderate to severe pain, there was a 28% reduction from baseline to end of treatment (P < 0.05) and a 39% decrease from baseline to end of follow-up (P < 0.01). Benefit was better in those patients with axonal changes and advanced CPT baseline scores. The clinical examination did not change. There were no adverse events or safety issues.

Conclusions: These pilot data demonstrate that directing PEMF to refractory feet can provide unexpected shortterm analgesic effects in more than 50% of individuals. The role of placebo is not known and was not tested. The precise mechanism is unclear yet suggests that severe and advanced cases are more magnetically sensitive. Future studies are needed with randomized placebo-controlled design and longer treatment periods.

Case Study Reference Source:

  • 1. Effect of Magnetic Therapy on Balance Deficits in Patients with Diabetic Polyneuropathy: Randomized Controlled Trial
    (Authors: Waheed Ali Hasan Abu-Mansour Filimban, Amir Abdel-Raouf El-Fiky, Omar Farouk Farahat Helal, Ashraf Abdelaal Mohamed Abdelaal)

  • 2. Interactions of Low-Frequency, Pulsed Electromagnetic Fields with Living Tissue: Biochemical Responses and Clinical Results
    (Authors: Ulrik L Rahbek, Katerina Tritsaris, Steen Dissing)

  • 3. Pulsed Magnetic Field Therapy in Refractory Neuropathic Pain Secondary to Peripheral Neuropathy: Electrodiagnostic Parameters—Pilot Study
    (Authors: Michael I. Weintraub and Steven P. Cole)