I have read many published reviews of the medical literature on the effectiveness of pulsed electromagnetic fields (PEMFs) in the management of osteoarthritis of the knee. The conclusions reached by the authors, who are almost all academics and rarely personally experienced in the use of magnetic fields, are only modestly positive, indicating some benefit. The authors generally use very stringent criteria to judge the design of the studies to draw their conclusions. It is very challenging and expensive to design and carry out a study that would meet the strictest standards for high-quality research. These reviews yielded conflicting conclusions regarding pain and function benefits of PEMFs. The process of research is “painfully” slow, that is, many of us have to remain in pain and resort to ineffective and dangerous conventional approaches while we wait for the brick by brick science process to produce sufficient evidence that would be acceptable by even the most hardened skeptics.
I was very pleased to read a new review with a different perspective regarding the analysis of the available research studies. These authors* reviewed 14 randomized, placebo-controlled trials that included a total of 482 patients in the treatment group and 448 patients in the placebo group. They found no significant effects at any of the time points considered in the effectiveness of PEMFs in treating pain when the data were looked at as a whole. However, when they separated out the trials using high-quality methodology, PEMFs were significantly more effective at 4 and 8 weeks than placebo. For function, a significant improvement was found at 8 weeks after starting treatment, with those receiving active PEMF treatment having 30% better results. They did not find any significant occurrence of adverse events.
Unfortunately, studies often do not differentiate the severity of the individuals entering the trials. Clinically it’s very evident that those with more severe function and who are considerably older do not fare as well with treatment at least at the four and eight weak points, considered in this review. Many individuals in my experience will begin see improvements right away and then the benefits continue to accumulate the longer the PEMFs are used. Most research trials have to end at some point because of the cost of continuing the research. In clinical practice, individuals may be able to use PEMF therapies for much longer periods of time. It is over the longer period of time that the most results are seen, especially in the more severe situations and in older patients who don’t have the healing capacity of younger people.
There is some new evidence that it’s possible to regenerate cartilage cells, if there is still a sufficient number of remaining cartilage cells in the joint. Joints that are bone on bone are not going to be able to get cartilage regeneration, unless new or experimental techniques for implanting cartilage stem cells are used as well. Relying on office-based treatments of arthritis is also going to be of limited value because the treatments can never be done over a long enough period of time, given the cost and inconvenience of that approach. So, I will almost always recommend individuals purchase a PEMF system for their own home use for the long-term. Almost all the PEMFs systems on www.drpawluk.com will work for arthritis of the knee, or most other arthritis as well, for that matter. Go to http://www.drpawluk.com/c/reviews to see devices that I have reviewed and recommend.
*Effects of pulsed electromagnetic field on knee osteoarthritis: a systematic review. Ryang We S, Koog YH, Jeong KI, Wi H. Rheumatology (Oxford). 2012 Apr 13.
Dr. William Pawluk