Combined Pulsed Electromagnetic Field and Physical Therapy Reduce Low Back Pain

by | Apr 29, 2020 | 2019, Alternative Therapies, EMF's

Written by Angeline A. De Leon, Staff Writer. A combination of pulsed electromagnetic field and conventional physical therapy protocol was superior to conventional physical therapy alone for alleviating non-specific low back pain in study participants.

back painNon-specific low back pain, lumbar pain that has no apparent relation to underlying disease, is a medical condition that is estimated to affect about 60% adults over the course of their lifetime 1,2. In industrial areas, low back pain is among the most common reasons for workplace absences 3. Treatment for chronic cases include invasive and non-invasive therapies; however, to date, no specific therapeutic approaches appear to be promising candidates as gold standard treatments for non-specific low back pain 4. In this respect, pulsed electromagnetic field therapy (PEMF), a non-invasive treatment modality that uses short bursts of electrical current to enhance cellular repair activity, is of great interest 4. Research evidence suggests that PEMF can effectively reduce pain in patients with knee osteoarthritis 5 and may enhance bone growth in those with acute fractures 6. PEMF has also been seen to significantly reduce back pain associated with lumbar arthritis 7. Some research has shown, however, that when added to standard therapy, PEMF does not appear to offer any additional benefit in treating low back pain 8. To clarify this, researchers at Cairo University (2019) looked at the effects of PEMF, in combination with conventional physical therapy, in patients with non-specific low back pain 9.

Using a prospective, randomized, single-blind, placebo-controlled study design, researchers enrolled a total of 50 patients (aged 20 to 40 years) with a neurological diagnosis of chronic non-specific low back pain persisting for at least the past 3 months. Subjects were randomized to receive either conventional physical therapy (involving Transcutaneous Electrical Nerve Stimulation, TENS, therapy for the low back and various stretching and strengthening exercises three times per week for one month) plus PEMF (using 50 Hz frequency with low intensity of 20 Gauss, for total of 12 20-minute sessions in one month) or conventional physical therapy plus sham electromagnetic field treatment. Pain intensity was assessed using a Visual Analogue Rating Scale (VAS), and spinal range of motion (ROM) and functional disability (Oswestry Disability Index, ODI) were evaluated.

Analyses revealed a significant between-group difference favoring the treatment group in pain intensity (Mean Difference = 1.52, 95% Confidence Interval: -0.34 to 3.35), disability (MD = 8.14, 95% CI: 6.5 to 9.96), ROM flexion (MD = -1.27, 95% CI: -1.09 to –1.45), ROM extension (MD = -1.1, 95% CI: -0.97 to –1.23), ROM right side bending (MD = 8.2, 95% CI: 6.56 to 9.84), and ROM left side bending (MD = 10.4, 95% CI: 8.81 to 11.99) (p = 0.05 for all).

Evidence from the current trial suggests that PEMF may be an effective adjunctive treatment for chronic non-specific low back pain. When combined with an individualized physical therapy program, PEMF resulted in significant improvement of pain intensity, functional disability, and lumbar range of motion. Differences in the efficacy of PEMF observed in the current study vs. other trials may be potentially attributed to differences in the intensity and frequency of PEMF therapy used; however, further research is still needed to refine the parameters required to achieve optimal pain relief 10. Other studies are warranted to determine the therapeutic effects of PEMF as an individual vs. adjunctive treatment for low back pain. The present study may be limited, considering the absence of double blinding in the trial design and the failure to conduct long-term follow-up assessments to examine the lasting effects of PEMF. It is also important to consider the incorporation of TENS therapy, a non-guideline approach 1, into the conventional physical therapy treatment protocol.

Source: Elshiwi AM, Hamada HA, Mosaad D, et al. Effect of pulsed electromagnetic field on nonspecific low back pain patients: a randomized controlled trial. Brazilian Journal of Physical Therapy. 2019; 23(3): 244-249. DOI: 10.1016/j.bjpt.2018.08.004.

© 2018 Associac¸˜ao Brasileira de Pesquisa e P´os-Graduac¸˜ao em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved.

Posted April 29, 2020.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

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