When you or a loved one have health challenges such as migraines, arthritis, breaking a hip, or depression, it can rob you of what matters most to you in life. It is impossible to recover the countless moments that were negatively impacted by health problems. Not to mention, the threat posed to your livelihood, lifestyle, and dependents if a health problem interferes with your ability to work, pay your bills, or be a caregiver.
Your doctor may say that there is not much more that can be done to help. Have you ever heard that and decided to embark on your own search for answers? These quests are lonely, discouraging, and fraught with uncertainty. The only alternative is a life of quiet desperation and resignation as the unaddressed problem bleeds into every area of your life.
This article was written for each of you who are holding out hope for solutions and willing to wade through Hell and high water to help yourself or your loved one. Even if it's just a small victory towards alleviating some of the damage, it's a win. Regaining the ability to participate more in life is priceless. Shortening the recovery time for someone who has already endured all the pain you can bear to watch is heroic.
The story of PEMF is still in its infancy, shrouded in mystery and entangled in countless complexities. (Consider reading the previous PEMF article in this series to learn more about it.)
If you have ever undertaken a project that took months of effort and a hefty investment only to see it fail, then you can relate to these dedicated researchers. They are willing to fight their way through discouragement and often defeat because they all have this in common with you—HOPE.
Hope helps us all keep walking this rough road together. Whatever your journey, this article was placed on your path for a reason. Its aim is to encourage you and help light your way through the darkness.
These scientists have no guarantees that the experimental treatments will work for the participants. It is also impossible to predict if PEMF would help with the unique challenges you are facing.
Everything you learn helps you navigate all available treatment options and create a plan of action to turn things around. The most complete healing possible might involve many different tools and strategies to reach that destination. We share your hope that all your hard work and research will eventually result in significant health improvements to celebrate!
(Foreward by Christa Rucker, April 2020)
The first article in this series explained the scientific principals of PEMF (pulsed electromagnetic field therapy) and its background. It was designed to help you avoid both manipulative marketing from any dishonest PEMF companies as well as any overly critical naysaying from skeptics.
Now we’re going to dive right into the scientific studies. Most of this article focuses on claims that have been studied adequately enough for published scientific reviews to have examined the collective body of evidence as a whole.
This way, you aren’t relying on just anyone to editorialize what they think of the studies. Instead, you will see what the accredited researchers concluded from analyzing data from multiple studies on a given use. In a few cases, cell studies will be referenced to support claims about what PEMF might be doing. Although, those cell-study claims are speculative.
The best PEMF devices have a similar or slightly higher intensity than the earth’s natural magnetic field. One that lets you adjust the settings yourself is better than those that follow automated, changing programs.
The theory floating around that PEMF induces brainwave entrainment is false. No research has ever studied the effects of any frequency-shifting program.
Bone healing has been the subject of several scientific reviews of PEMF over the last two decades. No other potential use for PEMF has garnered as much attention from Western researchers. Treatment of pain and swelling is a distant second.
Most other uses of PEMF have yet to attract enough study for reviews or meta-analyses to cover. At best, there are a few human trials to rely on. Those are supported by other lines of evidence, such as cell studies that look promising. Study authors repeatedly state that PEMF deserves much more attention than it has received.
The limited evidence available suggests PEMF probably has many positive effects. There is simply not enough evidence to say with certainty that it will improve specific health problems. Yet it's encouraging that the evidence we do have is not showing that PEMF won't work for treating the health problems being studied.
The foundational physics equations that united magnetism and electricity were devised in the 19th century by physician James Clerk Maxwell. Maxwell used the term relativity in his 1877 book Matter and Motion. Einstein was introduced to the concept of relativity through reading that book, which also shaped his understanding of electromagnetism.
Readers of Physics World voted Maxwell’s equations as being their favorite equations of all time (1). They held the key for the invention of nearly every technology used in modern society: radios, television, smartphones, radars, computers, wireless Internet connections, Bluetooth technology, and so much more!
Prior to Maxwell, it was believed the energetic force was on the magnets. Maxwell’s theory was that it was in the nearby field or space, giving rise to the theoretical concept that an electromagnetic spectrum even existed.
One of his most famous equations, Faraday’s Law, explains how a changing electric impulse can generate a magnetic field. The inverse is true as well because a changing magnetic field can induce an electric current (2).
The famous Faraday's Law equation explains why the changing electric impulse in the PEMF device generates a magnetic field around the device. This resulting field creates electrical impulses that may have beneficial, undetermined, or detrimental impacts upon many physiological processes in the human body, especially in the brain and bone. Our bodies are capable of receiving electromagnetic signals similar to a Wi-Fi connection or radio antenna.
The results of a double-blind, randomized, controlled trial (DB-RCT) found PEMF reduced pain and improved wound healing after C-sections. The study included 72 women. PEMF was administered to half; the others received a sham treatment.
In the first 24 hours after surgery, 72% of the sham group reported pain, but only 36% of the PEMF group. Those in the sham group needed two times the cumulative dose of analgesics to manage pain during the first 24 hours. The same pain management ratio was seen on day seven.
When the surgical incision was examined on the seventh day, women in the PEMF group had healed better than the others. No swelling, redness, or drainage of the incision site was seen in the PEMF group.
A DB-RCT of 56 women found PEMF to be beneficial for fibromyalgia symptoms such as pain, fatigue, and overall functioning. PEMF might improve markers of bone damage and inflammation characteristic of complex regional pain syndrome type I (CRPS-I), also called algodystrophy. That CRPS-1 review examined data from 22 cell studies and 8 animal studies on bone damage as well as 9 cell studies and 5 animal studies on improving inflammation. (1, 2, 3).
One DB-RCT found that 27MHz was effective for neck pain. Another study found PEMF useful for osteoarthritis pain of the hand and knee, but not of the neck. This DB-RCT found no effect on pain and swelling after implant surgery, and another showed no impact on heat pain.
Early evidence suggests PEMF could help alleviate headaches. Animal studies indicate that PEMF could have an analgesic effect by activating nitric oxide. Research also suggests the ideal frequency may differ based upon how soon PEMF is initiated after injury and found 17Hz is more effective than 50Hz (hertz) for pain management.
Despite those few hopeful studies already mentioned, even when PEMF improves physical outcomes, the results are disappointing in the majority of pain management studies. (1, 2, 3, 4, 5, 6). Early research had suggested that specific PEMF waveforms could have a positive effect on pain and swelling. As a result, this became one of two conditions that PEMF was approved to treat by the FDA. However, research in years since then indicates that PEMF is probably not very useful for this.
Inconsistencies could be explained by the study parameters or even statistical flukes. Standardized research is needed to know what specific combinations of intensities, frequencies, treatment onset, session lengths, and how many sessions are necessary. Until then, it is not possible to recommend any specific treatments or their predicted outcomes for pain management.
The most substantial evidence, by far, exists for bone healing. Cell studies clearly show that PEMF activates many pathways relevant to the development of bone. Much less evidence exists for other forms of tissue repair and healing.
Studies have observed the role of piezoelectricity in bone growth since the 1950s. Piezo is a Greek term meaning: to squeeze. Piezoelectricity is an electric charge that builds up in response to pressure. Stress causes the electrical charge across bones to change.
This change attracts bone-building cells (osteoblasts) to deliver minerals like calcium. This is how the pressure of gravity increases bone density. Researchers believe PEMF might help reduce the loss of bone density caused by long flights in space (1, 2, 3, 4, 5).
A 2019 review summarizes the evidence that PEMF activates these bone-related signaling pathways:
One study on osteoporosis in rats found no changes from PEMF except that the bone's interior matrix grew denser. The increase correlated with a higher rate of blood flow to the bone. This suggests increased circulation may also play a role in how PEMF facilitates healing.
Bone disorders are the condition for which PEMF has been studied most. Researchers behind a 2019 review noted, "...many preclinical and clinical efficacy evaluation studies are still needed to make PEMFs more effective."
PEMF treats osteoporosis and bone fractures (including delayed and non-union fractures). It also improves thigh bone osteonecrosis (also called avascular necrosis). In that disease, bone tissue is dying from inadequate blood supply (1, 2, 3). They also found PEMF is possibly useful for engineering bone tissue for implants and aiding core decompression and bone graft treatments.
A Chinese RCT for osteoporosis found PEMF as effective as the leading medication, alendronate. It defined a single course of PEMF as five weeks of forty-minute treatments, six days per week. The PEMF device used asymmetric 8Hz pulses with a peak intensity of 3.82μT (microteslas). A review of four studies in 2013 and another review in 2018, found the evidence promising but highlighted the need to study PEMF parameters more carefully.
Another Chinese research article states, “EMF interaction in tissue restoration is a matter of national priority.” In a 2014 review involving 737 patients from 13 trials measuring the time it takes bone fragments to fuse, researchers noted, "PEMF and LIPUS significantly shorten time to a radiological union for acute fractures... [and] diaphyseal fractures."
A review of 82 studies on diabetic skin wounds concluded, "...both PEMF and low-level laser therapy (LLL) demonstrated a significant clinical benefit compared to the control or sham treatment..."
An animal study evaluated treatments for burns affecting the skin of rats (2). It concluded: "Our study results showed the positive healing effects of electric stimulation and pulsed electromagnetic fields on burn injury. Pulsed electromagnetic fields therapy produced more positive signs of healing than the electric stimulation group."
One study looked at PEMF for tissue regeneration in a condition that degrades the tendon called tendinopathy. It is far more severe than tendonitis, which is acute inflammation that is a temporary response to injury. Due to the naturally limited blood supply to all tendons, untreated tendonitis can turn into tendinopathy if the tissue is unable to recover. Here is what they discovered.
In-vitro studies demonstrated that both pulsed electromagnetic fields (PEMF) and extracorporeal shock wave therapy (ESWT) increased the expression of a pro-inflammatory cytokine such as interleukin (IL-6 and IL-10). ...PEMFs may play a role [in the] treatment of tendinopathy and for tendon regeneration, increasing in vitro TGF-β production, as well as scleraxis and collagen I gene expression.
It is possible that PEMF may be useful for treating frozen shoulder. One study of 32 participants reported, "...(15/20) of participants reported pain relief of 30% or more with PEMF compared with 0% (0/12) of participants receiving placebo... [also] ...(11/20) of participants reported total recovery of joint function with PEMF compared with 0% (0/12) of participants receiving placebo..."
A rabbit study evaluated the best treatment for alkali chemical cornea burns. It found PEMF was as effective as red light therapy (aka low-level laser therapy LLLT) at reducing the loss of specialized fibroblasts within the cornea. The study found that red light therapy worked best because it also reduced inflammation (3). Some rabbits received both PEMF and LLLT. The two treatments together were not more effective than PEMF alone, and the combination was less effective than LLLT alone.
PEMF is likely useful for treating rheumatoid arthritis (RA) (1). RA is an autoimmune disease that results in progressive damage to cartilage and bone. As it progresses, cells in the synovial membrane proliferate and become inflamed.
The body attempts to develop new blood vessels, but this chain of events contributes further to the progression of RA. Many leading treatments for RA use anti-vascular-endothelial-growth-factor therapy (anti-VEGF), which works by turning these blood vessel growth factors off. PEMF has the potential to reverse vascular dysfunction by modulating VEGF.
MSCs (mesenchymal stromal cells/pericytes) play a crucial role in tissue repair. MSCs are found in the synovial membrane within joint tissue. The inflammatory processes that take over in RA prevent MSCs from achieving the differentiation necessary for joint repair. PEMF facilitates both differentiation and functional activity of MSCs.
PEMF has been demonstrated to have anti-inflammatory effects through modulating cytokines. PEMF also increases the deposition of collagen, which arthritis is known to damage.
Pain and swelling throughout the night can interfere with good sleep. There is weak evidence PEMF may treat pain and swelling. That means PEMF may improve sleep when it treats pain and swelling. There is only one sleep study on PEMF in otherwise healthy subjects.
This study showed remarkable results. It used a 4Hz field at a strength of 5μT placed under the pillow overnight. Study authors observed that it took 1–3 weeks for the benefits of PEMF to appear in a prior pilot study. Hence, they scheduled this study to last four weeks.
In the control group, only a single patient experienced a reduction of symptoms. Over half experienced no relief at all. In the PEMF group, 70% of patients experienced significant or complete remission of symptoms. A further 24% experienced noticeable improvement. Every single one in the PEMF group experienced at least some relief.
A 2016 review concluded that PEMF is likely useful for depression. (Note: one of the authors is co-owner of a company that sells PEMF devices.) The studies show that variations of PEMF improved depression in rats (as measured by the forced swim test). Both patients with bipolar disorder and those with treatment-resistant depression experienced improvement. Additionally, neurons became more excitable in healthy volunteers.
A case study reports that a 40-year-old woman with multiple sclerosis (MS) had sleep paralysis from the age of 16. Apparently, PEMF cured her sleep paralysis at a dose of 5Hz and 7.5pT picoteslas (the equivalent of 7.5×10-6µT microteslas) for two 20–minute sessions separated by a 15–minute break once or twice per week.
One of the several major theories about the biological origins of depression emphasizes the connections between different parts of the brain. Others point to reduced serotonin levels and neurogenesis resulting from inflammation. The authors of one review found that there is some evidence for the beneficial effects of PEMF relevant to every hypothesis of depression.
There is a possible connection in the way PEMF improves sleep and depression. Sleep-tracking data may provide a useful method for individuals to experiment with the effects of PEMF on depression. This is mere speculation supported by several compelling lines of evidence.
Depressed patients spend more time in REM and reach the first REM cycle of the night faster. Antidepressants seem to correct this and help delay the onset of REM. Researchers measured the time to REM onset after the first few nights that patients took an antidepressant. They found that this did a better job of predicting if it would help their depression than asking them how they felt.
Similar to antidepressants, high-frequency, repetitive, transcranial, magnetic stimulation (rTMS) also treats depression in part by delaying the onset of the first REM cycle. It is plausible that PEMF might do this as well. If you’re treating depression and using PEMF, consider tracking your REM sleep. If the first REM cycle is delayed, that’s a good sign.
What’s the connection between sleep, depression, and PEMF? During REM sleep, the brain produces vivid imagery, and the muscles are paralyzed. This prevents people from acting out every motion of their dreams in real life. Sleep paralysis involves an intrusion of these processes into a waking state of consciousness. In sleep paralysis, a person experiences vivid imagery and paralysis while awake and conscious.
Melatonin levels rise during the deep stages of sleep. During REM sleep, melatonin production slows down. This deactivates serotonergic neurons, creating paralysis. Afterward, melatonin levels rise again. This causes serotonergic neurons to reactivate, allowing voluntary movement to resume.
When serotonin is low, these neurons cannot return to their regular functioning. Night-time plasma levels of melatonin are low in MS patients, as is serotonin. MS patients are at an unusually high risk of developing sleep disorders.
Antidepressants that raise serotonin levels can also help treat sleep paralysis. This suggests that PEMF achieves these effects in a similar manner. When PEMF increases how easily neurons can fire, serotonin can travel fluidly throughout the brain.
Furthermore, depressed patients often have lower cAMP levels. Raising cAMP can have an antidepressant effect. Some antidepressants likely raise cAMP. There is in vitro evidence that PEMF should increase cAMP levels in the brain (1, 2, 3, 4).
Melatonin is produced by the pineal gland, which is sensitive to magnetic fields (1,2,3). In fact, this sensitivity is so important that it contributes to our sense of direction. There is no evidence yet that PEMF increases melatonin. So far, there is only evidence that other forms of EMF can reduce melatonin.
A meta-analysis of rTMS found it produced no consistent changes in BDNF levels. Of course, BDNF is not the only important factor in neurogenesis. No studies have addressed the effect of PEMF on BDNF or neurogenesis.
Specific neurons have a hard time firing in primary depression. For the participants of one study, only a higher dose of PEMF improved existing symptoms of apathy, such as fatigue, difficulty concentrating, or lack of motivation. This suggests PEMF may help depression by making it easier for neurons to fire. In contrast, anxiety often involves an increased tendency for other neurons to fire.
Specific regions of the brain are targeted by rTMS treatments. PEMF does not target isolated areas of the brain, which may be the difference. If PEMF increased the tendency for the wrong parts of the brain to fire, it could worsen anxiety.
Limited evidence does suggest PEMF may reduce improvements in anxiety. In a study of 40 patients, those using the Re5 PEMF device experienced more relief from depression than controls. On the other hand, they also experienced more symptoms related to anxiety.
Another study of lower back pain among military veterans found an increase in anxiety from PEMF treatment. Even four weeks after rTMS treatment ended, a dose between 2–5Hz resulted in lingering increased excitability of the parts of the brain that were targeted. If PEMF does this too, it could make anxiety worse for a long time. It is noteworthy that PEMF reduces cortical excitability at low doses of less than 1Hz.
A double-blind RCT of older volunteers found PEMF useful for reducing blood pressure. Researchers tested the effects on blood pressure using a PEMF device called Impulser™ Pro mattress on participants who used it for 15-minute sessions 5 days a week for 12 weeks. The 54 men and women in the study were an average age of 60.
That study concluded, "The results include statistically significant reductions in systolic and pulse blood pressure, while no significant difference in diastolic pressure or the index of arterial stiffness was observed. These findings suggest that PEMF treatment might be linked to improvements in peripheral resistance or circulation."
A study of anesthetized rats found just two minutes of PEMF dilated blood vessels by 9% (1). Studies find PEMF increases the development of new blood vessels by stimulating basic fibroblast growth factor.
This could be why PEMF was found to be useful for migraines (but not tension headaches). A double‐blind, placebo‐controlled study of 34 women and 8 men were randomized into two groups. One group received PEMF, and the rest had a sham treatment. Their inner thighs were treated with one hour sessions, five days a week, for fourteen days.
The study's authors said, "During the first month of follow‐up, 73% of those receiving actual exposure reported decreased headaches (45% good decrease, 14% excellent decrease) compared to half of those receiving the placebo (15% worse, 20% good, 0% excellent)."
According to this in-vitro study, PEMF alters the expression of genes that improve cell functions disrupted in Alzheimer’s Disease. They reported, "Our results demonstrate the ability of our LF-PEMF to modulate gene expression in cell functions that are dysregulated in AD [Alzheimer's Disease]..."
The loss of memory seen in aging might be the result of disorganized circadian rhythms. Less melatonin is produced as we age, and circadian rhythms are delayed in the elderly. Disrupting circadian rhythms in rats causes retrograde amnesia. Some drugs used to treat Alzheimer’s mimic the phase-shifting effects of light exposure.
The earth’s magnetic field goes through daily cycles. The cycle of heating and cooling creates jet streams in the atmosphere moving north and south. This creates regular circadian rhythms in the magnetic field of the earth. We may have evolved to be sensitive to these changes. Studies in hamsters, birds (1, 2), and human beings (1, 2) have suggested just that.
Shielding human subjects from the earth’s natural field disrupted their biological clocks, according to German studies. Their circadian rhythms restored in response to an artificial magnetic field at a dose of 10Hz and 25mv/cm.
A case report on Parkinson’s discovered that PEMF restored a patient’s ability to remember dreams. Another found t-PEMF improved Parkinson's-affected handwriting for months afterward. An RCT found it improved speed and explosive strength on rate-of-force tests. A study in aging rats found PEMF enhanced cognitive performance and voluntary movement.
Credible evidence exists for using nanosecond-pulsed electric-field (nsPEF) technology in cancer treatment. Since nsPEF is a form of PEMF, both types of devices may likely share similar mechanisms of action. Although nsPEF devices target cancerous cells by using higher intensities and frequencies than PEMF devices. Furthermore, most PEMF devices don’t target specific cells.
How many effects carry over from one set of parameters to others is, as usual, unclear. There is actually some theoretical reason to think PEMF might help cancer. When we look at the mechanisms behind nsPEF therapy, we can see that PEMF activates many of the same pathways.
As early as 1926, researchers suggested classifying cancer cells by their electric properties. Cancer cells have less potassium, magnesium, and calcium than healthy cells. They have more sodium and unstructured water. These are some of the factors that cause them to be more conductive than healthy cells.
It may even be possible to spot pre-cancerous cells by measuring their impedance. The increased negative charge on the surface of the cancer cell alters its permeability. This disrupts aerobic metabolism, which causes a shift to anaerobic metabolism. This shift promotes further cell division (mitosis), which is how cancer spreads. So one could infer that PEMF might affect healthy cells quite differently from cancerous ones.
PEMF promotes the growth of new blood vessels in healthy tissue but inhibits this process in tumors (1, 2, 3, 4, 5, 6). Chemotherapy targets all rapidly dividing cells indiscriminately, including healthy cells that are rapidly dividing by nature. PEMF can single out cancerous cells without harming healthy ones (1, 2, 3). Most likely, nsPEFs produce effects through pathways that are also activated PEMF.
A human study found the Therabionic nsPEF device was helpful for advanced liver cancer. It concluded, "In patients with advanced HCC, THERABIONIC is a safe and effective novel therapeutic option, which has a significant anti-tumor effect and provides pain relief in the majority of patients."
Studies have shown nsPEF treatments make both chemotherapy and radiation therapy more effective. One study found different types of cancer cells were sensitive to specific frequencies between 0.1 to 114 kilohertz (kHz). These settings were optimized further to destroy melanoma cells with a single treatment in vitro.
The literature is full of scattered evidence for many more potential effects of PEMF. Improved sperm quality was found at a dose of 15Hz at 8 Gauss (800µT.) A group of Russian alcoholics experienced reduced cravings for alcohol when using PEMF.
Clearly, PEMF deserves more methodical research attention than it has received. Until that happens, using PEMF is a bit of a gamble that may or may not be worth it for the chance to potentially achieve the desired benefit.
We need to standardize all of the research to date and pinpoint the differing PEMF parameters, including waveform, intensity, frequency, duration, device materials, and tissue density. It would give us a much better idea of how to use PEMF to facilitate a variety of positive outcomes and minimize the risk of side-effects.
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