Even strengths lower than the QRS may also treat knee pain in osteoarthritis. Treatment for eight 6-min sessions over a 2-wk period may give a 46% decrease in pain vs. an average 8% in the placebo group, sustained at the same level even two weeks after treatment.

A 50 Hz pulsed magnetic field sinusoidal, 0.035 Tesla field PEMF for 15 min for 15 treatment sessions improves hip arthritis pain in 86% of patients. Average mobility without pain improved markedly.

Post-traumatic Sudeck-Leriche syndrome (late stage reflex sympathetic dystrophy - RSD) is very painful pain and largely untreatable by other approaches. Ten 30-minute PEMF sessions of 50 Hz followed by a further 10 sessions at 100 Hz plus physiotherapy and medication reduced edema and pain at 10 days. There is no further improvement at 20 days.

Neuropathic pain syndrome (NPS) patients benefit from pulsed radiofrequency (PRF) treatment. Patients with severe left-sided sciatica and back pain, neuropathic pain in the anterior chest wall had been taking oral medications and had received repeated injections of local anesthetic agents and steroids with poor results. The patients treated with an invasive PRF applied to the related lumbar dorsal root ganglion for 2 minutes or the spinal roots of the thoracic T2-T4 dermatomes experience significant pain relief.

Even chronic musculoskeletal pain treated with MFs for only three days, once per day can eliminate and/or maintain chronic musculoskeletal pain.

A static magnetic foil placed in a molded insole for the relief of heel pain was used for 4 weeks to treat heel pain. 60% of patients in the treatment and sham groups reported improvement. There was no significant difference in the improvement on a foot function index. A molded insole alone was effective after 4 weeks. The magnetic foil offered no advantage over the plain insole, in this study. This study like others with low numbers of patients, may not have had a large enough sample. Placebo reactions in pain studies can be large and differences in benefit may be harder to detect. In addition, since magnetic foils produce fairly weak fields, placement against tissue becomes important, as does consideration of the depth into the body of the target lesion or tissue. Magnetic fields drop off in strength very rapidly from the surface.

Even small, battery-operated PEMF devices with very weak field strengths have been benefit musculoskeletal disorders. Because of the low strength used treatment at the site of pain may need to last between 11 to 132 days, between 2 times per week, 4 hours each or, if needed, continuous use. Use at night could be near the head, e.g., beneath the pillow, to facilitate sleep. Pain scale scores are significantly better in the majority of cases. Conditions that can be considered are arthritis, lupus erythematosus, chronic neck pain, epicondylitis, femoropatellar degeneration, fracture of the lower leg and Sudeck's atrophy.

240 patients treated with PEMFs in a conservative orthopedic practice had decreased pain, increased functionality and increased point pressure thresholds, disappearance of swelling and pathological skin coloration, less need for orthopedic devices and less reaction to changes in the weather. Treatments are daily for an hour. Conditions treated are: rheumatic illnesses, delayed healing process in bones and pseudo-arthritis, including those with infections, fractures, aseptic necrosis, loosened protheses, venous and arterial circulation, reflex sympathetic dystrophy all stages, osteo-chondritis dissecans, osteomyelitis and sprains and strains and bruises. The success rate approaches 80%. Even X-rays may show improvement. cartilage/bone tissue may reform, including the joint margin. About 60% of loosened hip protheses have subjective relief of pain and walk better, without a cane. Perthes’ disease rarely completely reforms the articular head of the hip.

Summary
PEMFs of various kinds and strengths have been found to have good results in a wide array of painful conditions. There is little risk when compared to the potential invasiveness of other therapies and the risk of toxicity, addiction and complications from medications. Clearly more research is needed to elaborate mechanisms and optimal treatment parameters. Many studies that have been reported here have been controlled trials and many have been double blind placebo. Medical practitioners are becoming gradually aware of the potential of MFs to successfully treat or significantly benefit the myriad of problems presented to them.

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