What is the effectiveness of Pulsed Electromagnetic Field (PEMF) therapy?

From the Guidelines

Pulsed Electromagnetic Field (PEMF) therapy is recommended for pain relief in patients with knee osteoarthritis, although the strength of recommendation is limited, as stated in the 2022 AAOS clinical practice guideline summary 1. When considering PEMF therapy, several factors should be taken into account:

• The therapy may be used to improve pain in patients with knee osteoarthritis
• The strength of recommendation is limited, implying that practitioners should exercise clinical judgment and consider patient preference
• Emerging evidence may clarify or help determine the balance between benefits and potential harm Key points to consider when using PEMF therapy include:
• Starting with low-intensity devices (1-30 Hz) for 15-30 minutes daily
• Targeting specific areas of pain or injury
• Using the therapy consistently for at least 4-6 weeks to evaluate benefits
• Consulting a healthcare provider before use, especially if you have implanted medical devices or are pregnant, as noted in the guideline 1 It is essential to weigh the potential benefits and harms of PEMF therapy, considering the limited strength of recommendation and the need for further research to fully establish its effectiveness for various conditions, as highlighted in the 2022 AAOS clinical practice guideline summary 1.

From the Research

Effectiveness of Pulsed Electromagnetic Field (PEMF) Therapy

• The effectiveness of PEMF therapy has been studied in various contexts, including bone healing and osteoarthritis treatment 2, 3, 4, 5, 6.
• A systematic review and meta-analysis of randomized controlled trials found that PEMF increased healing rate, relieved pain, and accelerated healing time in patients with fractures 2.
• Another study found that PEMF stimulated bone formation and fracture healing by promoting the synthesis of extracellular matrix proteins and exerting a direct effect on the production of proteins that regulate gene transcription 3.
• A clinical trial using low-amplitude PEMF on patients with non-union or delayed union of long bones found that 11 out of 13 patients had successful bone healing within an average treatment period of 14 weeks 4.
• A systematic review of systematic reviews found that PEMF therapy appears to be effective in the short term to relieve pain and improve function in patients with osteoarthritis, but the existing studies had low or medium quality and heterogeneous treatment schemes 5.
• A prospective randomized controlled study found that early application of PEMF in the treatment of postoperative delayed union of long-bone fractures led to a significantly increased rate of union and an overall reduced suffering time compared to sham treatment 6.

Key Findings

• PEMF therapy has been shown to increase healing rate, relieve pain, and accelerate healing time in patients with fractures 2.
• PEMF stimulates bone formation and fracture healing by promoting the synthesis of extracellular matrix proteins and exerting a direct effect on the production of proteins that regulate gene transcription 3.
• PEMF therapy appears to be effective in the short term to relieve pain and improve function in patients with osteoarthritis 5.
• Early application of PEMF in the treatment of postoperative delayed union of long-bone fractures leads to a significantly increased rate of union and an overall reduced suffering time compared to sham treatment 6.

Study Limitations

• The quality of evidence for PEMF therapy is generally low or medium, and more high-quality studies are needed to fully establish its effectiveness 2, 5.
• The treatment schemes used in PEMF studies are often heterogeneous, making it difficult to compare results across studies 5.
• More research is needed to fully understand the mechanisms by which PEMF therapy exerts its effects on bone healing and osteoarthritis treatment 3, 4.