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Appendix II

General and Systematic Reviews on CAM Magnetic Therapy for Pain Published From August 1999 to August 2003

Static Magnetic Therapy

Authors: Ratterman et al., 20021
Type: General review
Description: Summarized 9 clinical trials on static magnetic therapy for treating postpolio pain, diabetic peripheral neuropathy, neck pain, low-back pain, fibromyalgia, postsurgical pain, and headache.
Findings: The authors stated that static magnets may work for certain conditions, but there is not adequate scientific support to justify their use.

Electromagnetic Therapy

Authors: Hulme et al., 200319
Type: Systematic review
Description: Looked at 3 RCTs that compared pulsed electromagnets (2 RCTs) or direct electric stimulation (1 RCT) with placebo in treating osteoarthritis. Both trials of pulsed electromagnets studied osteoarthritis of the knee; one of these studied osteoarthritis of the neck as well. The primary measure of effectiveness was pain relief.
Findings: The review found the RCTs to show that pulsed electromagnets had a small-to-moderate effect on knee pain, and a much smaller effect on neck pain. They concluded that "the current limited evidence does not show a clinically important benefit" of pulsed electromagnets for treating osteoarthritis of the knee or neck. They also identified a need for larger trials to see whether clinically important benefits exist.

Authors: Huntley and Ernst, 200020
Type: Systematic review
Description: Reviewed 12 RCTs for 7 CAM modalities for pain and other symptoms of multiple sclerosis. Included one RCT of rMS (38 patients) and one RCT of pulsed electromagnets (30 patients). Other modalities examined were nutritional therapy, massage, Feldenkrais bodywork, reflexology, neural therapy, and psychological counseling.
Findings: Both magnet studies reviewed found short-term benefits in relieving painful muscle spasms and other symptoms, and in improving activity levels. Authors called for "rigorous research" on CAM for multiple sclerosis patients.

Authors: Pridmore and Oberoi, 200014
Type: General review
Description: Discussed an array of basic and clinical research on TMS, focusing on its effect on the central nervous system (CNS) and on its potential effectiveness in relieving chronic pain.
Findings: Authors concluded, "Evidence indicates that TMS can produce plastic changes in the CNS, which are observable at both the cellular and psychological levels." Citing a lack of comprehensive studies, they proposed that "studies are justified to determine whether TMS can provide short-term or long-term relief in chronic pain."

Electromagnetic and Static Magnetic Therapies

Author: Swenson, 200321
Type: General review
Description: Searched for studies on various treatments for nonspecific neck pain.
Findings: Found no studies on magnets for neck pain, despite the popular interest in magnetic therapy, and "several very limited reports" from use for other pain. The author stated that rigorous studies are "desperately needed," especially those that could effectively double-blind patients and practitioners to treatment.

Authors: Vallbona and Richards, 19999
Type: General review
Description: Pulsed Electromagnets--Commented on 32 RCTs of pulsed electromagnets for conditions such as neck/shoulder pain, bone and joint diseases, neurologic disorders, sleep disorders, wounds and ulcers, postoperative bowel obstruction, and perineal trauma from childbirth. Pain is a key symptom of many of the conditions examined, and pain intensity was a clinical outcome measure in many of the studies. Static Magnets--Discussed two RCTs: one for neck and shoulder pain and one for postpolio pain.
Findings: Pulsed Electromagnets--Authors found that 26 of 32 RCTs of pulsed ET showed it to be an effective treatment for the conditions studied. Pain was decreased in disorders including neck pain, osteoarthritis, and leg ulcers. Static Magnets--An RCT of static magnets for neck and shoulder pain did not find any significant pain relief in subjects using magnets. An RCT of static magnets for postpolio pain yielded data that "suggest significant pain relief realized by patients who were exposed to active magnets." Vallbona and Richards noted that many studies of static magnets rely on anecdotal evidence or small study sizes, are sponsored by magnet manufacturers, and/or are not published in peer-reviewed journals.

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