Appendix III Reports on Randomized Clinical Trials of Magnetic Therapy for Pain From
January 1997 to March 2004
Static Magnetic Therapy
Authors: Wolsko et al., 200427
Description: Participants (26) with osteoarthritis of the knee
received either a sleeve containing magnets, to be worn over the knee
area, or a placebo sleeve that appeared identical. They wore their sleeves
for the first 4 hours and then at least 6 hours a day for 6 weeks. Knee
pain was measured at 4 hours, 1 week, and 6 weeks.
Findings: There was a statistically significant improvement in
pain in the treatment group at 4 hours, but not at 1 week or 6 weeks.
Authors: Winemiller et al., 20037
Description: Participants (95) who had had plantar heel pain
for at least 30 days received either shoe insoles containing a magnet
or insoles that were identical except for having no magnet. They wore
the insoles at least 4 hours a day 4 days/week for 8 weeks. Outcomes were
measured by a daily pain diary.
Findings: There were no significant differences in pain outcomes
between the two groups. Both experienced significant improvement in morning
foot pain and in enjoyment of their jobs (because of reduced foot pain).
Authors: Weintraub et al., 200324
Description: Patients (259) with diabetic peripheral neuropathy
wore static magnetic shoe insoles or an unmagnetized sham device continuously
for 4 months. Primary outcome measures were burning, numbness and tingling,
exercise-induced foot pain, and sleep interruption due to pain.
Findings: Authors found that statistically significant reductions
in burning, numbness and tingling, and exercise-induced foot pain occurred
in the treatment group, but only during months 3 and 4. Some patients
in the treatment group with more severe baseline pain had significant
reductions in numbness and tingling and in foot pain throughout the study
period.
Authors: Hinman et al., 200225
Description: Participants (43) with chronic knee pain wore
pads containing static magnets or placebos over their painful joints for
2 weeks. Outcomes were measured using self-administered ratings of pain
and physical function, and a timed 50-foot walk.
Findings: At the end of 2 weeks, those wearing magnets reported
significantly less pain, and better daily physical function and walking
speed, than those wearing placebos. Most of those wearing magnets experienced
pain relief within 30 minutes of the initial application of the magnets.
Authors: Carter et al., 200222
Description: Participants (30) with carpal tunnel syndrome
wore a magnetic or placebo device on the wrist over the carpal tunnel
area for 45 minutes. Participants rated their pain at 15-minute intervals
while wearing the device, after removing the device, and after 2 weeks.
Findings: The magnet was no more effective than the placebo in
relieving pain. Significant pain reduction was reported for both treatment
and placebo groups during a 45-minute application. The reduction in pain
was still detectable 2 weeks later; authors suggested that this could
be from a placebo effect.
Authors: Segal et al., 200128
Description: Patients (64) with rheumatoid arthritis of the
knee received one of two magnetic devices: one containing four strong
magnets or one containing only one weaker magnet. There was no nonmagnetic
or sham treatment. Devices were worn continuously for 1 week. Outcome
measures were the participants' pain diaries in which they assessed their
level of pain twice a day.
Findings: Both devices produced significant pain reduction after
1 week of use. A significant difference was not seen between the two groups.
The authors indicated that a nonmagnetic placebo treatment should be used
in future studies.
Authors: Alfano et al., 200126
Description: Patients with fibromyalgia (94 subjects) received
either (1) usual care, (2) a pad containing static magnets placed between
the mattress and box springs, (3) an eggcrate-like foam mattress pad containing
static magnets of varying strength, or (4) a mattress pad containing magnets
that had been demagnetized. Outcome measures were functional status, pain,
and the number and intensity of tender points after 6 months.
Findings: Compared with the usual-care group and the sham group,
people who used the pads containing active magnets reported improvements
in function, pain intensity level, number of tender points, and intensity
of tender points after 6 months. However, except for pain intensity, measurements
were not significantly different from scores reported for the sham treatment
group or the usual-care group.
Authors: Collacott et al., 20008
Description: Participants (20) who had had chronic low-back
pain for at least 6 months wore a magnetic device for 1 week (6 hours/day,
3 days/week). After 1 week of no treatment, the participants wore a sham
device for 1 week (6 hours/day, 3 days/week). The primary outcome was
pain intensity, which was measured by a visual analog scale.
Findings: No significant differences in outcomes were found between
the magnetic and sham therapies.
Authors: Caselli et al., 199723
Description: Participants (34) with heel pain wore a molded
insole with or without a static magnetic foil insert for 4 weeks. The
outcomes were measured in terms of the foot function index (pain, disability,
and activity restriction).
Findings: Use of the magnetic insole was no more effective than
the sham as measured by the foot function index. About 60% of patients
from both groups noted improvement in heel pain after 4 weeks, which suggests
that the molded insole itself was effective in treating heel pain.
Electromagnetic Therapy
Authors: Smania et al., 200318
Description: Participants (18) who had painful trigger points from
myofascial pain syndrome received, over a period
of 2 weeks, either 10 sessions of rMS or a sham treatment. During each
20-minute treatment, two different coils from the rMS device delivered
pulsed ET when placed on each patient's trigger point. Patients were evaluated
for 1 month after the treatments, using pain scales and clinical exams.
Findings: The participants who received the magnetic therapy had
significant improvement in all pain measurements and in some range-of-motion
measurements that persisted throughout the evaluation period. The placebo
group did not show any significant improvement.
Authors: Nicolakis et al., 200230
Description: Participants (32) with osteoarthritis of the knee
lay on a pulsed electromagnetic mat or a sham mat for 30 minutes twice
a day for 6 weeks. The primary outcome measures were pain, stiffness,
and physical function.
Findings: At the end of 6 weeks, physical function scores were
significantly improved for the treatment group compared with the sham
group. Pain and stiffness decreased for both groups, with what the study
authors called a "marked" placebo effect for participants using the sham
treatment. There was no significant difference between the groups for
pain and stiffness.
Authors: Thuile and Walzl, 200229
Description: Two prospective studies of
ET for low-back pain (100 participants) and whiplash
(92 participants). Half of the participants in each study received ET
twice a day for 2 weeks plus standard medications. The other half received
only standard medications. ET consisted of applying a low-energy, low-frequency
magnetic field cushion for 16 minutes and using a whole-body mat for 8
minutes. Evaluation of the low-back pain participants consisted of counting
the interval to reported pain relief and/or painless walking, and measuring
hip flexion to the point of pain. Participants in the whiplash study reported
their pain on a 10-point scale and had their range of motion measured.
Findings: In the low-back pain study, the ET group reported the
following compared with the control group: statistically significant pain
relief and/or pain-free walking 3.5 days sooner and increased ability
to bend at the hip. In the whiplash study, the ET group, compared with
the control group, had significantly decreased pain in the head, neck,
and shoulder/arm areas after treatment, and significantly greater range
of motion.
Authors: Pipitone and Scott, 200111
Description: Patients (69) with osteoarthritis of the knee
used a pulsed electromagnet or a sham device for 6 weeks. Devices were
placed on or between the knees for 10 minutes three times a day. The primary
outcome measure was a reduction in pain.
Findings: Pulsed ET significantly reduced pain, measured by several
scales, over a 6-week period in the treatment group, and did not produce
any adverse effects. No improvements were noted with the placebo-treated
group. The authors suggested further studies of pulsed ET for osteoarthritis
and other conditions.
Authors: Jacobson et al., 200110
Description: Participants (176) with osteoarthritis of the knee
were treated with ET for a total of 48 minutes per treatment session for
eight sessions during a 2-week period or sat near the electromagnet with
the magnet off (placebo). Participants used a subjective 10-point scale
to rate their pain level before and after each treatment and 2 weeks after
the final treatment. Patients also kept a diary of pain intensity before,
during, and 2 weeks after the trials, in which they recorded entries daily
upon waking and before going to sleep. They did not take any medicines
or use topical analgesics.
Findings: ET significantly reduced pain after a treatment session
in the magnet-on (treatment) group (46% reduction) compared to the magnet-off
(placebo) group (8%).
Authors: Pujol et al., 199817
Description: Patients (30) with localized injury to the
musculoskeletal system received 40 minutes of either rMS treatment
or sham treatment. Stimulation intensity was adjusted in each patient
to avoid excessive discomfort. Outcome measure was a 101-point pain rating
scale.
Findings: After one treatment, the pain score decreased significantly
in rMS-treated patients compared with sham-treated patients (59% versus
14% reduction). The effect persisted for several days.
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