New York Times: Study on Using Magnet to Treat Pain Surprises Skeptics
By Lawrence K. Altman, M.D.
No on was more skeptical about
using magnets for pain relief than Dr.Carlos A Vallbona, former chairman
of the department of community medicine at Baylor College of Medicine
in Houston. So Dr. Vallbona was amazed when a study he did found that
small, low intensity magnets worked, at least for patients experiencing
symptoms that can develop after polio.
Dr. Vallbona had long been fascinated
by testimonials about magnets from his patients, and even from medical
leaders- But his interest in magnet therapy became more serious in 1994
when he and a colleague, Carlton F. Hazlewood, tried them for their
own knee pain. The pain was gone in minutes. "That was too good
to be true, "Dr. Vallbona said.
Dr. Vallbona knew that the power
of suggestion can fool both patient and doctor. But he also wondered:
could strapping small, low intensity magnets to the most sensitive areas
of the body for several minutes relieve chronic muscular and joint pains
among patients in his post-polio clinic at Baylor's Institute for Rehabilitation
Research. Valid studies could allow consumers to make informed choices.
And if magnet therapy were found to be safe and effective, it could
relieve pain with fewer drugs. Endorsements from professional athletes
are one reason Americans spend large sums on magnets to seek pain relief.
but most doctors take a "buyer beware" attitude because many
claims lack scientific proof or explanation of how they might work.
The FDA and Drug Administration has warned doctors and manufacturers
about health claims for magnets.
Aware of the medical profession's
skepticism about magnet therapy, Dr. Vallbona sought to conduct science's
most rigorous type of study. Participants would agree to allow the investigators
to randomly assign them to groups getting treatment with active magnets
or sham devices. But neither the patients nor the doctors treating them
would know what therapy was used on which patient.
First Dr. Vallbona informally tested
magnets on a few patients. One was a priest with post-polio syndrome
who celebrated mass with difficulty due to marked back pain that prevented
him from raising his left hand. After applying a magnet for a few minutes
the pain was gone. Then a human experimentation committee allowed Dr.
Vallbona to test 50 volunteers with magnets that at 300 to 500 gauss,
were slightly stronger than refrigerator magnets. they were made in
different so they could fit over the anatomic area identified as setting
of their pain.
It was difficult to design a system
to prevent participants from learning whether they were being tested
with a magnet or a sham. -So Dr. Vallbona asked Bioflex, a magnet manufacturer,
to prepare active magnets and inactive devices that could not be told
apart. The devices were labeled in code. As a further precaution, a
staff member observed the patients throughout the 45-minute period of
therapy to make sure they would not try to find out - by testing with
a paper clip say - what treatment they were receiving.
After the investigators identified
the source of the pain and then pressed on it, the 39 women and 11 men
in the study graded the pain on a scale of 0(none) to 10 (worst). Then
after the experimental treatment, the participants rated their pain
in a standard questionnaire. The volunteers were tested only one time.
The 29 who received an active magnet reported a reduction in pain to
4.4 from 9.6, compared with a smaller decline to 8.4 from 9.5 among
the 21 treated with a sham magnet.
The Baylor scientists emphasized
that their study applied only to pain from post-polio condition. nevertheless,
their report in last month's issue of Archives of Physical and Rehabilitation
Medicine. a leading specialty journal, has shocked many doctors who
have scoffed at claims for magnet's medical benefits.
In an article about magnet therapy
for chronic pain published five months ago, Dr. William Jarvis, a professor
of public health and prevention medicine at Loma Linda university in
California and president of the National Council Against Health Fraud,
dismissed magnet therapy as essentially quackery."
Now, Dr. Jarvis said in an interview,
the Baylor study changed his mind. "But like any other pilot study,
it needs to be replicated." he said.
Dr. Vallbona's findings have led
him to try to carry out a larger study in several medical centers, and
they are expected to lead other investigators to conduct their own studies.
Dr. Laura S. Halstead of the National
Rehabilitation Hospital in Washington, a pioneer in studying the post-polio
syndrome, was among experts who said that further studies were needed
to answer questions like: Will various strength magnets produce different
degrees of benefit. how long does the pain relief last? Will the effect
wear off after multiple applications? For what other conditions might
At the University of Virginia,
Ann Gill Taylor's team last month began recruiting 105 volunteers mf4th
fibromyalgia, a painful muscle condition of unknown cause, to test magnetic-
Like the Baylor study, the volunteers
and doctors are not told whether the subject would be sleeping on an
active or sham magnet. Participants are told that if they try to determine
whether their treatment is with a magnet or a sham one, it could ruin
the study. But Dr. Taylor said there was no way to prevent cheating.
Dr. Taylor said she also planned to conduct studies of possible uses
of magnets in relieving phantom limb and stump pain among amputees.
Dr. Vallbona said he did not know
why magnets worked for many post- polio patients but not for others,
or why some said they felt improvement in areas of the body far distant
from where the magnet was applied.
Magnets' medical benefits have
been proclaimed for centuries. So why has it taken so long to do studies
to begin to answer the questions? The reasons involve economic, political,
professional and human factors. Many doctors criticize the lucrative
magnet industry for not investing in studies the way drug companies
often do. "They dont do simple research." Dr. Jarvis
said, and "it is hard to imagine an easier study to conduct than
a magnet one pain." Yet doctors share the responsibility to do
such research, and only rarely have they reported undertaking the scientifically
controlled studies need to settle major disputes about reported therapies.
In many such debates, doctors demand
a biological explanation for a therapy's benefits. Without documentation
that satisfies them, doctors may summarily reject the claims. yet in
their everyday practices, the same doctors may use other therapies that
lack scientific proof for why they work.
Scientists working in nonprofit
medical schools and university hospitals are strongly influenced by
economics because they need government grants to pay for their overhead.
Since scientific success is measured in part by the dollar amount of
their grants, doctors tend not to pay for their studies, even if they
are relatively inexpensive.
The Baylor study was exceptional.
It was done without a grant. Had it been done with government aid, Dr.
Vallbona said, it would have cost about $50,000. Bioflex provided the
active and inactive magnets free, the doctors donated their time and
insurance -companies were not charged for magnet therapy.
Until recently government agencies
and the scientists who judge applications to them have tended not to
support studies on magnets and other therapies on the fringe. The reluctance
is well founded. Over history , so many claims for popular remedies
have failed to hold up that many doctors are reluctant to put aside
a promising project of their own to study something that may well turn
out to be a fad. Scientists are heavily influenced by peer pressure.
Senior scientists often discourage younger investigators from replicating
another groups studies because doing so is less likely to advance
their careers than making novel findings.
But in an age of medical consumerism,
patient demand is changing some research agendas. For instance, the
National Institutes of Health has created an office of alternative medicine,
which is paying for the magnet studies at the University of Virginia.
In tackling fringe areas, scientists
usually know that they are stepping in deep water, risking scorn from
colleagues who believe that what they are studying is theoretically
unsound at best and quackery at worst. Even so, many with the courage
may not know how deep the waters are.