Electromagnetic Therapy For Arthritis

Introduction

Do you suffer from arthritis or have a family member or friend who has it? Are you curious about how it develops and how it is treated? In this review, we will discuss arthritis and a form of therapy known as electromagnetic therapy.

So, what is arthritis? It is typically the inflammation of ajoint (found in the hands, hips, and knees) and can affect our daily life due to the pain it can cause.¹ There are different types of arthritis that will be covered in this article and their different causes.

As mentioned previously, one form of therapy is electromagnetic therapy. It is a technique that utilises electromagnetic fields (EMF) for therapeutic purposes and has different forms of application. These will be tackled in this article as well. 

Understanding arthritis

Arthritis can be a crippling disease that people deal with. It has various forms, such as rheumatoid arthritis (RA), osteoarthritis, psoriatic arthritis, and juvenile idiopathic arthritis.^2,3,4,5 Arthritis happens once physiological changes of the joints occur; like the degradation of cartilage, bone remodelling, or it can be due to an autoimmune cause like in RA.^4,6 Overall, it is an inflammatory disease that can affect our joints.⁶ A summary of the types of arthritis are listed below:^2,3,7,8,9

• Rheumatoid arthritis (RA): is a chronic inflammatory disease that causes the synovial membrane to thicken, bone tissue to erode, and cartilage in joints and bones to be destroyed. It is an autoimmune disease that is a major source of morbidity and mortality in humans, affecting around 1% of the adult population.
• Osteoarthritis (OA): is one of the most common types of arthritis and affects around 7% of the world’s population. It is predicted that 1/3 of people above the age of 65 will encounter this disease.
• Psoriatic arthritis (PsA): this form of arthritis is a complex inflammatory illness with heterogeneous clinical features; it complicates psoriasis in 30% of patients. Currently, there are no defined diagnostic criteria for PsA, however, it is identified through inflammation in the joints, entheses, or spine in the presence of skin/nail psoriasis and the absence of rheumatoid factor and anti-cyclic citrullinated peptide.
• Juvenile Idiopathic arthritis (JIA): is an umbrella term for a form of arthritis of unknown origin. It affects patients below the age of 16 and lasts for more than 6 weeks. It is the most common chronic inflammatory and rheumatic illness in children.

The most common symptoms include pain and stiffness of the joints of the hands, knees, and hips.¹ It can make walking/exercise difficult and hinder our ability to do daily tasks. Even though arthritis is one of the world’s 15^th biggest causes of lived disability, there still is no definitive cure for it; this is due to the poor ability of cartilage to repair itself, as it has no blood supply.^10,11 So, the main form of treatment currently is the use of non-steroidal anti-inflammatory drugs (NSAIDs) or joint replacement surgery for end-stage illness.⁷

Electromagnetic therapy

Basics of therapy

EMF has caught the attention in the rehabilitation field through its non-invasive, safe and easy application to treat pain in musculoskeletal diseases.¹² It combines the interaction of electromagnetic fields generated by electrical current passing through a conductor and the biological tissue of our body under the principles of physics.^12,13 There are different types of EMF therapy and one of the most used ones is pulsed electromagnetic field (PEMF) that has shown to decrease pain in OA patients.¹⁴ There were studies done using different PEMF parameters of various combinations of intensities and frequencies to produce different effects on the tissue in question; for example, 75 Hz and 3.8 mT PEMF are better in the knee in OA compared to 8 Hz, 3.8 mT PEMF.¹⁴

Types of electromagnetic therapy

There are several types of EMF therapies including:^12,13,14,15

• Pulsed electromagnetic field (PEMF): Requires a device that generates a pulsating electromagnetic field to stimulate cellular activity. PEMF has been shown to increase extracellular matrix production and to reduce the release of proinflammatory cytokines and death of the cartilage cells (known as chondrocytes); this decreases inflammation and alleviates pain.
• Extremely low frequency (ELF): Pico tesla ranges are aimed at improving neurotransmission, and milli tesla ranges are aimed at correcting local immune pathology.
• Transcranial Magnetic Stimulation (TMS): Utilises the use of an electromagnetic coil placed on different areas of the scalp. This coil then generates magnetic pulses that stimulate different areas of the brain for the desired clinical outcome.
• Pulsed Shortwave Therapy: High-frequency electromagnetic fields to generate heat and alleviate pain.

Clinical studies and evidence

Multiple studies were done assessing the effect of PEMF on pain, stiffness, physical function, and quality of life. a review by Yang et al., in 2020, showed that 15 studies comprising a total of 985 participants were assessed for pain, 7 studies were performed to assess stiffness and 8 studies (457 participants) for physical function were performed.¹³ The results showed statistically improved stiffness, physical function, quality of life in OA patients, as well as decreased pain when compared to placebo.¹³ Even though these results showed positive feedback, it was limited to a short-term effect (up to 3 months), which requires more studies in the field to improve this outcome.¹³

Safety and considerations

So far, there are no known significant implications or side effects to the use of PEMF, and there are no reports of problems with excessive exposure to EMF. This is further supported by the possibility of treating specific conditions (like osteoporosis) for up to 8 hours a day.¹⁶ However, certain patients should be careful when going for this therapy including:¹⁶

• Pregnant women,
• Children,
• Individuals with certain conditions: tuberculosis, juvenile diabetes, magnetisable prostheses, epilepsy, heart conditions (cardiomyopathy, pacemakers, severe arrhythmia), tumours, acute infections/viral diseases, or fungal infections.

It is best to consult with your health provider before starting EMF therapy.

Availability and accessibility

There are different ways of accessing electromagnetic therapy, these include therapies in a clinical setting or at home:¹⁶

• Medical setting: the most common setting to find electromagnetic therapy would be in hospitals, clinics, and specialised treatment centres where they would be offered to you under supervision.
• Home-based devices: portable and home-based devices are also available for patients; however, professional advice is recommended before going for this treatment and for the appropriate use.
• OTC devices: some electromagnetic therapy devices, especially ones with lower intensities and used for general well-being, can be available over the counter (OTC) or online. Buyers are encouraged to check that the devices they buy are reputable and adhere to safety standards and regulations. 
• Other: other factors can influence the availability of this therapy including geographical availability, insurance coverage which can affect a person’s ability to go for this treatment, and regulatory approval that varies among countries.

It is important for individuals and patients considering electromagnetic therapy to consult with healthcare professionals to ensure proper diagnosis, treatment planning, and safety.

Summary

Given the safety, non-invasive nature and effective result of EMF, especially PEMF, this treatment choice has a great deal of promise to be used as a stand-alone or adjuvant treatment method for musculoskeletal problems; based on the current encouraging results of the forthcoming published studies. A good number of studies have demonstrated the ability of EMF to stimulate reactions in different musculoskeletal diseases. However, several points remain unanswered, such as the unknown parameters of selection and a better understanding of the underlying disease. Therefore, further research is required from well-designed, high-quality studies to clarify the deeper mechanisms, standardise the treatment parameters and extract the optimal protocol for healthcare decision-making. However, it is very clear that PEMF has a strong and potent role in treating and alleviating the symptoms of certain diseases, including arthritis, to provide patients with a better and more tolerable life.

FAQs

What can you do for unbearable arthritis pain?

Apply ice or heat for pain and consider NSAID therapy with the consultation of a healthcare provider. Certain exercises and/or physical therapy can provide more support.¹⁷

What are the 5 worst foods for arthritis?

Diet can influence our body and associated illness, certain foods can lead to weight gain, increase inflammation and as a result worsen arthritis. Some examples include sugary snacks/drinks, highly processed food, alcohol, salty foods, and purines.¹⁸