Overview

When one speaks of electromagnetic fields, what comes to your mind? 

An electromagnetic field is nothing but a combined invisible force composed of electric and magnetic fields. Cell phones, MRI scans, generators and even induction hobs work through electromagnetic fields. Would you be surprised to learn that apart from these functions, EMFs also have the potential to improve the speed and efficiency at which your wounds may heal?

In this article, we will speak about electromagnetic therapy, its principles, and its progress in improving wound healing.

Introduction

Wound healing is a complicated process involving multiple cell types. Different cells play a role at different stages in this multiple-stage process. Wound healing essentially takes place in four stages:¹

1. Hemostasis: 

When the body is wounded blood vessels are severed, resulting in a release of blood and allowing entry of foreign particles. In response, the body releases platelets at the site of injury. Platelets are blood cells involved in clotting. These cells create a mesh of protein that blocks the wound temporarily, minimising blood loss and preventing the entry of bacteria. This is called a clot. The clot serves as a dam through which several proteins, termed “clotting factors” (including growth and healing factors), are released into the wound site. The platelets plug the blood vessel, and the second stage of healing commences.

2. Inflammation:

Inflammation is a process whereby more blood is directed towards the injury site. This facilitates the transport of important immune cells and healing cells, which defend the body against the entry of harmful foreign bodies and further the wound-healing process. Macrophages and neutrophils are the main types of cells involved. These destroy and engulf bacteria and cell debris, further, they release several factors necessary for wound healing and angiogenesis (production of new blood vessels).

3. Proliferation:

Macrophages also call or recruit the cells needed to close up the wound permanently. New blood vessels supply these cells with oxygenated blood as they divide and populate the cut, healing the wound.

4. Remodelling:

Finally, over the course of several weeks to months, a remodelling process takes place in which the recruited cells produce extracellular matrix proteins, which form scar tissue and remodel into normal tissue as the wound fully heals.

Multiple cellular signalling pathways exist to heal wounds, several of which are influenced by an electric component. Studies into the cellular perspective of such a healing process^2,3 revealed to scientists that several of these pathways are regulated by the flow of specific charged molecules into and out of cells. This electrical flow activates signalling pathways that release various molecules and factors that facilitate the healing process such as growth factors. 

It was, therefore postulated that the application of electromagnetic fields may potentially influence such electric currents in the body to facilitate accelerated healing.

Understanding electromagnetic therapy

What is electromagnetic therapy?

Electromagnetic fields are created by the movement of electrically charged particles. In other words, a charged particle in motion, such as electrons in an electronic circuit, creates an electromagnetic field. Alternatively, a moving magnetic field may also create an EMF.⁴

Electromagnetic therapy refers to the use of EMFs in a clinical, therapeutic setting as an intervention for a disease or a symptom.⁵

EMF therapy is a non-invasive process working on the principle that applying an external EMF can alter or improve bodily processes based on signalling pathways comprising charged particles, by directly influencing various aspects of these charged particles.⁵ Apart from the significant role of electromagnetic radiation in the medical field for detection via MRI scans and X-rays,⁶ research has been conducted into the use of EMFs in other biomedical functions. So far, Electromagnetic therapy has been utilised for the treatment of neurological conditions such as depression and Alzheimer's. Further, low-intensity non-ionizing electromagnetic fields have been used to treat malaria.⁷ A type of electromagnetic therapy known as PEMF has been shown to be a potential treatment method for certain cancers.⁸ As such, the potential for the development of electromagnetic field therapy heralds the entrance of a non-invasive, low-cost alternative for various fields of medical treatment.

Evidence of electromagnetic therapy’s potential in wound healing

Research into electromagnetic fields as a medical intervention has been conducted since the 1950s. Several studies in the late 90s and early 2000s evidenced accelerated wound healing as a result of PEMF in mammals such as rats⁹

Later garnering traction in the treatment of racehorse injuries, Pulsed Electromagnetic Field (PEMF) was approved by the FDA for medical therapy of humans in 1979, specifically for accelerating the healing of bone fractures.¹⁰

Since then, it has also been approved to improve wound healing procedures such as cervical fusion¹¹ and pressure ulcer healing¹²

Studies into other EMF therapies have helped bolster the reputation of such technologies, into which more investment and research will help improve medical therapeutics.¹³ But what exactly is PEMF, and how does it work?

Pulsed electromagnetic field therapy (PEMF)

As mentioned above, the body’s cells are stimulated during injury to release several healing factors. These factors are activated by signalling pathways that function through the movement of charged molecules like ions and electrons into and out of the cell. This means that the body essentially creates its own electric field in response to injury.³ Being electrically charged, these particles can be influenced by the application of an external magnetic field, which may serve to additively improve the functioning of the body’s own field.

PEMF involves the application of short pulses of low-intensity electromagnetic energy into a target region over a period of hours. This means the cells are exposed only briefly to the electromagnetic field, while the low frequencies do not interfere with molecular bonding or DNA structure within cells.¹⁴

While PEMF therapy has been in use for multiple decades, there has not been much standardisation or categorisation  of the technology.¹⁵

Low-level laser therapy (LLLT)

Low-level laser therapy (LLLT) is another form of Electromagnetic therapy which utilises low-intensity beams of near-infrared light in order to stimulate cellular processes. Generally, LLLT is used for the reduction of pain and inflammation,¹⁶ however, it serves another purpose in the stimulation of healing of various tissues, including nerves.

LLLT works on the principle of mitochondrial biostimulation. “Mitochondria is the powerhouse of the cell” is a statement we are all familiar with. What this powerhouse does is create energy for metabolic processes that facilitate the growth, division, and release of regenerative molecules by the cell - all of which promote healing, apart from several other cellular processes.¹³

Studies into LLLT have also revealed its effect on increased production of various healing and growth factors as well as proteins like collagen, which serve as scaffolding for the healing of wounds.^17,18

Once again, however, more research is necessary into LLLT in order to standardise aspects like dosage, optimal intensity, optimal exposure time and so on.¹³

Extremely low-frequency electromagnetic fields (ELF-EMF)

ELF-EMFs or Extremely Low-Frequency  Electromagnetic Fields are commonly produced by various electric devices from cell phones to power lines. With studies revealing the bio-modulating effects of ELF-EMFs, much interest has been garnered in whether they could play a therapeutic role.¹⁹ ELF-EMF therapy involves the usage of non-ionizing low-energy electromagnetic fields within a frequency range of 3-300 Hz with the aim of modulating various biological phenomena.¹⁴ Various parameters, including specific frequency, waveform, amplitude, time of exposure, etc. can influence the effect of ELF-EMF therapy. 

With an effect on platelet activation, these fields can help in hemostasis. Its ability to influence free radical concentration assists in slowing down inflammation processes, protecting cells from oxidative damage. ELF-EMFs have also been shown to activate factors involved in angiogenesis, assisting in the proliferative phase. Finally, it also modulates collagen synthesis, accelerating the remodelling phase. Playing a role in each phase of healing, ELF-EMF shows great potential in the facilitation of improved healing processes.

Benefits of electromagnetic therapy for wound healing

To summarise, we see several benefits offered by electromagnetic therapy in the process of wound healing.

1. Accelerated tissue repair: by activating growth factors and clotting factors, EMF therapies bring about a quicker initial response to an injury.
2. Reduction of inflammation and pain: by bringing about a balance of free radicals and antioxidants in the body, the technology has the potential to reduce inflammatory responses, which often cause excessive damage to healthy tissues in and around wounds.
3. Improved blood circulation: by stimulating angiogenesis, EMF  therapies ensure that cells involved in wound repair are well nourished.
4. Minimised scar formation: These technologies allow wounds to be more efficiently healed by stimulating collagen synthesis and the production of extracellular matrix proteins.

Considerations and precautions

While electromagnetic therapies have shown great potential in their ability to improve the efficiency and speed of wound healing, there are, of course, certain considerations related to research gaps:^13,14

1. Electromagnetic waves such as those in ELF-EMF have often been cited as having several negative effects on human health. In fact, they have been alleged to cause diseases, including cancer. While several studies have been conducted, the evidence supplied has not definitively proved a connection. Regardless, research into such effects must offer conclusive data with regard  to safety.
2. Standardisation of such therapies must be brought about. Dosage evaluation and other aspects must be researched in order to determine how such treatments must be conducted.
3. More research is necessary in order to investigate the potential effects of altering signalling pathways involved in such biological phenomena.
4. Care must be taken with respect to specific patients and the potential of patients with other disorders/conditions that may indicate any kind of susceptibility to electromagnetic therapy. For example, such treatment is not recommended for pregnant women.

Conclusion

Advancements in research into the therapeutic application of electromagnetic fields lay out a wider realm of possibilities in non-invasive medical interventions with a multitude of potential fields of use. As significant strides are made in exploring innovative new technologies, electromagnetic therapy in the form of PEMF, ELF-EMF, and LLLT emerges as a promising new frontier in the pursuit of efficient and rapid wound healing therapies. With the technology already in wide use in the treatment of fractures and in sports medicine, the use of such therapies adorns the scientific landscape with glimpses of improved patient outcomes, cultivating a positive outlook on the healing of injuries, from chronic wounds to surgical incisions.