Pulsed electromagnetic field therapy
||This article needs more medical references for verification or relies too heavily on primary sources. (January 2016)|
Pulsed electromagnetic field therapy (PEMFT), also called pulsed magnetic therapy, pulse magnetotherapy, or PEMF, is a reparative technique most commonly used in the field of orthopedics for the treatment of non-union fractures, failed fusions, congenital pseudarthrosis and depression. In the case of bone healing, PEMF uses directed pulsed magnetic fields through injured tissue to stimulate cellular repair. The FDA has cleared several such stimulation devices.
Electromagnetic field therapy has been in use since the invention of electricity. It was widely adopted in East and Western Europe but its use was restricted to animals in North America until recently. Veterinarians became the first health professionals to use PEMF therapy, usually to heal broken legs in racehorses. Professional sports doctors then decided to experiment with veterinarian devices off label on professional athletes which ultimately led to legal FDA licensed devices in 1979 to stimulate bone growth.
In 2004, pulsed electromagnetic field system was approved by FDA as an adjunct to cervical fusion surgery in patients at high risk for non-fusion. On 10/13/2015 the FDA reclassified PEMF devices from their existing Class 3 category to a Class 2 status. PEMF devices that have been FDA cleared to make health claims require a doctors prescription for use.
Use of PEMF in Wellness Devices
The original PEMF devices consisted of a Helmholtz coil and your body is placed inside the magnetic field to get a treatment. Today, the majority of PEMF wellness devices resemble a typical yoga mat in dimensions but are slightly thicker to house several flat spiral Tesla coils to produce an even electromagnetic field. A frequency generator is then used to energize the coils to create a "pulsed" electromagnetic field. Today, there is a wide variety of professional and consumer PEMF devices that are sold and marketed on the internet as FDA registered wellness devices. The majority are manufactured in Germany, Austria and Switzerland and are imported into North America as electric massagers or full body electric yoga mats. They are either placed on a massage table for clinical use or directly on the floor in the home to practice simple yoga postures. The companies that sell and manufacture them make no medical claims as to their effectiveness in treating disease mainly to bypass FDA clearance medical device regulations and approvals.
Delayed- and non-union fractures
In 1974 it was demonstrated that a pulsed magnetic field applied across the site of a bone fracture can accelerate the healing process (Bassett et al., 1974). The mechanism of osteogenesis is not clear; however, the use of PEMF therapy as an adjuvant therapy for delayed- and non-union fractures was supported by empirical evidence collected through clinical studies. While PEMF therapy may offer some benefit in the treatment of fractures, the evidence is inconclusive and is insufficient to inform current clinical practice.
Although electricity’s potential to aid bone healing was reported as early as 1841, it was not until the mid-1950s that scientists seriously studied the subject. Fukada’s and Yasuda’s discovery of the electric potential of bone provided evidence of electricity’s effect in promoting osteogenesis (bone growth), particularly in long bone non-unions. During the 1970s, Bassett and his team introduced a new approach for the treatment of delayed fractures, a technique that employed a very specific biphasic low frequency signal  to be applied for non-union/delayed fractures. The use of electrical stimulation in the lumbosacral region was first attempted by Alan Dwyer of Australia. In 1974, he reported successful initiation of graft incorporation in 11 of 12 fusion patients. Since that time, electrical stimulation has been shown to significantly increase the probability of bony arthrodesis in spinal fusions.
Transcranial magnetic stimulation is FDA approved since 2011 for use on patients that failed to respond to antidepressants. Weak magnetic stimulation of the brain is often called transcranial pulsed electromagnetic field (tPEMF) therapy. Early hints of efficacy of tPEMF as antidepressant came from observations that bipolar patients improved their mood after a magnetic resonance spectrogram, an approach which has been labeled LFMS. Studies in rodents have shown behavioural effects of tPEMF that are consistent with antidepressant effects. In humans, the treatment is usually given once or twice daily for two or more weeks.
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Pulsed electromagnetic field systems with FDA PMA include the EBI Bone Healing System from Electrobiology, Inc., which was first approved in 1979 and indicated for nonunions, failed fusions, and congenital pseudarthroses; and the Cervical-Stim from Orthofix, which was approved in 2004 as an adjunct to cervical fusion surgery in patients at high risk for non-fusion.
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- NeuroStar TMS Therapy system
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