Evaluation of pulsed electromagnetic field therapy for the treatment of chronic postoperative pain following lumbar surgery: a pilot, double-blind, randomized, sham-controlled clinical trial

Abstract

BackgroundThe incidence of chronic postoperative pain following lumbar spinal surgery has increased with the overall increase in the prevalence of lumbar surgery. This study was conducted to evaluate the analgesic effectiveness of pulsed electromagnetic field (PEMF) therapy in subjects with persistent pain following lumbar surgery.Patients and methodsA randomized, double-blind, sham-controlled, multicenter study in 36 subjects with persistent low-back and/or radiating leg pain after lumbar surgery was conducted. Eligible subjects were randomized (1:1:1) to receive one of two doses of therapy (42-μs or 38-μs pulse width) or treatment with a sham device. Subjects self-treated twice daily for 60 days. The primary end point was change in pain intensity (∆PI) using the Numerical Pain Rating Scale between average baseline (Days −5 to −1) and end of treatment (Days 56–60) for lumbar and radiating leg pain. Secondary outcome measures included the Oswestry Disability Index, Beck Depression Inventory-II, Patient Global Impression of Change, and consumption of analgesics.ResultsLow-back pain scores for the 42-μs group decreased by 40.2% (p = 0.028), compared to 18.6% for the 38-μs pulse width group (p = 0.037) and 25.6% for the sham group (p = 0.013 per protocol population). Average leg pain scores decreased by 45.0% (42 μs, p = 0.009), 17.0% (38 μs, p = 0.293), and 24.5% (sham, p = 0.065). The proportion of subjects responding to therapy, time to 30% reduction in pain scores, and Patient Global Impression of Change were improved with the PEMF 42-μs device over the sham control, although results were associated with p-values >0.05.ConclusionPEMF therapy (42-μs pulse width) was associated with trends for a reduction in pain, compared to sham treatment. Secondary endpoints were consistent with an overall beneficial effect of the PEMF 42-μs pulse width device.

Analysis of Spinopelvic Sagittal Balance and Persistent Low Back Pain (PLBP) for Degenerative Spondylolisthesis (DS) following Posterior Lumbar Interbody Fusion (PLIF)

“…To date, PLIF is considered to be the optimal procedure due to its high fusion rate and effective decompression of neural roots [3]. However, some patients complain about new onset or persistent low back pain after PLIF surgery, known as "persistent low back pain" (PLBP) or "failed back surgery syndrome" (FBSS) [4]. Unfortunately, there is for sure no one exact cause for PLBP.…”

Global Responses of Il-1β-Primed 3D Tendon Constructs to Treatment with Pulsed Electromagnetic Fields

“…In 1979, the U.S. Food and Drug Administration (FDA) approved PEMF as safe and effective to treat delayed and non-unions in bone [12]. Since then, PEMF has been proposed to be effective in treating a variety of pathologies, including delayed wound healing [13], chronic postoperative pain [14], and osteoarthritis [15,16]. In vitro, PEMF has been shown to be potent in limiting the catabolic effects of pro-inflammatory cytokines on hyaline cartilage [17,18], suggesting that PEMF is able to limit inflammation and promote soft tissue repair.…”

Pulsed Electromagnetic Field Inhibits Synovitis via Enhancing the Efferocytosis of Macrophages

“…PEMF is a noninvasive and safe treatment that commonly used in clinic to treat a variety of diseases/injuries including nonhealing fractures, postoperative pain, that edema, and osteoarthritis [13,14]. Li et al reported that electromagnetic fields are beneficial for relieving pain in patients with OA [15].…”