Introduction: Pulsed electromagnetic field (PEMF) therapy has proven to be effective in acute tissue healing and pain reduction. It encourages the growth, maintenance and healing of living cells, soothes muscle pain and stiffness, and improves tissue oxygenation and blood circulation. It is hypothesized that by inducing electrical magnetic current into damaged cells, PEMF therapy slows or stops the release of pain and inflammatory mediators, increases blood flow of the cells, and re-establishes normal cell interaction. With reduced inflammation, pain decreases, energy increases, and faster tissue healing occurs. We conducted a study on the clinical efficacy and potential biochemical pathways of PEMF therapy
Methods: The study was designed as a prospective randomized, double blinded study. Patients who met the inclusion criteria recorded pain score and had regular wound size measurement and fluid assays. Our wound assays analyzed for transforming growth factor beta (TGF-b), tumor necrosis factor alpha (TNF-a), vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9). The study duration was 16 weeks.
Results: 46 patients completed the study. No patient sustained any harm from the devices. Six patients received placebo devices and 27 received active devices. In the treated group, wound area went from 17 ± 15 cm to 2 ± 3 cm2 and wound circumference improved from 175±113 to 13±13 mm. These were both clinically and statistically significant (p < 0.01). For the control group, area went from 13 ± 14 cm to 11 ± 14 cm2 (p= 0.06) and circumference from 157±82 to 97± mm (p = 0.12) not significant. Pain score rating and medication use were both significantly better for the treated group compared to control. We saw a statistically significant increase VEGF and decrease in TNF-a and MMP-9 compared to the control group.
Discussion: Our results confirm the vulnerary potential of PEMF therapy for patients with chronic venous stasis ulcers when combined with standard evidence-based care. we were only able to document improved healing trajectory. We were also able to document improved pain control with this technology. Pain control may translate to less inflammation and suggest a mechanism of action in this clinical setting. We identified increase in VEGF and decrease in TNF-a and MMP9 which may help elucidate the pathway of action. Further work is needed to better elucidate mechanism and long-term efficacy.
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