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October 5, 2009
Magnets for Relief of Pain
People dependent on pain medication to alleviate the effects of fibromyalgia, Temporomandibular joint disorder (TMJ), multiple sclerosis or other disorders have often looked towards alternative therapies to alleviate their pain when prescribed medications are ineffective. One alternative method that has gained widespread popularity is the use of magnets for pain relief. Magnets produce a measurable force called a magnetic field. They come in different strengths, measured in units called gauss or tesla (1 tesla = 10,000 G). The magnetic field of the earth is .5G and magnets marketed for pain generally range from 300 to 5000 G, in indication of how much stronger the magnets used for alternative therapies are. There are a number of different theories behind the use of magnets for pain relief, most of which have not been studied extensively.
Why Magnets? A List of Theories
Some of the leading theories behind the use of magnets for pain relief are:
· Magnets change how nerve cells function and block pain signals that are sent to the brain.
· Magnets restore the balance between cell death and growth.
· Magnets increase the flow of blood and delivery of oxygen and nutrients to tissues.
· Magnets increase the temperature of the area of the body being treated.
Each company selling magnets for pain relief explains the science behind the product using a combination of these theories. The most popular theory advanced by the websites is that magnetic field block the pain signals that are being sent to the brain. This is most likely because it is the easiest theory to explain and, in its simplest form, seems possible.
Health Risks (or Lack Thereof)
One of the reasons magnetic therapy is popular is that there are no health risks. The only people excluded from using magnetic therapy are those with implanted pacemakers, insulin pumps, defibrillators, or any other implanted electro-medical devices. Women who are pregnant are also not supposed to use magnets for pain relief. The websites selling magnetic pain relief products all include disclaimers stating that s medical practitioner should diagnose the source of the pain before using the products and that the magnets should be used as a supplement to prescribed medication.
Who is selling magnetic relief and what are they claiming?
The companies attempting to sell products that provide pain relief in the form of magnets rely mostly on client testimonies in support of their products.
Companies like HelioHealth (http://www.healiohealth.com/tek9.asp?pg=products&grp=474) advertise that by applying magnetic fields to the body for therapeutic purposes, one can speed up the healing process, improve sleep quality, and help in the relief of joint and muscle pain, inflammation, and stiffness. The scientific explanation for their magnetic products is that the application of a magnetic field to the injured area helps restore the normal electromagnetic balance by relaxing the capillary walls. This allows for increased blood flow, which in turn increases the oxygen and nutrients surrounding the injured areas.
QMagnets (http://www.qmagnets.com/)“stops your pain dead in its tracks” by apparently short circuiting the nerve’s pain signal. This particular site relies on testimonies from athletes as well as research done by Dr. Robert Holcomb at Vanderbilt University. The website describes how the Q (quadropolar) magnets are comprised of four alternating magnetic poles, with a steeper gradient that allow for an increased effect. The website has a number of complicated links that do eventually explain the science behind the Q magnet; however, the testimonies are the most important selling point for the website. One of the most interesting tactics taken by the website is that is presents an extensive list of articles and studies published on the use of magnets for pain relief. The site does admit that magnetic therapy is “sometimes effective”; however, all of the articles are in support of the alternative therapy.
Synergy for Life (http://www.123ezpainrelief.com/) focuses on promoting their own product against the other magnet products available rather than explaining why magnets are the way to go in the first place. This site assumes the person perusing for magnetic products has already researched the science behind magnetic relief systems. One of the site’s selling points is that it offers three types of magnets, all stronger than what the other companies might be offering, according to Synergy for Life. The experts listed on the site are “experts in magnetic therapy”. The names of two doctors are listed, with no other credentials either than the fact that they have supposedly received they medical degrees.
Another product, XTRAFLUX magnets, are being sold on the Relieve Pain Today website (http://www.relievepain.com/). XTRAFLUX magnets provide “deep magnetic field penetration” according to the website and a re double coated with nickel and gold to “influence everything within inches of their surface”. Rather than make its own claims about the effect of magnets on pain relief the website refers the reader to the book Magnet Therapy-The Pain Cure Alternative by Lawrence et al. (1998). The book (via the website) claims that magnets increase the body’s endorphins, increase blood flow, relax muscles, and flush away the pain’s acid from the pain site. The chemistry behind the supposed responses to magnet use is not explained.
Dr. Bakst Magnetics (http://www.drbakstmagnetics.com/) specializes in magnetic pain relief products for back pain and knee pain relief. Aside from a page with testimonials, Dr. Basket Magnetics boasts that it has received the only concept patent for magnetic pain relief. This site also has a link to a video clip from the Rachel Ray Show where Peter Vidmar, an Olympic gold medal gymnast, endorsed the belt for his back pain. While he admits on tape that his pain is not cured, he makes a convincing appeal to the audience that his pain has been alleviated. The doctor on Rachel Ray also pointed out that there is no scientific evidence to back magnetic products; however, he mentions that the lumbar support provided from the help can definitely help with pain. Thus regardless of whether or not the magnets are effective, the belt is useful for back pain relief according to Rachel Ray. This site follows the theory that the magnetic field blocks the pain receptors entirely so that the brain never receives a pain signal.
The question each person should know the answer to before using magnetic therapy is, do magnets help in the relief of pain? Only recently has there been an influx of studies on the use of magnets for pain relief. Below is a review of some of the more extensive studies and literature reviews on magnetic therapy.
Kuipers et. al. (2006) studied the influence of static magnetic fields on pain perception and sympathetic nerve activity. Using a randomized, double blind, placebo-controlled method, the researchers recruited 15 volunteers (8 men and 7 women) to participate. The study used magnets of .06T, the strength of many of the commercial devices used by the public and marketed as having health benefits. Subjects participated in two testing sessions where they were instructed to lie on a mattress for the period of one hour. Within the mattress were magnets arranged in a grid composed of 21 rows separated by 7.5 cm. The rows alternated between 4 and 5 magnets. The control mattress was the same as the original mattress; however, all the magnets had been removed. Both mattresses were enclosed in identical covers to prevent the researchers as well as the participants from identifying the type of mattress. The order of the sessions were randomized, selected by a third-party researcher who flipped a coin to determine whether the control session would be first or second. This researcher was not a part of the data analysis following the experiment’s conclusion, which assured that the study would be double blind.
The subjects were required to perform three tasks following the one-hour rest period. In the first task, subjects were required to squeeze a dynamometer (a device used to measure force or power) with their non-dominant hand for two minutes. In the second task, postexercise muscle ischemia was induced by inflating an arm cuff for two minutes. In the final task the subject’s non-dominant hand was placed in a cup of ice water for two minutes. Recordings were made of muscle sympathetic nerve activity using electrodes inserted into nerves in the fibula. An additional measurement was also taken using self-report. Subjects were asked to rate their perception of pain every 15 seconds on a scale of 0 to 10 using a visual analog scale.
There were no statistically significant results found for either the placebo or the magnet condition. Pain perception increased over all three tasks and over both conditions. At the conclusion of the experiment participants were also asked whether or not they could differentiate between the mattress in the placebo condition and the mattress in the magnet condition. 12 of 15 subjects said they were unable to detect a difference. Of the three that said they could detect a difference, only one participant correctly responded.
The experimenters concluded that acute exposure to static magnetic fields, at strengths commonly used by the public, did not alter pain perception during exercise, muscle ischemia, and cold compress. It must be pointed out that the study had a fundamental problem in that there were only 15 subjects. Other limitations included the fact that acute exposure to magnets limited the ability to draw further conclusions about prolonged magnet use. The study also only included magnets of .6 T; it is possible that other strengths could elicit some response. The study also used magnets embedded in a mattress; it is unclear if the magnets were placed in the proper place for ultimate relief or if the magnets were close enough to the body.
In a meta-analysis conducted on nine randomized, placebo-controlled studies, that assessed pain using a visual analog scale, Pitler et al. (2007) looked at existing studies testing magnets on pain to determine the effect of magnets on pain. The differences between the placebo and the static magnet trials were determined by looking at the mean change in pain, as measured on a 100 mm visual analog scale. The researchers originally selected 29 studies for review; however, 20 of these were excluded for reasons such as the fact that only the abstracts were available or certain information was requested of the original researchers and not received. Aside from the meta-analysis, a systematic review was conducted on 16 of the randomized controlled trials for which sufficient information was available.
The results of the meta-analysis revealed no significant effects of static magnets for pain relief relative to placebo. The researchers pointed out, however, that there is a strong case of clinical heterogeneity within the review. There were a variety of differences in conditions causing the pain as well as differences in the duration of the magnet intervention. To reduce clinical heterogeneity, a number of different sensitivity analyses were conducted. A sensitivity analysis of randomized controlled trials assessing only musculoleskeletal pain conditions with intervention periods between two and four months suggested no significant differences. An assessment of osteoarthrtitis in four double blind randomized controlled trials showed some positive effects of static magnets relative to placebo and weak magnets. This was the one condition for which the evidence appeared encouraging.
Alfano et al. (2001) conducted a six-month-long randomized, placebo-controlled study on the relief of pain in fibromyalgia patients. Two different configurations of magnets were tested along with two placebo groups. The subjects were adults who met the 1990 American College of Rheumatology criteria for fibromyalgia: widespread pain of greater than 3 months’ duration and pain on palpation at a minimum of 11 of 18 specified sites (Wolfe et al., 1990). Subjects were recruited through clinical referral and media announcements and evaluated at a university-based clinic. 119 subjects were enrolled in the study after providing written consent. Subjects were then randomly assigned to one of five groups based on the following interventions:
Functional Pad A: designed to expose the body to a uniform magnetic field of negative polarity. A grid of 2.54 ´ 5.08 ´ 0.95 cm ceramic magnets with a manufacturer’s rating of 3,950 gauss, placed 2.54 cm apart within the pad, produced the magnetic field. The pad was placed between the subject’s mattress and box spring, as recommended by the manufacturer. The thickness of a typical mattress placed the body 15 to 25 cm above the magnetic source. At the surface of the mattress the body was exposed to an approximate field of 0.6 to 0.3 mT.
Functional Pad B: exposed the body to a magnetic field that varied spatially and in polarity. The ceramic disk magnets, 1.8 cm in diameter and 0.3 cm in thickness (manufacturer’s rating, 750 Gs), were placed 12.5 cm apart along the width and 5 cm apart along the length of the sleep pad.
Sham Pad A: Identical in appearance to Functional Pad A.
Sham Pad B: Identical in appearance to Functional Pad B.
Usual Care: were instructed to maintain their fibromyalgia treatment regimens that were reported at baseline and to refrain from introducing additional therapies during the course of the study.
Subjects in the other groups were also instructed to maintain their regular treatment regimes.
The measurements taken at baseline, three months, and six months were pain rate, the number of tender points, and functional status. Measurements for pain rate and tender points were taken by asking the subject to rate pain intensity on an 11-point scale from 0 (“no pain”) to 10 (“worst pain ever experienced”) for each site after 4 kg/cm2 of pressure was applied. Patients must have reported a minimum pain level of 2 for the site to be considered a positive tender point. One physician was responsible for collecting the pain data to assure that there was no external variability. Tender points were considered to be a valid measurement of pain as the number of tender points has been found to be strongly correlated with fibromyalgia symptoms (Wolfe, 1997) and to be a reliable measure of change suitable for clinical trials (Hewett et al., 1995). Functional status was measured using the FIQ, which is an assessment and evaluative instrument used to evaluate fibromyalgia patient status and progress.
The results of the study were determined by subtracting the baseline scores from the six-month follow up scores. A negative score represented improvement and a positive score represented deterioration. On average, all of the groups showed reductions in pain as measured by the FIQ and the overall test comparing groups was statistically significant. However, the individual treatment groups did not show statistically significant results. The authors of the study point out that both functional pad groups did show reductions in pain intensity scores, with the subjects in Functional Pad A reporting the lowest pain intensity scores.
The authors of this study conclude that despite the lack of scientific evidence, the promotion of magnets for pain relief has been very successful, with profits reaching 5 billion dollars from worldwide sales (Weintraub, 1999). Although this study showed now adverse effects and the functional pad groups showed improvements in functional status, pain intensity level, tender point count, and tender point intensity, the results were not statistically significant.
In conclusion, the recent influx of research on the effect
of magnetic fields on pain due to the growing magnet industry has not shown
that magnets have strong effects on pain. While there are no disadvantages to
supplementing physician-ordered treatment with magnets (other than the cost)
there has been no study that has overwhelmingly proved magnets have an effect
on pain. Why, then, has the industry remained so successful? After looking at
the websites that sell magnet products, it is apparent that they cater to a
part of the population that really has nothing to lose by trying the product.
For example, there is no cure for fibromyalgia, multiple sclerosis, or TMG. People
with these disorders may be inclined to look for alternative therapies for lack
of a better option. Many of the websites offer products at a low enough cost
that the possibility of pain relief far outweighs the cost. Another reason the
websites have been so successful is they rely on testimonies from supposed
consumers. Many of the reports are extremely compelling, complete with pictures
of the consumer and the product they used. The Q Magnet website has a detailed
blog where satisfied customers can post their stories and videos. Someone doing
research on pain management could easily be swayed by the incredible success
stories put forth by the websites. In the end, however, until there are
additional studies done that have statistically significant results, one cannot
conclude that magnets have an effect on pain.
1. Alfano AP, Taylor AG, Foresman PA, Dunkl PR, McConnell GG, Conaway MR, et al. Static magnetic fields for treatment of fibromyalgia: A randomized controlled trial. J. Alternative Complementary Medicine 2001; 7(1):53 -64.
2. Ernst E, Pittler MH, Wider B, et al. Complementary and alternative therapies for pain management. London: Mosby/Elsevier; 2007.
3. Hewett JE, Buckelew SP, Johnson JC, Shaw SE, Huyser B, Fu YZ. Selection of measures suitable for evaluating change in fibromyalgia clinical trials. J Rheumatol 1995;22:2307–2312.
4. Kuipers NT, Sauder CL, et al. (2006). Influence of static magnetic fields on pain perception and sympathetic activity in humans. Pennsylvania State University College of Medicine: Journal of Applied Psychology.
5. Larence R, Rosch PJ, Plowden J. Magnet Therapy: The Pain Cure Alternative. Rocklin, California; Prima Publishing, 1998.
6. Weintraub M. Magnetic biostimulation in painful diabetic peripheral neuropathy: A novel intervention. A randomized, double-placebo crossover study. Am J Pain Management; 1999;9:8–17.
7. Wolfe F. The relation between tender points and fibromyalgia symptom variables: Evidence that fibromyalgia is not a discrete disorder in the clinic. Annals of the Rheumatic Diseases 1997;56:268–271
8. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P. The American College of Rheumatology; 1990 criteria for the classification of fibromyalgia: Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33:160–172.
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