This study examined whether a non-thermal, non-invasive, pulsed electromagnetic field (PEMF), known to modulate the calmodulin (CaM)-dependent nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling pathway, could reduce pain in early knee OA. This randomized, placebo-controlled, double-blind pilot clinical study enrolled 34 patients. Patient selection required initial VAS ≥4, 2 h of standing activity per day, and no recent interventions such as cortisone injections or surgery. Results showed VAS pain score decreased in the active cohort by 50 ± 11 % versus baseline starting at day 1 and persisting to day 42 (P < 0.001). There was no significant decrease in VAS versus baseline at any time point in the sham cohort (P = 0.227). The overall decrease in mean VAS score for the active cohort was nearly threefold that of the sham cohort (P < 0.001). The results suggest that non-thermal, non-invasive PEMF therapy can have a significant and rapid impact on pain from early knee OA and that larger clinical trials are warranted.
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The authors gratefully acknowledge partial support of this work by the Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit Michigan, and Ivivi Health Sciences, LLC, San Francisco, CA, who manufactured the PEMF devices utilized in this study.
Conflict of interest
FN and RZ have no association with Ivivi Health Sciences. AAP is a basic science consultant to Ivivi Health Sciences and had no contact with patients in this study.
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Nelson, F.R., Zvirbulis, R. & Pilla, A.A. Non-invasive electromagnetic field therapy produces rapid and substantial pain reduction in early knee osteoarthritis: a randomized double-blind pilot study. Rheumatol Int 33, 2169–2173 (2013). https://doi.org/10.1007/s00296-012-2366-8
- Knee OA
- NO signaling