Online Chiropractic CE | How Electromagnetic Field Therapy Can Help Back Pain Patients Posted on Oct 13, 2023

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The relationship between electricity and magnetism is well-known. By passing current through a coil of wire, we can generate a magnetic field perpendicular to the current flow in the coil. If a conducting medium, such as soft tissue, is adjacent to the magnetic field, electric current will be generated in the tissue, giving rise to the origins of pulsed electromagnetic field therapy and other magnetic therapies.

For chiropractors, electromagnetic field therapy has been a subject of long-standing interest and has held the promise of providing relief for various conditions, including back and neck pain, osteoarthritis, and neuropathy. However, previous studies often failed to find statistically significant improvements in clinical settings. Part of this can be attributed to a lack of understanding of the key factors, including strength, pulse duration, and frequency of electromagnetic field therapy required to generate the desired physiological outcomes.

In recent times, we have gained a deeper understanding that Highly Focused ElectroMagnetic (HIFEM) treatments are essential to induce structural changes in human tissue and achieve therapeutic goals.

The first significant clinical breakthrough in HIFEM therapy occurred when a company received FDA approval in 2000 for a non-invasive electromagnetic stimulation device designed for pelvic floor strengthening. This therapy proved to be highly effective, particularly for female patients suffering from urinary incontinence. Notably, the treatment was painless, as it directly stimulated muscles without causing nerves to fire impulses to activate the neuromuscular junction. Despite its clinical success, the device is currently unavailable in the United States due to commercial reasons. However, a resurgence of interest in electromagnetic field therapy has led other companies to introduce similar devices.

Another remarkable application of electromagnetic field therapy emerged from an unexpected field: neuropsychiatry. Studies have shown that pulses of 100-200 microseconds at 2 tesla units, equivalent to 40,000 times the Earth's magnetic field or the strength of an MRI unit, have achieved an impressive 80% success rate in treating patients who did not respond to oral antidepressants. This approach has received FDA approval for this purpose.

Initially, it was believed that the therapy's benefits were related to depolarizing brain neurons, akin to Electro Convulsive Therapy (ECT). However, a groundbreaking article in 2016 by Lan and colleagues demonstrated through MRI imaging studies that this therapy, now referred to as Transcranial Magnetic Stimulation (TMS), caused morphological and structural changes in the brain. This was a significant breakthrough, showing that electromagnetic fields can indeed induce structural and morphological changes in biological tissue.

In 2018, further research presented at the American Society of Laser Medicine and Surgery revealed that Highly Focused Electrical Magnetic (HIFEM) therapy in the 7-tesla range caused structural changes in muscle and fat. Using MRI and ultrasound measurements, they observed a 16% increase in abdominal muscle and a 19% reduction in overlying fat following four 30-minute treatment sessions over two weeks.

This specific application of electromagnetic field therapy is best understood by patients as Transcutaneous Electromagnetic Muscle Strengthening (TEMS). The potential benefits of TEMS in chiropractic practice are readily apparent.

Patients dealing with back pain can benefit significantly from developing a strong core musculature. TEMS offers a completely painless method for patients to strengthen their core muscles without the physical strain that exercise can entail. Enhanced core strength not only aids in overall body posture but also indirectly contributes to the treatment of back pain.

Much like how strengthening the pelvic musculature indirectly addressed urinary incontinence, strengthening a patient's core abdominal musculature can be an indirect approach to managing back pain. TEMS therapy can also be utilized to strengthen gluteal, hamstring, and quadriceps muscles, further enhancing posture and mobility.

Questions that clinicians may have regarding the effects of magnetic field therapy on muscle have been addressed in recent research by Duncan and colleagues. They demonstrated that highly focused electromagnetic field therapy increased muscle mass density by 20.56% in a porcine model. While there was an 8% increase in the number of muscle fibers, this did not reach statistical significance. However, the average increase in diameter size of individual muscle fibers by 12.15% was statistically significant. Such structural and morphological changes are typically achieved through intense weightlifting routines in the gym.

Studies have also documented the longevity and durability of the muscle mass increase induced by electromagnetic field therapy. In a recent paper by Busso and Denkova, they revealed that treating the gluteal muscles and buttock areas not only resulted in persistent muscle mass increases at two months but also measurable growth at three months compared to measurements taken four weeks post-treatment.

Combining the treatment of gluteal muscles and abdominal musculature with TEMS therapy provides back pain patients not only with a stronger muscular core to stabilize their back but also aids in posture and walking. The results of TEMS therapy are likely to be long-lasting. If patients do not experience complete relief from their back pain after an initial treatment course, they are likely to request further therapy, just as urinary incontinence patients did. Given that TEMS therapy is painless, non-invasive, and administered in just 30 minutes, there is no reason why patients should not continue with this innovative treatment for back pain as long as they experience its benefits. 

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