Injury type: Acute

Category: Allied Health Options

Rating: No Research

What is it?

An alternating or pulsed electromagnetic field passed through the tissue (i.e. muscle) between electrodes placed on or near the skin. It must be applied by a qualified professional using a machine based in their clinic.

How does it work?

Alternating or pulsed electromagnetic fields (PEMF) induce electric current within the tissue. Even though these currents are extremely small, there main therapeutic purpose is thought to enhance bone and/or tissue healing. Human tissue contains charged molecules that can respond to the charge of magnetic fields. It is thought that magnetic field passes through the skin into the underlying tissue (i.e. muscle) and may relax capillary walls, thereby boosting blood flow to the painful area. They can also help prevent the muscle spasms that underlie many forms of pain apparently by interfering with muscle contractions. Also, they may interfere with the electrochemical reactions that take place within nerve cells, impeding their ability to transmit pain messages to the brain.

Is it effective?

There is limited evidence from two randomised controlled trials on people with cervical disc herniation1 or chronic non-specific neck pain (excluding whiplash)2 to suggest that while PEMF may be a safe treatment option, it offers little superior effects to the sham group, when applied in conjunction with conventional physical therapy (i.e. transcutaneous electrical nerve stimulation, hot pack with/ without home-based exercise program).

Two additional studies have examined the effect of PEMF on people with whiplash. A systematic review3 updating evidence on passive physical modalities suggested that pulsed electromagnetic therapy is ‘possibly helpful/ might consider’ as a management option for recent grades I-II whiplash. A narrative review4 also found a significant improvement in pain in patients with acute whiplash who were treated with PEMF. However, both reviews draw their conclusion based on the same randomised controlled trial, which was published in 1990s and hence could be considered as out of date.

Are there any disadvantages?

There has been no research on the disadvantages associated with PEMF. It must be applied by a trained professional, therefore there may be considerable costs involved, especially if multiple treatments are required. The treatment may not be suitable for everyone.

Where do you get it?

PEMF may be provided by therapists (i.e. physiotherapist) involved in facilitating recovery from whiplash.

Recommendations

Based on current evidence, PEMF cannot be recommended as a treatment option for patients with acute whiplash. More up-to-date, robust research is required to strengthen the evidence base.