Many people ask, what’s the scientific evidence for using magnets for pain relief?
Like any medical treatment, the subject of evidence should address the question, does it work? But the bottom line is…do the benefits outweigh the risks and inconvenience and justify the costs? The simplicity and low costs of static magnets, certainly sets a low bar in this respect.
For instance, treating conditions such as failed back syndrome with a spinal cord stimulator will cost in the vicinity of $50,000. On top of that, there’s the significant health risks of the surgery itself and ongoing complications and inconvenience for the patient. Yet in many cases, the benefits do outweigh the risks and justify the expense.
Therapies with a risk of serious side-effects and significant expense, understandably require a much greater burden of proof than a treatment with quite the opposite profile. However, not all regulatory bodies see it this way and many will require a high level of evidence to make even mild health claims, regardless of the risks and costs. Which is the reason why as a Class I Medical Device, you see many disclaimers on this website with regard to Q magnets application.
The hierarchy of evidence pyramid, ranks the strength of evidence; based on study design.
Expert opinion is the least reliable and case studies are also on the lower end of the quality of evidence spectrum. Nonetheless, case studies can be useful when looking at complex conditions, because they are real clinical cases and patient care should always be based on sound clinical reasoning.
The following are some of the more credible case studies…
CASE STUDY #1 & 2: ABDOMINAL & GENITAL PAIN
Holcomb et al. (2000) reviewed the cases of two adolescents with medication-resistant chronic pain of the low back and abdomen who had undergone multiple evaluations and interventions by medical specialists. Both cases were treated with multiple alternating quadrapolar array magnet devices made from rare earth magnets. Both were provided rapid relief (within minutes) which was sustained for more than two years.
The safety and effectiveness of Q magnets has not been established in the treatment of chronic low back and abdominal pain.
Further case studies can be seen on the clinic website of physiotherapist, Dianne Hermans. For full disclosure, Dianne has a financial interest in Q magnets, however these case studies were presented almost 10 years prior to Q magnets in their current form.
CASE STUDY #3: CHRONIC CERVICAL HEADACHES.
CASE STUDY #4: TREATMENT FOLLOWING WHIPLASH
The case studies by health professionals are not an endorsement of Q magnets, but for educational purposes only.
Many clinical trials have shown health benefits using magnets. Even for magnetic mattress pads, single bipolar magnets for pain and magnetic bracelets, see the following…
- Magnetic mattress pad in a randomised double-blind pilot study on patients with fibromyalgia. By Colbert et al (1999)
- Static magnet used in a double-blinded, placebo-controlled pilot study to relieve menstrual pain. By Eccles (2005)
- Magnetic bracelets used in a randomised clinical trial to relieve osteoarthritis of the hip and Harlow et al (2004)
Looking through the research, there is a clear pattern. The clinical trials that show a therapeutic benefit, reside predominantly in the studies using multipolar magnets, such as quadrapolar and alternating pole concentric rings. For instance…
Iron filings showing magnetic field lines on Quadrapolar versus Bipolar magnet
CLINICAL TRIAL #1: QUADRAPOLAR MAGNETS TO TREAT WRIST FRACTURE:
Costantino et al. (2007) studied 40 patients with wrist fractures after applying a Quadrapolar array of 12,500 Gauss magnets in the plaster cast directly over the fracture site. Resulting in bone callus formation that produced a 35% improvement in healing rates compared to ‘standard’ time.
The safety and effectiveness of Q magnets has not been established in the treatment of fractures.
CLINICAL TRIAL #2: CONCENTRIC RING MAGNETS TO TREAT TRIGGER POINT PAIN.
Vallbona et al. (1997) studied 50 patients diagnosed with post-polio syndrome who reported muscular or arthritic-like pain. The double-blind randomized clinical trial applied (300 to 500 gauss) magnetic devices to the affected area for 45 minutes. The magnets used in this study were a multipolar magnet with concentrically arranged circles of alternating magnet polarity.
The type of magnet used is this study was not a Q magnet. The safety and effectiveness of Q magnets has not been established in the treatment of post-polio pain.
Outcome measures were scored using the McGill Pain Questionnaire. Results of the study using the 10-point scale as follows…
Placebo group – experienced a decrease of pain of 1.1 ± 1.6 points (p<0.005)
Active group – experienced a decrease of pain of 5.2 ± 3.2 (p<0.0001).
Those who received the active device reported much less pain than those who had the inactive device.
Vallbona concluded the application of a static magnetic field of 300-500 gauss over a trigger point offers significant and prompt relief of trigger point pain in post-polio subjects.
Vallbona C., Hazelwood C.F., et al. (1997). Response of pain to static magnetic fields in postpolio patients: a double-blind pilot study. Arch Phys Med Rehabil. 1997;78(11):1200-3. PMID: 9365349; doi.
The same type of alternating concentric ring magnets were used in a randomised clinical trial with 30 subjects at the Armstrong Atlantic State University Physical Therapy department. The results were not peer reviewed and published, but were presented at a conference, details here.
Obviously not all studies show that magnetic field therapy has a therapeutic benefit. But it’s misleading to make blanket statements based on a specific study to say… “magnetic field therapy does not work”. Such studies can in fact be very useful in learning what works and what doesn’t and why.
For instance, the following clinical trial by Cepeda (see Clinical Trial #4 below), concluded that…
“In summary, bipolar static magnetic therapy lacks efficacy, and its use is not recommended for acute pain relief.”
A more accurate conclusion would have been…
“In summary, placing the type of static magnet used in this study around a surgical wound lacks efficacy, and is not recommended for acute pain relief.”
After all, I doubt the same researchers would inject a local anaesthetic into the elbow joint and from that deduce it lacks efficacy for knee pain. Other studies, such as by Man did place the magnet directly over the surgery site and did show a benefit
Although this study could be perceived as negative, it is still very useful. The lesson learned is that poor placement will produce poor outcomes.
CLINICAL TRIAL #4: EFFECT OF MAGNETIC THERAPY ON POSTOPERATIVE PAIN.
Cepeda et al. (2007) used quadrapolar static magnets for this study, but unfortunately did not place the magnets over the wound. Health professionals experienced with using quadrapolar magnets know that after
surgery, you place the magnets directly over the wound incision, over the dressing of course. The image below shows where the magnets were applied for this study.
In fact, very few are even close to the recommended treatment protocol for abdominal pain.
Unlike systemic drugs used by anesthetists, the physiological effect of magnets is very specific and localised. The intensity of a static magnetic field diminishes in proportion to the inverse of the cube of the distance. Correct placement of Q magnets to effect nerve tissue, pain and inflammation is vital in order to achieve pain relief or injury recovery. Placements out by as little as 1cm or ½ inch can make all the difference.
This study was never going to achieve a successful outcome for magnetic therapy because of its poor design.
For different reasons, the following clinical trial by Collacott concluded that the type of permanent magnet used in the study, had no effect on chronic low back pain. At least the authors were intelligent enough to make the following qualifications…
A stronger magnet may be necessary to penetrate to the source of chronic low back pain.
Our results did not support the findings of Vallbona and Weintraub. However, there were considerable differences in the study designs and populations, including the cause of pain. The patients of Vallbona and colleagues had muscle pain while Weintraub’s subjects had neuropathic pain. The source of pain in our participants would appear to be deeper than that of the former, and may explain the lack of beneficial effect from the magnets used (300 G).
Although this study could be perceived as negative, it is still very useful. The main lesson learned is that poor selection of magnetic device will produce poor outcomes.
CLINICAL TRIAL #5: EFFECT OF MAGNETIC THERAPY ON CHRONIC LOW BACK PAIN
Collacott et al. (2000) was a randomized, double blind, placebo-controlled crossover pilot study with a sample of 20 subjects with chronic degenerative low back pain. The active multipolar magnet with 30mT (300gauss) was worn for six hours per day for three days per week for one week for a total of 18 hours for both demagnetized sham and magnetic devices.
The multipoilar arrangement of the magnetic device can be seen from the manufacture’s (Nikken) 1996 patent # 5,538,495.
An amusing perspective with this study is how often it is quoted by sceptics as proof that magnetic therapy does not work. However, the 300G magnets used would barely penetrate 12mm (1/2 inch), which when considering the spinal cord at the lower back level is closer to 50mm (2 inches) away from the skin’s surface would explain why this study proved no efficacy.
A more scientific response to the two studies above is described by Colbert, that is, the type of magnet used for the condition treated did not show a therapeutic benefit.
There is so much misleading information out there with regard to static magnets. For instance, the statements put out by government organisations such as the US National Centre for Complementary and Integrative Health do not even mention the more promising areas of research. They have since shortened their fact sheet, but the previous one is still available for download on our website. Our response to the misinformation on the fact-sheet can be found here.
The published article by Laakso (2009) provides the most recent and useful review into static magnets and explains the differences between quadrapolar and bipolar magnets. The article can be downloaded here. Another review by Pittler (2007) published in the British Medical Journal is often quoted and some of the differences between it and Laakso are explained here. Almost all other reviews, including NICCH display such a poor understanding of the science, some of the most important aspects do not even rate a mention.
Laakso’s review concludes…
In a review of the known literature presented herein, it is not yet clear if static magnets have a significant role to play in the effective management of neuromusculoskeletal pain although some of the research is encouraging.
One of the early studies covering Holcomb’s work at Vanderbilt Medical University was a cell study. While only an in vitro study, it was important none-the-less because it demonstrated that different designs of static magnets can produce different physiological effects.
BASIC SCIENCES STUDY #1: EFFECTS OF MAGNETIC FIELDS ON ACTION POTENTIAL FIRING
McLean et al. (1991) Effects of Steady Magnetic Fields on Action Potentials of Sensory Neurons in Vitro. Environ Med: 1991; 8 (2): 36 – 45. Download.
This was a foundational study on the effects of static magnetic fields on sensory neurons, comparing the common bipolar magnets with multipolar magnets including the quadrapolar array. More specifically that Quadrapolar magnets will block action potential firing of a dorsal root ganglion, while the common bipolar magnet has no effect. The comparison below is described.
CLINICAL TRIAL #6: QUADRAPOLAR MAGNETS TO TREAT RHEUMATOID ARTHRITIS OF THE KNEE
Segal et al. (2001) studied 64 patients with Rheumatoid Arthritis who suffered moderate knee pain by application of four 190 mT (1900 gauss) quadrapolar magnets in one group and in a placebo group with a weak standard bipolar magnet with a homogeneous field of strength 72 mT (720 gauss).
The safety and effectiveness of Q magnets has not been established in the treatment of rheumatoid arthritis.
Subjects randomly assigned to the quadrapolar magnet group showed a greater reduction in joint pain than did the control group after one week follow up (40.4% vs 25.9%) and twice daily pain diary results (p< 0.0001) for each vs baseline.
However, comparison between the two groups demonstrated no statistical significance (p<.23). Subjects in the quadrapolar magnet group reported an average decrease in the global assessment of the disease activity of 33% over one week, as compared with a 2% decline in the control group (p<0.01).
After one week, 68% of the quadrapolar magnet treatment group reported feeling better compared with 27% of the control group. Whilst 29% of the active group and 65% of the placebo group reported feeling the same as before treatment (p<0.01). Segal concluded that both devices demonstrated statistically significant pain reduction compared to baseline. However, a significant difference was not observed between the two treatment groups (p<0.23).
Segal recommended that a nonmagnetic placebo treatment be used to further characterize its therapeutic potential for treating rheumatoid arthritis. Randomised controlled clinical trials are difficult to control for with static magnets. Protecting the blind in clinical trials that run for days or weeks is difficult, because subjects can somewhat easily test the magnet at home with something metal. Segal’s study used a weak placebo as a workaround, but the question is, is this a true placebo or does it become a dose comparison study.
Segal, N.A., Toda, Y., et al. (2001). Two configurations of static magnetic fields for treating rheumatoid arthritis of the knee: a double-blind clinical trial. Arch Phys Med Rehabil: 2001 Oct;82(10):1453-60;. PMID: 11588753; doi.
CLINICAL TRIAL #7: QUADRAPOLAR MAGNETS TO TREAT LOWER BACK PAIN.
Holcomb et al. (1991) in a multicentre randomized crossover study on 54 subjects with low back or knee pain. The placebo was non-magnetic and the active device was an inhomogeneous 200 mT (2000G) quadrapolar array.
The magnetic devices were worn for 24 hours with a seven day washout period. Holcomb reported a significant reduction in low back and knee pain at 1 and 24 hours but not at 3 hours.
There was also an increased use of analgesia (Laakso et al, 2009). Unfortunately this article has not been peer reviewed and efficacy of blinding and low subject numbers are questioned along with heterogeneity of diagnosis (some subjects had both back and knee pain (Laakso et al, 2009).
Holcomb RR, Parker RA, Harrison MS. Biomagnetics in the treatment of human pain-past, present, future. Environ Med. 1991;8:24-30.
What about using the north or south pole of a magnet? Some people think that’s the critical thing about using magnetic therapy, except when you look at the published research, it seems to be saying it makes no difference. See the article – Is there any difference to using the north or south pole of a magnet.
The following link explains the rationale and evidence for which magnet to use…
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