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Is There a Role For Magnetic Therapy in Pain Management?

Written By cikgu sham on Sunday, February 12, 2012 | 4:21 PM


The mere mention of magnetic therapy will elicit a wide variety of reactions, but the response from doctors is fairly consistent - a glazed eye cynicism. And possibly for good reason, you see, it goes way back to the nineteenth century German doctor Anton Mesmer who practiced so-called animal magnetism and was so discredited that even today his name lives on through the English word mesmerise. Mud sticks and magnetic therapy in the eyes of doctors never recovered. Go online today and you can read the comments from many Doctors that magnets have little or no effect on mammalian tissue but you don't have to dig too deep to find published evidence from numerous medical journals that clearly refutes these comments. Not to mention the 1000's of satisfied users of magnetic therapy who can attest to its benefits.

Magnets were used and studied by some of the great doctors of yesteryear including the 16th century doctor William Gilbert who was president of the Royal College of Physicians and personal physician to the queen. In fact Gilbert wrote what is widely regarded as the beginning of modern science and electricity, a book called De Magnete. In it are some remarkable insights, like according to Dias, the "magnet reconciles husbands to their wives"! If only it were that easy, maybe that was the origin of the term "opposites attract"?

More recently with the advent of the MRI, the promising research being undertaken on strong magnetic fields for the treatment of depression and the research into static magnets to treat pain by neurologists at Vanderbilt Medical University throughout the 1990's, long held paradigms are slowly shifting. With the development of newer and more effective static magnet devices, magnetic therapy is gaining more credibility and will slowly make the transition from pseudoscience to alternative to complimentary therapy and finally to main stream medicine. This is a common occurrence in medicine, omega-3 supplements and fish oil were mocked 4 decades ago as ridiculous, now it is established medical practice.

Medicine has a long history of being slow to catch on, which is best illustrated by the story of Ignacio Semmelweis. Ignacio was a 19th century Hungarian obstetrician otherwise known as the "saviour of mothers" after he discovered why mothers giving birth attended to by doctors had 3 times the chance of dying than those by midwives. You see, the doctors came straight from giving autopsies to delivering baby's without washing their hands and transferred infections. But what became of Dr Semmelweis and his discovery? Well he was effectively driven out of the medical profession and died in an asylum and it wasn't for another 50 years until washing hands between patients became standard clinical practice. Think of the 10,000 or 100,000's of needless deaths that occurred due to this belligerence.

The legacy of Dr Semmelweis lives on in the Semmelweis Effect which is a metaphor for human behaviour characterized by reflex-like rejection of new knowledge because it contradicts entrenched norms, beliefs or paradigms.

And if you thought this sort of thing couldn't possibly happen in our day of instant communication, then spare a thought for Dr Barry Marshall from Perth who discovered that the bacterium Helicobacter pylori lived in the stomach and were the cause of stomach ulcers. This was at a time when conventional science taught that no bacterium could live in the stomach. 12 years after his discovery, exasperated and with very little recognition he resorted to infecting himself with the bacteria to bring on stomach ulcers and quickly cure himself with antibiotics. The time-lag reflects, as Professor William Doe of the Australian National University comments, "how difficult it is to change medical paradigms because everyone has a vested interest in the status quo". The pharmaceutical industry held the biggest vested interest in ulcers. Two of its biggest all-time earners had been the acid suppressing drugs cimetidine (Tagamet) and ranitidine (Zantac). These drugs did not cure ulcers, meaning patients often needed lifelong therapy. The similarities between stomach ulcers and pain are striking if not magnified.

When discussing magnetic therapy one needs to be specific, are you talking about electromagnetic (magnetism generated from electricity) or static magnet therapy? If static magnets are you talking about the weaker rubberized or ceramic magnets or the more recent stronger rare earths such as neodymium and then are you talking about bipolar or multipolar? Most people think that a magnet is a magnet, but as you delve down the rabbit hole of the complex world of quantum physics, things are very different to what they appear on the surface. Magnetic fields are a vector quantity and as such have both quantity and directional values. Different magnetic materials have different properties and the size of a magnet also determines the strength and depth of penetration.

In addition, magnetic fields are highly specific and unless the right type of field in the right dose envelopes the target tissue, then they cannot be effective.

The following table from Colbert et al (2008); Static Magnetic Field Therapy: Dosimetry Considerations, shows the energy product of different magnetic materials. The rubberized flexible magnets have about one fiftieth of the energy of the newer neodymium magnets and will barely penetrate 1cm into the body.

Magnetic Material Energy Product (MGOe)

Rubberized Flexible...........0.5 - 1.5..........MGOe
Ceramic...........................1.5 - 3.5..........MGOe
Rare Earth Neodymium......30 - 50............MGOe

Static magnets are made from iron alloys. The rare earth magnets such as Neodymium are the strongest static magnets currently made. Even neodymium magnets come in different grades with the highest rating, N52 MGOe with a magnetic flux density of up to 14,000 Gauss or 1.4 Tesla. 1 Tesla is equal to 10,000 Gauss, the earth's magnetic field is around 0.5 Gauss or 0.00005T and MRI's operate at around 2 to 3T.

All material is made up of molecules, which are made up of atoms which are made up of the charged particles electrons and protons. Electrons prefer to exist in pairs as they orbit the nucleus of protons and neutrons. It is the unpaired electrons in iron and the rare earths that provide them with their magnetic potential. Electrons create their own spin and tiny magnetic dipoles. In a non-magnetic material these are randomly orientated in all directions and effectively cancel each other out. During the manufacturing of magnets they are exposed to very strong electromagnetic fields which align the magnetic dipoles of the unpaired electrons. This gives the new material its permanent magnetic properties as the magnetic flux density is the vectorial sum of all the tiny magnetic dipoles induced by each spinning electron.

Most people are aware that the opposite poles of a magnet attract and like poles repel. In fact all magnets have a north and south pole and true monopoles only exist in theory. When multiple poles of magnets interact e.g. 4 alternating poles (+ - + -) on the one face as with a quadrapolar or Q magnet, it sets up field gradients where the adjacent poles meet. These field gradients are also called an inhomogeneous field and have a different effect on moving charged particles than the common bipolar magnets.

At the cutting edge of quantum physics is the Large Hadron Collider in Geneva which contains over 1,600 superconducting magnets, including 392 quadrupole magnets weighing around 27 tonnes each. The quadrupole magnets focus the particles as they accelerate around the 27km circular tunnel at 11,000 revolutions per second at 99.9999991% of the speed of light. This incredible concentration of energy is supplied by these very powerful magnets.

In the last 20 years enough credible research has been undertaken into static magnets and in particular certain types of therapeutic magnets to propose mechanisms of action and some quite remarkable clinical outcomes in the use of quadrapolar magnets.

Much of this research was pioneered by neurologists Dr Robert Holcomb and Dr Mike McLean while associate professors of neurology at Vanderbilt Medical University. Here they harvested live nerve ganglions from patients undergoing back surgery (with their permission of course) and exposed them to a variety of static magnetic fields. What they found was remarkable, when they exposed the nerve cell to a steep field gradient such as is generated by a quadrapolar magnet, the effect was to interrupt the nerve impulse or action potential.

The action potential is a self generating wave that carries the nerve signal, such as pain along the nerve to the brain. The researchers even exposed nerve cells to the noxious stimuli capsaicin which got the sensory neurons really firing, but after 5 minutes of exposure to the gradient of the quadrapolar array, the signal was totally blocked and fully recovered 10 minutes after the removal of the field. While many studies show promise under the microscope, the real test is, does it work in real life on real patients with real conditions? This is where the science needs to make the leap from laboratory to clinical research.

The research paper Epilepsy & Behavior2: S74-S80 (2001); Static Magnetic Fields for the Treatment of Pain. McLean et al, available on the qmagnet website, describes the effects on a neuron by exposure to the magnetic field produced by the alternating quadrapolar array. The cell study demonstrates how the steep field gradient blocks the firing of the action potential after a few minutes, even with increased stimulus and is reversible after the removal of the field.

Only in the last year, an Australian company (Neuromagnetics Australia Pty Ltd) invented a new quadrapolar magnetic design called Q magnets. The design combines the very strong neodymium rare earth magnets with new magnetising techniques to produce a quadrapolar magnet array of four alternating quadrants or poles in one round disc magnetic body. It also has a flux plate attached to the top of the Q magnet to further increase the field gradient and drive the field deeper into the body to enhance the therapeutic effect and target the deeper nerve structures.

Without getting side tracked into some of the more, shall we say unusual approaches, there are generally three theories into the application of magnets.

They are worn on the body like jewellery to affect the energy flow in the body.
Apply either the South or North pole over different parts of the body, usually the painful area or acupuncture or acupressure points or say the belly button.
The magnets are placed on very specific points on the body, usually over nerves where they interrupt the pain signal.

Effects purported by practitioners of magnetic therapy are increased circulation, reduced inflammation, correction of energy imbalances, enhanced immune function, more restful sleep, stress relief and reduced or cessation of pain.

While there may be some legitimacy to all three approaches, the third approach has been more thoroughly researched and has a significant body of published data to verify the therapy. The research undertaken at Vanderbilt suggests that the common bipolar magnets that are sewn into mattresses, blankets and pillows are having negligible effect on the nerve stimulus pathways. Besides, magnets used in this way are hardly going to be placed over specific anatomical structures.

In order to understand how Q magnets work, one must first understand the mechanism of pain. All pain is first interpreted in the spine. Noxious stimuli such as heat, pressure or chemicals are detected by nociceptors which are sensory nerve receptors found in all tissue (except brain) such as the skin, muscles and joints. This stimulation is transduced into an electrical signal called an action potential and carried back to the spine. The perception of pain is frequency coded and depends on both the number and type of nerve fibres activated and the frequency of the signal.

There are two types of nociceptors; C-fibres and A-delta fibres. C-fibres are unmyelinated slow conducting nerves that carry impulses at less than one meter per second and are responsible for the dull, burning, aching, throbbing pain. A-delta are the myelinated fast conducting nerves with impulses travelling at over 15 meters per second and are responsible for sharp pain. Essentially your A-delta fibres carry the sharp immediate pain perception to the spine and it's usually immediately returned with a withdrawal reflex action. After this, the C-fibres take over with that slow dull ache that I am sure many reading this will have experienced. Tissue damage produces an "inflammatory soup" with the release of pain chemicals such as bradykinin, leukotrienes and prostaglandins. The pain persists because these pain-mediating chemicals linger and make the nerve more sensitive to further stimulation which is the body's natural protective mechanism.

When pain becomes more persistent, it said to be chronic and this is usually accompanied by an increased sensitivity to pain or sensitization at the spinal cord level (central sensitization or secondary hyperalgesia) and not just at the site of the injury (peripheral sensitization or primary hyperalgesia).

A common treatment to combat inflammatory pain is to take anti-inflammatory drugs that will reduce the production of the enzyme cyclooxygenase, which is a key ingredient in the production of prostaglandins. The best-known anti-inflammatory drug is Aspirin. For more severe chronic pain, the use of opioids such as morphine seems to be the treatment of choice.

Once you have a basic understanding of how pain works and how multipolar static magnets that can generate steep field gradients work, it's not difficult to bring it together into a working theory for the application of static magnets in the treatment of pain. The steep field gradients work mostly on dampening down the hyperexcited unmyelinated C-fibres that have become sensitized. This is why they are so effective at blocking the dull aching pain, but have little effect on the sharp reflex pain carried by A-delta nerve fibres.

Professional Motocross rider Steve Sommerfeld has been using Q magnets since 2009 to speed recovery times from some of the serious injuries his extreme sport dishes out. There are a number of photos and videos on the qmagnet and Lifestyle Pain Clinic website that graphically show the therapeutic effects of Q magnet therapy on haematoma a day or two after the accident. Many professional sporting teams use Q magnets as an adjunct in therapy for soft tissue injuries to speed up the recovery process.

Other famous Australian athletes such as champion AFL player Simon Black have used Q magnets for years to speed up recovery times and at the same time allow him to train with greater intensity while nursing a specific injury.

There have been many cases where patients with severe, long term chronic pain and symptoms such as lower back pain, referred pain and allodynia (pain that is caused from what is normally an innocuous stimulus such as brushing) have been fitted with the large 5cm octapolar device (OF50-3) which can cover both L4-5 and L5/S1 spinal segments and the symptoms almost immediately improve. The patient with this type of condition will usually need to wear the device constantly for many months, during which they can then rehabilitate by strengthening the affected muscles and joints which would have previously been intolerable.

More health professionals are adopting this technology as it's quick and simple to apply and there are no side effects. As more research is conducted, more clinically reliable outcomes should be achieved. This is one of the major reasons doctors prescribe pain relieving drugs. While they might have side effects, they are reasonably reliable but not in all cases. Take the case of trigeminal neuralgia, one sufferer, a Ms Diplan from Maryland in the US was referred to purchase Q magnets by her neurologist. She had severe and debilitating pain through the jaw for over a year that was not responding to drug therapy. After applying a Q magnet for two days, her pain was gone and in many months since has not returned. Many other sufferers of trigeminal neuralgia have had almost precisely the same experience, either complete cessation of pain or drastic reductions in medication after using Q magnet therapy.

More and more professional sports people are using Q magnets as self treating therapy. Look at what professional sports teams are doing as they are usually at the cutting edge of rehabilitation because one missed game for a key player can have huge implications for a team. Some of the treatments used by professional athletes such as injecting stem cells to regenerate cartilage can be very expensive and probably not realistic for the average population who are more than likely better off simply taking a few more weeks with restricted duties rather than spend the $10,000's of dollars for expensive interventions.

However the cost of a few hundred dollars for the purchase of a set of Q magnets that will last the lifetime to the purchaser becomes financially viable and clinically relevant.

All professional sports people are subject to lost game time from injury. The Brisbane Lions have been using Q magnets for three years to speed up injury recovery and help keep the players out on the track for longer. In the case of the Lion's full back Daniel Merrett, he says "the Q magnets have a great effect on pain reduction which allows me to progress through my rehab stages and get back on the field sooner".

Peter Stanton is a highly regarded sports physiotherapist. Peter treats many professional athletes from around the world at his practice UQ Sports & Rehab in Brisbane. He says using Q magnets as an adjunct in treatment saves him around 2 weeks in correcting pelvic instability in athletes and they are able to train with much greater intensity while they are under his care.

I have presented numerous cases at national and international conferences of patients that have had positive responses to using Q magnets. One Sports Medicine Australia presentation was of an equestrian rider who was on an invalid pension after suffering a whiplash injury. He travelled from Sydney to Brisbane for treatment and I provided advice on correct application of the devices. In a period of 6 months he was back competing and working part-time. Since he was a former participant through the Royal North Shore Pain Clinic they wanted to write him up as a special case. But as he said, "it wasn't the RNSPC that got my life back, it was the Q magnets that I wore most of time after completing their program".

Much more research is required on the application of multipolar magnets such as quadrapolar or Q magnets that generate steep field gradients. Their effect on the lives of individuals suffering debilitating pain can be life changing, however the research needs to make clearer how many individuals with certain conditions might benefit and to what degree. Right now some of the more innovative and intuitive health professionals have embraced this new technology with promising results which would indicate it's currently a mix of both art than science. There is certainly a role for magnetic therapy in the treatment of pain, but looking at the evidence one has to more clearly define magnetic therapy in terms of the type of magnets used and how they are applied.

REFERENCES:

Colbert et al (2008): Static Magnetic Field Therapy: Dosimetry Considerations.
About this Author

Dianne Hermans is a senior physiotherapist and principal physiotherapist at the Lifestyle Pain Clinic in Manly in Brisbane, Australia. She has a particular interest treating chronic and complex pain. Dianne has presented at national and international professional conferences on the application of Q magnets for the successful treatment of chronic pain. She is currently enrolled in a Masters program at Griffith University and is conducting a double-blind Randomised Controlled trial using Q magnets. Dianne is Principal Clinical Educator for Q magnets and has trained hundreds of health professionals in their use and application.

Neuromagnetics Australia Pty Ltd manufactures and distributes Q magnets, or "Quadrapolar Magnets". Q magnets are listed with the Therapeutic Goods Association (Australia) as a Class I Medical Device for the temporary relief of pain.

For more information on the Lifestyle Pain Clinic, see Pain Clinic Brisbane.

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