Efficiency of pulsed electromagnetic fields on pain, disability, anxiety, depression, and quality of life in patients with cervical disc herniation: a randomized controlled study
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(7):23 Turk J Med Sci. 2019 Aug 8;49(4): 1095-1101.What this means for my practice?
Results of this randomized controlled trial suggest that combining pulsed electromagnetic field therapy with transcutaneous electrical nerve stimulation and hot pack improve pain severity after 12 weeks. As well, it may improve quality of life factors including sleep, energy, social isolation, physical activity and energy levels at 3 and 12 weeks follow up. Yet, this study had several limitations including the short term follow-up of 12 weeks for outcome assessment, and small number of patients in each arm which could have increased bias in the results. Furthermore, the lack of a placebo by itself without any form of treatment is another limitation. Therefore, future larger randomized controlled trials utilizing long-term follow-up (>1 year) of outcomes and implementing a placebo without any treatment are needed to help confirm the findings of this study.
Study Summary
Seventy-four patients diagnosed with cervical disc herniation (CDH) and intervertebral disc protrusion/extrusion were both given the transcutaneous electrical nerve stimulation (TENS) combined with a hot pack and randomized to receive additional pulsed electromagnetic field (PEMF) therapy (n=37) or a sham PEMF with no current flow (n=37). Outcomes of interest included severity of pain on the visual analogue scale (VAS), function via the Neck Pain and Disability Scale (NPDS), anxiety and depression via the Hospital Anxiety and Depression (HAD) scale, and quality of life via the Nottingham Health Profile (NHP) and its sub-scores (pain, energy level, emotional reaction, sleep, social isolation, physical abilities). All outcomes were evaluated at 3 and 12 weeks follow-up. Results revealed that VAS pain was statistically significantly lower in the PEMF therapy group compared to sham at 12 weeks follow-up (p=0.02), however this was not observed at 3 weeks follow-up (p=0.19). Moreover, NHP-Sleep, NHP- social isolation, NHP-physical abilities, NHP-energy level, and NHP-total scores were all statistically significantly improved in the PEMF therapy group compared to the sham group at 3 and 12 weeks follow-up (p<0.05 for all). All other outcomes at 3 and 12 weeks follow-up were not statistically significantly different between the 2 therapies (p>0.05 for all).
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