What’s controllable?

A button to start or stop a 20 min. cycle. There’s only the one applicator which would be placed directly over the body part requiring treatment.

Frequency

 4.7 Hz. As with any capacitance discharge PEMF there is likely to be a spray of frequencies at the point of discharge.

Applicator/s

1 paddle type applicator

Pulse Rise Time: <1.8 uS (microseconds)

Pulse Duration: ~2.5mS (milliseconds)

Strength/s

Peak: 43,133 Gauss* (~43 kilo Gauss)

Other:

Energy Storage Capacitor: 600uF, 450 Volts DC

Typical Energy Storage: 36.75 Joules (Watt*Seconds)

Maximum Energy Storage: 42.18 Joules (Watt*Seconds)

Typical Peak Charge Voltage: 350 Volts DC

Maximum Peak Charge Voltage: 375 Volts DC

Minimum Peak Current Discharge into Coil: 150 Amps RMS

Main Coil Inductance: ~2.5mH (milli-henries)

Minimum number of Pulse Discharges 30 Million (30,000,000)

Waveform

Power supply

International AC-DC Wall Adaptor

Can run off a 12 volt battery separately or from a car cigarette lighter outlet 

Time control

After about 20 minutes of pulsing, the MP5 will turn itself off. If desired it written may be run for several climate cycles at one setting or used several times a day. Once run for more than one cycle, the paddle head will get very hot. This tends to limit the number of cycles that this can be run. It is going to be uncommon that it would need to be run multiple times during a specific treatment session.

We have become a commodity culture. We are driven to find the cheapest solutions, including waiting for insurance to cover our healthcare needs. The best solutions for your health are rarely the least expensive. Health is not a commodity. It takes effort and resources to be as healthy as possible. By only accepting choices covered by insurance, we are severely limiting the options available to us and are much more likely to encounter side effects and complications. These options are typically limited to physical therapy, procedures, and pharmaceutical drugs, because the mass marketing approaches do not cover PEMF.

Unfortunately, I have discovered that you generally need a stronger magnetic field to penetrate deeper into the body. If the magnetic field has to go more than a half an inch into the body, then it needs to be fairly strong to have relatively rapid results. Very weak magnetic fields can still produce results, but they can be frustratingly slow, or even ineffective for your problem.

In this case, if the area of injury is not protected (or is not properly immobilized to reduce the continued irritation of the tissues and overuse syndrome) then the magnetic field will be competing with continued aggravation.

If, for example, you have a headache that will require 10 aspirin to relieve, and you take only 2 aspirin, then you will experience 2/10 worth of relief. You will likely become frustrated with the aspirin, on which you spent money trying to obtain relief. You may come to the conclusion that aspirin is an ineffective treatment. The truth, of course, would be that it was not the aspiring that was ineffective, but the dosage.

Now, liken this to PEMF therapy. If you  were to purchase an inexpensive, perhaps disposable device, which we know has limited strength as well as a limited lifespan, its inability to produce results may lead you to dismiss the entire gamut of PEMF devices. In this case, like in the case of the aspirin, it is not the treatment that is ineffective, but the dosage, or, with a PEMF system, the choice of device itself. These kinds of experiences lead people to believe that PEMFs don’t work and they don’t last, and causes people to be unlikely to try them again, even if an appropriate device is recommended.

Purchasing less expensive systems can lead you to inadequate results and frustration. It is best to obtain a system that is correct for the problems intended to be treated. This is one of the reasons we set up DrPawluk.com, that is, to best tailor your device selection to your specific needs. This may mean that you will have to pay more than with a few self-directed, price-based purchase decisions. However, better selection would be more likely to guarantee the results desired.

In the case of pain management, this becomes especially important, since people often come to the decision to use PEMFs long after they’ve attempted many other approaches, at great cost, already having complications and having endured prolonged suffering.

What is good health worth after all? I frequently tell my patients, pay me now or pay me later, unfortunately, later you will have to pay with interest, which may sometimes be exorbitant.

I have seen over the years people being recommended all sorts of magnetic systems for all sorts of problems. What I described above has been the exact experience I have witnessed, in over 20 years of working with magnetic therapies. Many people discovered that their purchases didn’t work. This is not to say that they never worked. It is true that some benefit can be derived from even weak systems, if applied properly. Unfortunately, this negative experience leads to closed-mindedness toward all the other potentials of these technologies – and continued frustration with therapeutic alternatives.

There has even been research conducted on magnetic systems having been improperly applied. The conclusions derived then, are that magnetic therapies don’t work. One example involved a magnetic back system, published in the Journal of the American Medical Association. Editorial comments concluded that magnetic therapies don’t work. This has had the unfortunate consequence of leaving a lot of doctors who read this journal to conclude and maintain a conviction that magnetic therapies don’t work. While there are many reasons for doctors to put down magnetic therapies, this type of negative research is a disservice to our whole society. This is not to mention those suffering and seeking conventionally-accepted treatments that likewise don’t work and may even cause significant harm. Somehow, doctors recommending these conventional therapies are blind to the side effects and complications associated with them. And, they do not consider other appropriate alternatives, being caught in the vise grip of conventional medicine.

In general, I believe that we should all always think about our overall health. All too often we think ‘local and short term’ and not ‘general and long term’. If you have only one problem in your body, for example a heel spur, then a strong local magnetic system may suffice. But, if you also want to be healthy overalll, then you would want a whole body system that also allows local treatment. Obviously, if you have problems in many areas of your body, like arthritis in your neck as well as your lower back, then a system covering a larger area would be best, to limit how much time you need to spend treating all the areas that need attention. If you have had multiple surgeries and are in a lot of pain, you will likely need a stronger system, local and/or general. If you have a lot of pain away from home, you will likely need a system that will allow treatment while travelling. This may require two systems, one for home and one for travel, since there aren’t any whole body systems that are strong enough and portable at the same time.

So, to conclude, you really need to think more about what your health problem is. This will drive what the best likely solution is, a decision not made solely based on cost. You may have to pay more upfront so that you do not have to throw away many disposable systems before you realize what you’ve spent. This way, you will not have to endure unnecessary, long term suffering as a result, without getting a reasonable benefit.

I certainly am sensitive to the reality of what people can afford. You should understand that whatever decision you make for a particular PEMF system, regardless of the basis for that decision, whether cost or probable benefit, you’re in the long run probably better off getting the right system from the beginning, not just the cheaper system.

If you really can’t decide what system may be best for you, www.drpawluk.com  can help you with that. I can assure you, we do not always recommend the most expensive systems. Having you be helped is our priority. We are happy if you are happy. If you are happy you will share your experience and together we can all help more people with their suffering and the needless procession of multiple unnecessary drugs or damaging procedures. We all know many, many people who can use better options.

William Pawluk, MD, MSc

Heart disease is the number one cause of mortality in the United States and Canada. The heart is a very electrically dynamic organ. Heart disease includes many causes. These range from vascular disease, electrical conduction defects, muscle problems, valvular effects, congenital defects, infectious problems, trauma and pericardial problems, all as the direct or primary cause of the cardiac disease. Other non-direct problems can also affect the heart secondary to other systemic issues, including, but not limited to, hypertension, kidney disease, lung disease, autoimmune diseases, toxicities of various kinds, etc. Finding nonpharmacologic and noninvasive ways of managing heart disease in a safe, effective, nontoxic way is always a goal.

Magnetic fields have been found to significantly affect cardiac function, in addition to effects on a myriad of other body systems and problems. Not all magnetic fields are the same. Different types of magnetic fields may have different effects on the heart. Treatment of secondary causes can be just as important as the primary management of the heart itself.

The purpose of this paper is to explore the interaction of electromagnetic fields (EMFs) and the heart. We will review the basic science of EMFs and tissue, the heart as an electromagnetic organ and the geomagnetic and occupational influences that may affect it. This will serve to emphasize how readily cardiac tissue may be affected by EMFs. Animal studies often serve as a basis for understanding how human functioning may be affected by any therapy, before human treatment is tried. Finally, we will end with evidence of human benefits.

BASIC MECHANISMS AND CONCEPTS

EMFs either pass through the heart without interaction or they interact directly. The latter is called “coupling.” There are established basic mechanisms through which static and time-varying electric and magnetic fields interact directly with living matter. Induced time-varying fields can stimulate excitable cells such as cardiac muscle. Static and time-varying fields interact with the body differently.

Every mammalian system reacts to the influence of EMFs. On the cellular level, cell membranes, mitochondria and nuclei are the most sensitive. Effects of EMFs depend on many factors, such as age (children and old people are more reactive), sex (men are more sensitive), and functional state (a functioning organ reacts more strongly).

The heart muscle itself, because of its electrical activity, creates its own endogenous EMFs. Using a special magnetometer, one can see that the heart produces its own measurable, dynamic magnetic fields – electrical and magnetic activity follow each other, as night and day. These measurable fields allow for the mapping of the heart’s magnetic field under normal and pathological conditions and making possible a new tool for functional cardiology. EMFs generated by the cardiovascular system itself have biological effects not only on the heart itself but also on non-cardiac cells in the body distal to the heart by interacting with the immune system.

Extremely low frequency (ELF) EMFs easily penetrate tissues and cause virtually no sensory reactions. The reaction of the cardiovascular system to ELF EMFs is complex and includes direct responses of cardiac muscle, the autonomic nervous system, blood vessels, etc., and reflex responses mediated by the central nervous system. ELF EMFs increase the diameter of capillaries and greatly improve microcirculation, systemically and locally in the heart itself.

High frequency and high strength EMFs undoubtedly affect the cardiovascular system. Laboratory studies show that effects result even from EMFs below 150 Hz and 1G. The cell membrane is the primary site of EMF interaction, leading to intracellular changes in gene function and protein synthesis. These effects are highly nonlinear, with dose-response patterns that show “windows” of action and resonance-like phenomena. Power transmission lines can have health effects, but electrical transportation systems and electrical appliances are more common sources and have much more powerful EMFs. Movement in the environment interacts with other external EMFs and work synergistically together to cause bioeffects. New lower limits to field strength actions are often discovered. There are no known lower limits for the intensity of EMFs to affect biological systems. Only the microscopic design of a receptor in the body and the time-variation dependency of its interaction with the many varied EMFs define the level of sensitivity to EMFs.

Extremely weak alternating, sinusoidal (power line) fields of certain frequencies interact with the local geomagnetic field and/or with EMF therapeutic systems. EMFs can act through another organ or tissue’s EM field, local and/or atmospheric geomagnetic fields and possibly even the moon. Even the body’s electrical currents interact with external fields and participate in control of life processes. External EMFs interact with most, if not all, organs and functions in the body.  All these interactions clearly paint a very complex picture of EMF actions on the body – leading to the natural conclusion that human functioning is fundamentally inseparable from the EMFs around it.

ELF (below 300 Hz) EMFs interact strongly with biological systems, both electrically and magnetically. The magnetic field aspect of an ELF EMF penetrates the body without obstruction since the magnetic permeability of tissue equals that of air. Effects are directly related to the strength of the electrical currents induced in the tissue by the magnetic field aspect. Effects are seen at current strengths close to natural currents in the body and even fields well below those of natural tissues cause cellular responses. These involve membrane signal systems, cell surface receptors and all body biochemical systems, including enzyme activity and gene expression.

ANIMAL STUDIES

In dogs’ hearts, considered comparable to human hearts, the natural heart EMFs, due to the beating of the heart, are much larger by adding external EMFs. The heart contributes between 5% and 10% of the total field induced in the human body by external electric and magnetic fields.

Cells or tissues can be protected against a lethal stress by first exposing them to a sublethal dose of the same or a different stressor to produce stress proteins in tissues. This concept is known as “preconditioning” and gives protection against oxidative stress, caused by ischemia/reperfusion, UV light exposure, heat, chemicals and electromagnetic field (EMF) exposure. Rodent heart muscle cells preconditioned by low energy EMFs for 30 minutes have more effective induction of stress proteins than heat. As little as 10 seconds of exposure produce a detectable response at 30 minutes, last for more than 3 hours and can be restimulated by a second exposure to fields of different intensity. However, in egg embryo studies, continuous exposure to ELF EMFs for 4 days, twice daily for 30 minutes or 60 minutes for 4 days reduced the protective effect. 30-minute exposures once daily and 20-minute exposures twice daily did not reduce protection. A protective role is seen against cardiac ischemia in chick embryos. EMFs for 20 minutes induce stress proteins in the laboratory. This raises the strong possibility that using them before, during and after the surgical trauma can use EMFs for minimizing heart damage from heart surgery or transplantation or heart attack in humans.

For other kinds of cardiac actions, short-term exposure to sinusoidal ELF EMFs (5-8 Hz) in adult and old male rabbits for 15-120 minutes causes mild decreases in the ECG heart rate if exposure lasts 60 minutes. Old rabbits developed extra beats. In animals with experimentally induced myocardial infarctions, EMFs are not necessarily beneficial. There is little data comparing different kinds of EMFs. It remains to be determined what the optimal configurations are for different situations. One study examined the difference between pulsed (PEMF) and alternating/sinusoidal (AMF) field effects on the hearts of dogs, exposed for an hour per day for 10 days. The AMF caused marked changes in heart dynamics: decreased ventricle function and increased peripheral resistance and end diastolic pressure in the right ventricle, as well as, left ventricular work. Systolic blood pressure (BP) and contractility and heart rate still decrease with PEMFs, but are less marked. Thus, use of PEMFs may be less aggressive for cardiac problems than sinusoidal fields.

Basic actions at the cell level account for these actions. A 16 Hz frequency modulation increases mean flow of Ca++ out of frog heart cells at low intensities. This compares with calcium flow in brain tissue, suggesting that neural tissues may generally react at these modulations and intensities and act through changes in Ca++ in and around cells. Chronic exposure to 50 Hz EMFs of rats at 2 hr/day for lower intensities or 0.5 hr/day to higher intensities produced increased blood flow to the heart tissue and enlargement of the coronary vessels. Higher intensity EMFs affect the heart function of rats (25) with 14 days, 4 hours a day of stimulation. EKG changes are temporary, but, at the end of 14 days of stimulation only heart rate remains decreased.

Hypertension, if untreated for a long time, can cause heart damage and ultimately heart failure. Static magnetic fields (SMF) of 2000 G placed on each carotid sinus area (south and north poles, respectively), decrease systolic, diastolic, and mean blood pressures by 10%. Heart rates were not affected. This action is most likely due to Ca++ transport changes across the carotid pressure receptor membranes.

Stress has very strong actions on the heart. When ultrahigh-frequency (UHF) EMFs are given to dogs subjected to emotional stress, several cardiovascular changes resulting from stress are improved. Stress increases blood pressure by 40-50%, heart rate by 20% and makes the left ventricle function hyperdynamically. Even though the UHF EMF does not eliminate the stress reaction of the cardiovascular system, it is less pronounced overall. UHF EMFs seem to accelerate central adaptation mechanisms, rebalancing circulation and decreasing adaptation time for cardiac stress.

ENVIRONMENTAL AND GEOMAGNETIC FIELDS

Studies from Eastern Europe have found that changes in the geomagnetic field can worsen heart disease and that the major effects occur on the first or second day after a magnetic storm. Geomagnetic activity can be quiet, unsettled, active, or stormy. While myocardial infarction rates (MIs) from circulation blockages do not seem to change with geomagnetic activity, cardiac electrical activity is probably more sensitive and affected. The admission rates of patients with new episodes of electrical conduction problems causing paroxysmal atrial fibrillation (PAF) were highest during the two lowest levels of geomagnetic activity, more in males and persons over 65 years. Males under age 65 with PAF are at greater risk of stroke from the PAF. Thus, increases in heart electrical instability appear to happen during periods of lowest geomagnetic activity.

Geomagnetic fields (GMF) also interact with ELF EMF therapy. Even a very weak EMF, up to 70 uT applied to the whole body or locally, for 8-12 minutes, 1-2 times per day for 10-20 days has clinical benefit in most patients. Sensitive patients improve after only one or two days, most others take 5-10 days. On days when GMF increases two-three fold, some patients complain of discomfort during the exposure and have increased blood pressure (BP). In most, (47%) the BP shows no changes, 38% decrease BP and 15% are increased.

Environmental exposure of EMFs also affects cardiovascular function. Average 50-60 Hz working environments do not have much effect on human heart rates. In AM radio station workers exposed to high frequency (HF) fields, 83% have heart rhythm disturbances and decreased signals in their ECGs.

There are significant differences between clinical ELF PEMF systems and high frequency (microwave or cell phone levels) sources. Any publicly oriented article or book, unselectively citing references mixed with ELF exposures and those in the HF kHz and over range, clearly does not understand EMFs and is indiscriminately comparing apples and oranges, in terms of their clinical effects. Indeed, there are many clinical therapy systems that use high frequencies, but they are usually used for tissue destruction, for tumors and colon, bladder, skin and heart arrhythmia lesions, etc. General or public use of EMFs for personal use should be restricted to low strength ELFs or high frequency EMFs that do not create heating.

Duration of exposure to environmental fields is probably important as well. Changes in heart rhythm may be affected in the workers professionally exposed to 50-Hz electric and magnetic fields (EMF) over long periods. There can be a global decrease of cardiac rhythm in both high (over the industry norm) and low (at or below industry norms) professionally EMF-exposed groups compared to the non EMF-exposed control group. These changes may increase the risk of cardiovascular diseases. Other environmental or home-based “electromagnetic pollution” has the risk of inducing health problems. Fortunately, measures can be taken in the home and office to decrease background EMF risks.

HUMAN EVIDENCE

Experimental studies show that EMFs can affect the function of the centers of the autonomic nervous system controlling cardiac rhythm. A temporary increase in BP is seen with clinical exposure to industrial 50-60 Hz EMFs, but extended exposure causes the systemic pressure to decrease. Microcirculation dilatation occurs, with increased blood flow in the capillary bed and precapillary arterioles and an increased permeability of the vascular wall. Even lymphatic vessel flow increases. Circulation changes produced by EMFs are depending on the functional state of the central regulatory apparatus, especially the hypothalamus. Experimental PEMFs are found to act directly on the tissue of a beating heart.

Medium powerline-type field exposure for 3 hours causes a significant slowing of the heart rate. EMF effects are related to changes occurring during the recovery phase of the cardiac cycle. Humans are more responsive to some combinations or levels of field strength than others.

EMF therapy acts beneficially on the functional state of the nervous and endocrine systems as well as on tissue metabolism. The heart rate and BP decrease and the cardiovascular system is less reactive to adrenaline and acetylcholine. The parasympathetic nervous system is activated. Stimulation of the autonomic ganglia along the spine reduces cortisol and aldosterone. MFs typically cause only a momentary change of the microvascular bed with slowing blood flow. This then changes over to a longer period of an increased heart rate, rate of blood flow and filling of the blood vessels.

Sinusoidal PEMFs improve microcirculation in people with ischemic heart disease and vascular diseases of extremities. PEMFs act more strongly than permanent magnets. ELF MFs improve both lipoproteins and cholesterol levels. But, a static magnetic field of more than 50 mT (500 Gauss) at the tissue increases risk of atherosclerosis, with irregularly arranged lipid deposits in middle to large size arteries and fibrosis and calcification. In people with low blood pressure, EMFs improve heart contractions and cause more normal bioelectrical function. In most people, EMFs lower BP by lowering vascular resistance, with vasodilatation.

Hypertensive patients are affected positively, depending on the function of the heart before magnetic treatment. People with normal functioning hearts just have their vascular resistance lowered. EMFs normalize heart function and circulation in patients with high BP, and at the same improve circulation. The improvements in systemic vascular tone, as well as lipid metabolism and coronary circulation make MFs very useful treatment for people with the combination of hypertension and ischemic heart disease.

Early in the course of use of MFs in patients, there are changes in ECGs to a lower wave size pattern, sinus rhythm and extra beats, and a decrease in heart rate. With continuing magnetotherapy, these changes disappear and cardiovascular function is improved. This is common with MF therapy. Meanwhile, there may be temporary worsening while repair and rebalancing is happening, with the outcome being more normal function and health. To get better results with EMF treatments, understanding the underlying cause of the problem and function of the organ system is critical for designing the proper protocol to use for an individualized approach. The best outcomes occur this way. Without an understanding of the physiology and the type of field to use and how, less than optimal results can happen. Awareness of the potential for initial de-stabilization minimizes misunderstanding in managing the course of therapy and should be carried out with the assistance of a knowledgeable professional.

Good results are not always seen. In one small series, patients were treated with sinusoidal EMFs for arrhythmias caused by ischemic heart disease, post myocardial infarction and cardiomyopathy. A sinusoidal EMF used for 10 sessions daily, alternating between placement to the sternum for 15 minutes and “palm – wrist” area for 5-7 minutes. EMFs did not normalize heart rhythm. One woman had an attack of paroxysmal tachycardia occurred. Six patients reported unpleasant sensations (“sickness at heart” and headache) during or after EMF therapy, occurring most often with cardiomyopathy. A sinusoidal EMF may even increase BP in males, whether exposure was for 20-40 minutes or 1 hour.

Magnetolaser therapy (MLT) has been studied in single placebo control trial in the treatment of ischemic heart disease patients, with exertional angina and moderately to severely impaired function, post-myocardial infarction. Most had significantly decreased circulation. MLT was applied to 3 tender zones on the chest: in the front over the upper part of the heart and middle of the sternum, and in back between the scapulas to the left of the mid line, for 12 min, 4 min for each exposure zone, daily over 15 days. Work capacity increased in 84% of the MLT group but worsened in the placebo group. The work increased most for patients with functional classes II and III angina. MLT was also useful for patients with conduction disorders, eliminating extra beats in 29% and decreasing them by more than 70% in 32% of cases and stopping paroxysmal atrial fibrillation in 53%. The treatment lasted through the follow-up period of 12 to 16 months. These impressive results show that MLT facilitates adaptation to a physical load, and promotes rearrangement of central hemodynamics and recovery and stabilization of electrical activity of heart cells, safely and simply.

Heart rate variability (HRV) results from the action of neuronal and cardiovascular reflexes, including those involved in the control of temperature, blood pressure and respiration. Changes in HRV are predictive of a number of cardiovascular disease conditions and specific alterations in HRV have been widely reported to be associated with adverse cardiovascular health outcomes. Low strength, 60-Hz continuous or intermittent MFs in healthy males has little or no effect on HRV, indicating they do not induce stress effects. HRV alterations during magnetic field exposure may occur when accompanied by increases in physiologic arousal, stress, or a disturbance in sleep. There appear to be significant differences in heart rate and mean 24-hour personal exposure to MF between occupational and non-occupational group. It is not yet known whether clinical EMF exposure, in those who’s HRVs shows clear departures from normal, improves the HRV.

Patients with so-called Electrical Hypersensitivity (EHS) have a misbalance of autonomic regulation being more hypersympathetic, as measured by heart rate (HR) and electrodermal activity and sympathetic skin responses to visual and audio stimulation. There are frequency-intensity-duration components to these exposure sensitivities.

Much of the biological effect of high frequency fields is due to tissue heating, not just EMF effects. However, biological effects, not due to tissue heating (nonthermal) have been found with millimeter-range (MMR; about 300 GHz) MFs. These EMFs probably affect the command centers of organs through reflex systems. It is preferable to select biologically active points for MMR exposure; tender zones and areas of large joints, where tissue sensors are numerous and nerve fibers contact collagen directly. Local skin exposure to MMR EMF affects cerebral function. Clinical benefits are seen with treating heart angina and hypertension, especially essential hypertension. It is noted that patients with symptomatic, renal hypertension don’t respond. Cardiac rehabilitation in rats with MMR EMF added after myocardial infarction promotes tissue repair and functional recovery. Human clinical studies confirm this. Only favorable effects occur: more rapid tissue healing, activation of ATPases, antioxidant properties, and so on.

Use of mobile phones is commonplace. Mobile phones produce biologically active HF EMFs. Digital mobile telephones have the theoretical possibility of affecting implanted cardiac pacemakers. The META series of pacemakers are mostly immune to clinically important EMF interference from digital mobile telephones. It appears that use of digital mobile telephones by patients with appropriately programmed pacemakers is safe.

There is also much evidence of accelerated tissue healing effects where there has already been tissue damage, either from ischemia or mechanical or surgical trauma. Tissue healing with PEMFs appears to be accelerated by about one third to one half the usual time and results in fewer tissue complications, such as infections and poor or aggressive scar formation. In addition to stress protein effects mentioned above, but also free radical scavenging and accelerating RNA/DNA production in laying down new repair tissue. This means that, if cardiac surgery is required, not only would EMFs help tissues to be less traumatized but also would help speed recovery afterwards.

Cardiac vascular and peripheral vascular blockages depend on the development of “soft” and “hard” atheromatous plaque formation. It is these plaques and their actions on platelet dynamics that can cause vascular obstructions, occlusions or thromboses, leading to cardiac ischemia (angina) or heart attacks. This is the basis for several drug therapies aimed at reducing platelet adhesiveness, including daily aspirin and warfarin, to name a few. PEMFs have similar, strong effects in reducing platelet function and other clotting factors and probably acts synergistically and additively with these drugs. The primary actions studied have been on ADP dependant platelet adhesion, reduction in thrombin and increased thrombolysis.

SUMMARY

EMF therapy acts beneficially on the functional state of the cardiovascular, nervous and endocrine systems as well as on tissue metabolism. The heart has been found through numerous studies to be very electromagnetically sensitive. This sensitivity extends to all external fields, whether therapeutic or otherwise, including their interactions with each other and with the body. Some of the benefits to the cardiovascular system are indirect, acting through stress reduction effects, emotional responses, endocrine system, the immune system and especially the autonomic nervous system. Autonomic neural regulation makes the tone of the vascular system normal. Even cardiac muscle blood vessels are dilated. Decreased vascular resistance decreases the workload of the heart, reducing strain, which if applied over long periods of time could lead to decreased cardiac wear and tear. EMFs have a moderating effect on cardiac function as well as the microcirculatory system. Pulsed magnetic fields, versus sinusoidal fields, appear to be less aggressive towards the heart. Much of  their actions depend on cellular Ca++ ion changes.

There are multiple other actions of EMFs on the cardiovascular system. One is an anti-atherogenic effect and a reduction of platelet adhesion factors, which could reduce the possibility of cardiac vascular occlusions and cardiac damage. Because of actions on stress proteins, cardio-protection is now a feasible use, not only for treating or reducing cardiac ischemia but also for the trauma created by cardiac surgery. EMFs are even useful post-operatively in facilitating and accelerating recovery through wound healing effects, for superficial and even deep tissues.

There are significant differences between clinical ELF PEMF systems and high frequency (microwave or cell phone levels) sources. Any publicly oriented article or book, unselectively citing references mixed with ELF exposures and those in the HF kHz and over range, clearly does not understand EMFs and is indiscriminately comparing apples and oranges, in terms of their clinical effects. Indeed, there are many clinical therapy systems that use high frequencies, but they are usually used for tissue destruction, for tumors and colon, bladder, skin and heart arrhythmia lesions, etc. General or public use of EMFs for personal use should be limited to low strength ELFs or high frequency EMFs that do not create heating.

The evidence reviewed here gives reasonable support for wider medical application of magnetic field (MF) therapy as a method of non-drug therapy in cardiovascular disease, alone or in a complementary fashion with medical or other modalities.

Copyrighted. December 2003.

It is necessary to say that other devices of lower intensity and different applicator configuration have not been compared head-to-head with these high intensity rTMS systems. There is evidence to suggest that even extremely tiny intensity magnetic fields [pico Tesla] have shown benefit in a wide range of neurological and psychiatric conditions. Research also shows that less powerful PEMFs can have significant effects on EEG brainwave patterns. Changes in EEG patterns definitely affect neurochemistry and therefore mood. Controlling the intensity of PEMFs (especially to achieve lower intensities) may be important for many people. In addition, rTMS rarely achieves frequencies higher than about 20 Hz. It is known that many inflammatory regenerative processes require higher frequencies. There can be significant side effects from the use of rTMS, even in well controlled settings. Therefore, lower intensity PEMFs may have a role and place in helping individuals with many conditions for which rTMS has been applied.

In my book on magnetic therapy, Magnetic therapy in Eastern Europe: a review of 30 years of research, and a recent review of research since 1992, I summarize the results of various PEMF devices using a range of frequencies and intensities. They have been found to help some of the following conditions: stroke, neuro infections, RSD [reflex sympathetic dystrophy], migraine, muscle sclerosis, spinal degenerative conditions, radiculitis, inguinal nerve injuries, peripheral nerve injuries, Ménière’s, and spinal cord injuries, among others.

Research is even being conducted at the Department of Psychiatry, Harvard Medical School and McLean Hospital, using low intensity PEMFs. Mood improvement was reported by 23 of 30 bipolar disorder subjects who received the PEMF treatment and by four of 14 healthy comparison subjects. Significant differences in mood improvement were found between the bipolar disorder subjects who received actual PEMF stimulation and those who received sham stimulation. The electric fields generated by this low intensity PEMF were smaller (0.7 V/m) than fields used in repetitive transcranial magnetic stimulation (rTMS) treatment of depression (1-500 V/m) and also extended uniformly throughout the head, unlike the highly nonuniform fields used in rTMS. At this point research is ongoing with this system.

Many of the devices listed in our product reviews probably also have significant benefits for mood disorders and other neurological conditions.

PEMFs are expected to influence nerve cell firing/function of selected brain areas. It appears to be that low-frequency ≤ 1 Hz suppresses while high-frequency ≥ 5 Hz activates local neural activities. There was the question of which side of the brain to stimulate, the side with the lesion or the opposite side. Several randomized controlled trials have confirmed that low-frequency PEMF applied to the brain hemisphere opposite to the side of damage (non-lesional) can significantly improve motor function of the affected upper limb in post-stroke patients. It is speculated that exposure to the non-lesional hemisphere reduces possibly protective nerve function inhibition by the non-lesional hemisphere towards the lesional hemisphere, leading to facilitation of beneficial functional reorganization in the lesional hemisphere. Intensive occupational therapy (OT), especially using constraint-induced movement therapy (CIMT) for upper limb hemiparesis also appears to activate areas around the stroke lesion in chronic stroke patients. In chronic stroke, CIMT is currently considered to be most useful. In another study using high-frequency PEMF with CIMT over the lesional hemisphere daily for two weeks, compared to patients treated with CIMT only, improvement of motor function was not significantly different.

To be in the study the patients had to meet the following criteria: 1) ability, at least subjectively, to flex all the fingers of the affected upper limb in full range of motion. 2) Age between 18-90 years. 3) Time after the stroke more than 12 months. 4) Only a single-sided stroke. 5) No cognitive impairment with a pretreatment Mini Mental State Examination score of more than 26. 6) Being in a plateau state for at least 3 months. 7) No history of seizure within preceding year. 9) No documented epileptic discharge on pretreatment electroencephalogram. 10) No current use of antiepileptic medications for the prevention of seizure. 11) No pathological conditions known to be contraindications for PEMF.

In the current study, follow-up evaluation after discharge showed persistent improvement of motor function of the affected upper limb up to four weeks after treatment ended. The duration of improvement of motor function of the affected upper limb appears to be relatively short after a single session of low-frequency PEMF. A different study reported that the improvement induced by application of low-frequency PEMF to the non-lesional hemisphere daily for five consecutive days was maintained for two weeks after intervention. In yet another study, the improvement of motor function of the affected upper limb in patients who received CIMT was also maintained up to several months after the intervention. Whether there are longer-term effects using each of the two interventions remains unknown for now. What is also not known is whether continued use of PEMFs in the home setting long-term may continue to show improvements. This may be expected to be true given that the brain tends to repair very slowly, even given appropriate stimuli.

This study also showed no significant relationship between any of the six tested baseline parameters and the response to the intervention. The intervention can produce beneficial functional reorganization even in elderly patients and in those whose strokes were years earlier. Since this study did not include acute/subacute stroke patients within one year after onset, it remains unknown if earlier application of the protocol during the acute/subacute phase of stroke can produce more functional improvement than those seen in our patients. It has been reported that beneficial functional reorganization is higher in acute/subacute phase than in later phases of stroke.

While more research clearly needs to be done, this study is encouraging in showing that the combination of higher intensity PEMF and occupational therapy improves function, even in patients who had their strokes over a year earlier, and in some cases up to nine years earlier. Additionally, this study was performed in a hospital setting for a limited period of time using very expensive rTMS PEMF, with limited availability equipment. While not proven, it may not be unreasonable to expect that a home-based, high intensity PEMF system may produce similar results. A combination of low and high frequencies may be even better, some reducing nerve cell firing, as would be desirable with spasticity, and others increasing nerve cell firing, where there is a reduction in neuron function. It is generally axiomatic in medicine that little gain in function is likely to happen in these patients after the first 3 to 6 months following a stroke, with conventional PT/OT alone. So any therapeutic approach that is not likely be toxic or invasive, such as higher intensity PEMF , has a good chance of being able to provide benefit, and may well be worth considering.

Another just recently published study (Avenanti) of higher intensity, low frequency PEMF for stroke, investigated the long-term behavioral and neurophysiologic effects of combined higher intensity PEMF and physical therapy (PT) in chronic stroke patients with mild motor disabilities more than 6 months poststroke. In this study, thirty patients were enrolled in a double-blind, randomized, single-center clinical trial. They each received 10 daily sessions of 1 Hz higher intensity PEMF over the intact, that is nonaffected, motor cortex, with either real (R) or sham (S) approaches, administered either immedi­ately before or after PT. Outcome measures included dexterity, force, interhemispheric inhibition, and corticospinal excitability and they were assessed for 3 months after the end of treatment. The researchers found that treatment induced progressive rebalancing of excitability in the 2 brain hemispheres and a reduc­tion of inter-hemispheric inhibition in the R groups. PT produced improvements in all groups. The aspects of functions that were trained showed only small and transitory improvements in the S patients. The R group had greater behavioral and neurophysiologic improvements especially in the group re­ceiving R treatment before PT (R-PT), with robust and stable improvements. The post PT-R group showed a slight decline in their improvement over time. They concluded that priming PT with inhibitory higher intensity PEMF  before the PT (in the hemisphere opposite to the stroke lesion) is optimal to boost brain plasticity related to the functions trained with PT and rebalance motor excitability and suggests that higher intensity PEMF is a valid and promising approach for chronic stroke patients with mild motor impairment.

These patients were enrolled as outpatients in a Neurorehabilitation clinic. They were included if they had a unilateral stroke, greater than six months after the first ever stroke, and had mild upper limb motor deficit. Anyone with a seizure disorder was excluded. The higher intensity PEMF was applied immediately before or after PT. There were eight patients in each experimental group with a total of 14 patients in the sham treatment arm. Treatment lasted for 10 days with two PEMF sessions per day, of 25 min. each, and 45 min. of standard task oriented upper limb exercises.  The PEMF was applied to the motor cortex. The sham was the same activated coil applied perpendicularly to the scalp so that no current was induced in the brain. To check stability, two pretreatment evaluations were performed two weeks and one day before starting treatment. Post treatment evaluations were performed at 1, 7, 14, 30, and 90 days post treatment. Neural excitability of both hemispheres was assessed at baseline, pretreatment, day six [pre treatment] and at each of the post treatment follow-ups.

The exciting aspect of this study was that they actually checked for cortical excitability. Chronic stroke patients typically show less excitability on the affected side of the brain compared to the opposite side of the brain. In a normal non-stroke brain there is a cross communication between the sides of the brain where each side balances the other with inhibition and stimulation. Because of the damage to the side affected by the stroke the opposite side becomes uninhibited and can irritate the affected side, creating spasticity in the affected extremity. Before the study, the researchers believed that doing higher intensity PEMF before PT could potentially prime functional neural networks for the PT intervention to work better, leading to superior outcomes. This study provided evidence that higher intensity PEMF stimulation induces reduction of interhemispheric inhibition from the intact side of the brain to the affected side, long-term potentiation of excitability of the affected side leading to improved and obvious functional improvements, in particular when PT is preceded by the higher intensity PEMF. One to three months after treatment the group receiving PT first started to show a decline in performance and excitability of the affected side. In the group receiving higher intensity PEMF first, the outcomes remained stable over time by boosting brain plasticity caused by use of the brain and the affected extremity, mainly by stabilizing the physical learning processes of the brain. They found evidence of a daily, cumulative lowering of excitability in the intact hemisphere. This was paralleled by a strong cumulative increase in the excitability of the affected hemisphere. This study provides direct neurophysiologic evidence that 10 days is more effective than five days of higher intensity PEMF treatment. The sham PEMF stimulation group showed only a modest improvement lasting only a few weeks with no significant changes in excitability. This is not surprising since the PT was relatively short, patients were all chronic poststroke, and all had already received cycles of rehabilitation before. Even though it is known that PT this late after stroke is less effective, this study indicates that brain stimulation may overcome this limitation.

The practical importance of this randomized controlled trial, is that, even post stroke, at least up to six months afterward the stroke, the use of higher intensity PEMFs and PT may produce significant improvements in function, that was thought to be lost permanently. The questions that ultimately remain is whether similar benefits can be seen more than six months after the stroke and whether various higher intensity PEMF systems may produce similar results. Given the lack of toxicity for PEMF therapies, below the level of inducing seizures or contractions, post stroke patients may find significant benefit from these therapies.

Higher intensity PEMF therapy systems that could be considered for stroke management, in the light of the studies above, would include the PEMF 100, Curatron XP/PC, Sota and Almag. The PEMF 100 and Curatron would be expected to provide the better results, because of their frequencies and intensities.

References
Kakuda W, Abo M, Shimizu M, Sasanuma J, Okamoto T, Yokoi A, Taguchi K, Mitani S, Harashima H, Urushidani N, Urashima M. A multi-center study on low-frequency PEMF combined with intensive occupational therapy for upper limb hemiparesis in post-stroke patients. J Neuroeng Rehabil. 2012 Jan 20;9(1):4.

Avenanti A, Coccia M, Ladavas E, Provinciali L, Ceravolo MG. Low-frequency rTMS promotes use-dependent motor plasticity in chronic stroke: A randomized trial. Neurology. 2012 Jan 24;78(4):256-64.

Osteonecrosis of the femoral head is the end point of a disease process that results in progressive collapse of the femoral head followed by destruction of the hip joint. It has been recognized as a side effect of the longer term, high-dose steroids used to treat diseases such as Acute Respiratory Syndrome (SARS), Acquired Immunodeficiency Syndrome (AIDS) and Systemic Lupus Erythematosus (SLE), rheumatoid arthritis, inflammatory bowel disease, such as ulcerative colitis and Crohn’s disease, among others. High-dose corticosteroid administration is considered to be the most common risk factor for osteonecrosis. Dosages typically considered to be associated with the disease are > 2 g of prednisone, or its equivalent, over within a period of two to three months. Lower dosages are not typically related to osteonecrosis of the femoral head. With the progression of osteonecrosis, both the bone and cartilage femur part of the hip are deformed, which ultimately leads to collapse of the load-bearing area of the femoral head. Once osteonecrosis collapses the femoral head, most patients require surgical treatment. Several surgical treatments have been established to prevent collapse, such as core decompression, osteotomy,  vascularized or bone grafting  and hip replacement. The results of these procedures are not always successful and may create serious complications, often leaving these individuals with significant hip damage,  disability and misery. Therefore, preventing osteonecrosis would be an ideal strategy for this disease, but there is no established prophylactic measure.

It is well documented that pulsed electromagnetic fields (PEMF) are useful for enhancing bone repair in nonunion fractures and related bone-healing problems. In addition, it has already been found useful for the treatment of osteonecrosis of the femoral head, at the early stage, The optimal protocol for PEMF is unknown. Various biological factors are involved in bone remodeling, especially bone cell (osteoblast) growth factors. There is some indication that lipids may block nutrient vessels thus leading to blockages of the blood vessels supplying the hip. This study was done on rats to see if PEMFs could prevent the osteonecrosis commonly seen with the use of high-dose steroids. The PEMF devices used consisted of a signal generator and a pair of 40-cm diameter coils placed on either side of the cage of the animals. The signal was repetitive, single, square-wave pulses with pulse duration of 4.5 ms and frequency of 15 Hz. The magnetic field increased from 0 to 12 G in 4.5 ms and then decreased back to 0 in 20 ms, for 4 h/day. There were two control groups. One received IV lipids and steroids (MPSL), similar to the PEMF group, and the other was a neutral control (PS). This chart shows the progression of osteonecrosis in each of the study groups. It can be seen that the MPSL group all developed osteo necrosis by the fourth week. Some of them resolved in the subsequent four weeks after the last dose of steroids with the final percent being 75% versus only 29% in the PEMF treated group. This is a very large and clinically significant difference.

 Table 1: Incidence of osteonecrosis of the femur (%)

 *P < 0.05 versus MPSL group.

PEMF stimulation has been used successfully to treat nonunion fractures and osteonecrosis or aseptic necrosis of the head of the femur, but relatively little is known about its effects on preventing steroid-induced osteonecrosis. Furthermore, the mechanisms and the optimal protocol for PEMF stimulation for the prevention of steroid-induced osteonecrosis are unclear. There are some differences in osteonecrosis in rats as compared to humans. For example, osteonecrosis often leads to femoral head collapse in humans but not in rats, based on the differences in anatomy in adult rats versus adult humans. Also, the metabolic rates are higher in rats than in humans, so osteonecrosis can be seen in rats within one w Herries is red or really important study eek after steroid treatment. Steroid-induced osteonecrosis can be prevented by anticoagulants or lipid-lowering agents, with reductions in osteonecrosis that range from only 30% to 40%. This study found a 60% reduction and no side effects. Therefore, PEMF stimulation is a safe and effective treatment for preeither red or really important study venting osteonecrosis. They also found that the incidence of osteonecrosis in the usual high steroid group displayed progression over the course of treatment, while that in the PEMF group did not. PEMF stimulation may prevent osteonecrosis by decreasing serum lipid levels, increasing TGF-b1 and RNA. TGF-b1 is involved in many aspects of skeletal development and regulation, such as fracture repair and bone regeneration, as it can promote the proliferation and differentiation of osteoblasts, that is, bone building cells. The results of this study showed that the mRNA and protein expression of TGF-b1 was suppressed in the steroids group but increased in the PEMF group.

PEMF stimulation has been used successfully to treat nonunion fractures and osteonecrosis or aseptic necrosis of the head of the femur, but relatively little is known about its effects on preventing steroid-induced osteonecrosis. Furthermore, the mechanisms and the optimal protocol for PEMF stimulation for the prevention of steroid-induced osteonecrosis are unclear. There are some differences in osteonecrosis in rats as compared to humans. For example, osteonecrosis often leads to femoral head collapse in humans but not in rats, based on the differences in anatomy in adult rats versus adult humans. Also, the metabolic rates are higher in rats than in humans, so osteonecrosis can be seen in rats within one week after steroid treatment. Steroid-induced osteonecrosis can be prevented by anticoagulants or lipid-lowering agents, with reductions in osteonecrosis that range from only 30% to 40%. This study found a 60% reduction and no side effects. Therefore, PEMF stimulation is a safe and effective treatment for preventing osteonecrosis. They also found that the incidence of osteonecrosis in the usual high steroid group displayed progression over the course of treatment, while that in the PEMF group did not. PEMF stimulation may prevent osteonecrosis by decreasing serum lipid levels, increasing TGF-b1 and RNA. TGF-b1 is involved in many aspects of skeletal development and regulation, such as fracture repair and bone regeneration, as it can promote the proliferation and differentiation of osteoblasts. The results of this study showed that the mRNA and protein expression of TGF-b1 was suppressed in the steroids group but increased in the PEMF group.

As a preventive therapy, PEMF could be used in combination with corticosteroid for treatment of many clinical conditions, such as AIDS and SLE, which require high-dose corticosteroid treatment. Daily treatment with PEMFs of 4 or more hours appears to be necessary, and it may be preferable to do the treatment at night. Therefore, a PEMF system is necessary that can run for hours at a time and could easily be focused on the hips. While PEMF stimulation can prevent steroid-induced osteonecrosis in rats, it is not an unreasonable assumption that similar use of PEMFs could well be very helpful with humans too. This should be a very important and useful prevention strategy in any people needing higher dose steroids, likely to equal or exceed 2 g total in a given course of treatment. Someone on 60 mg per day of prednisone would exceed this limit in just about one month. At 40 mg per day the dose would be exceeded in about two months. So, anyone expected to need at least this much steroid in their course of treatment needs to have a prevention strategy in place. The risk may further be exaggerated when multiple courses of steroids are used in relatively short periods of time. A prevention strategy using PEMF stimulation could reduce a very large, and unnecessary, toll of suffering. It is simple and inexpensive with virtually no side effects or risk. Waiting to see that there are osteonecrosis-like effects already happening to the hips may not produce as effective results. The extent to which PEMFs may help once osteonecrosis has begun is unknown, and is not as likely to be as effective. Therefore a PEMF prevention strategy should be begun at the initiation of any course of high-dose steroid therapy.

From Pulsed electromagnetic fields stimulation prevents steroid-induced osteonecrosis in rats.

Ding S, Peng H, Fang HS, Zhou JL, Wang Z. BMC Musculoskelet Disord. 2011 Sep 29;12:215.

As we know, surgery not only creates tissue trauma in the area of the actual incision, but also in all the tissues that are manipulated during the procedure. These tissues are subject to significant amounts of bruising – as though you were pounding them with a hammer or squeezing them with a vise. In fact, the tissues surrounding the incision site are worse off in many ways than the area of the actual incision itself, which tends to be linear and very limited. Therefore, helping these “innocent bystander” tissues is actually more important to recovery than the incision itself. This is why I recommend using the OrthoCor right up to the day of the surgery, to enhance the health and vitality of the surrounding tissues so that they may recovery more quickly from their bruising event.

There is no contraindication to using the OrthoCor immediately after surgery. I usually recommend at least eight hours rest after the surgery, to allow any bleeding in the tissues to settle down. Then, the OrthoCor should be used for upwards of 4 to 6 hours per day until complete healing has occurred. Whatever additional rehab is necessary can and should continue, with the use of the OrthoCor at home afterwards.

Ice is still a mainstay for reducing edema postoperatively, however, it should be understood that the depth of penetration of the cold from the ice is very limited. This is where the OrthoCor is a fantastic complement to conventional approaches, since the PEMF from the OrthoCor penetrates much deeper than the cold from the ice could ever go. For ice to go very deep, you would have to do irreparable damage the superficial tissues (i.e. frostbite). So, again, the combination of other types of rehabbing, including ice, is much better than either alone. Reducing swelling superficially is the least important aspect of the recovery process. The most important aspect is to facilitate and accelerate the natural regeneration of the healing process of the tissues that have been damaged during the surgery, especially the deeper tissues.

The challenge I face in explaining how PEMFs can help is that people don’t understand the degree of damage caused by the surgery itself. Surgeons know what they know, but it is a rare surgeon who thinks outside the lesion and the prevailing approaches. PEMFs are not unique, however they can be considered to be ‘alien’ among American physicians, who tend to be closed-minded. Eastern European surgeons frequently go beyond the bounds of conventionality to achieve better results. Trauma surgeons around the world learn on the battlefield, and do not rely only on what is written in the medical journals. In fact, medical science is frequently expanded because of experience as much or more than actual research. Practically speaking however, both are very valuable and neither is to be discounted. If good science already exists, it should be considered and not ignored. The problem is that there is rarely enough science that is systematic research. As is somewhat discussed in my book, Magnetic Therapy in Eastern Europe: a Review of 30 Years of Research, Eastern European surgeons have been using PEMFs postoperatively for decades. They discovered that they had many fewer complications and tissues healed much more quickly with the use of PEMFs—even in dramatic wounds.

Other physical therapies can also be used concurrently with PEMFs like the OrthoCor. One example is interferential TENS. The OrthoCor and interferential TENS operate on very different principles. TENS typically mostly blunts the body’s ability to perceive pain. It has a very limited role in healing the wound, and if so, only very superficially at that. The OrthoCor produces high frequency PEMFs which penetrate deep into tissues. This particular PEMF device has FDA approval for healing swelling in tissues and reducing pain. Other studies on this particular signal have shown significant acceleration of wound repair. So, using the TENS and OrthoCor together would significantly decrease the need for pain medication.

One of my patients used a pulsed magnetic field system before and after her total hip replacement, and only used two doses of pain medication and stopped using her cane within two days. All this because of the PEMF treatments. Her surgeon and physical therapists were amazed at how well she did, especially considering that she was 75 years old!

In terms of recovery, OrthoCor can certainly be used to shorten the total healing process. Studies on wound healing indicate that PEMFs can potentially decrease the healing rate by half the time normally required. Even then, the wound seems to be stronger, and is less prone to complications like infections.

PEMFs, of the kind I usually recommend, typically penetrate all the way through the body without being used up by the body. However, like a light, the intensity of the light is strongest rate next of the light and decreases as you move away from the light. The same thing happens with PEMFs – the intensity drops off as you move away from the applicator. That means that the part of the body next to the applicator will get the highest field intensity and the other side of the body away from the applicator will get a very low level of intensity. This is an important consideration in where to place applicators and will determine often what kind of results will be obtained.

Some health problems require higher field intensities. Some health problems do better with lower field intensities. Some problems require a broader range of frequencies, while others do better with a minimal number of frequencies. So, selecting the right device becomes important to achieve the best results. Every magnetic system will produce benefits to some extent. The right magnetic system for the circumstances will tend to produce results faster. Unfortunately often people have to make purchasing decisions based on affordability and so the right magnetic system may not always be possible to obtain.
If this is the case, then it will likely take more time for benefits to be achieved and patience will be required.
Many people get tremendous results quickly and are very happy with their PEMF system even in the first week or so of use. For some people the results don’t happen quickly. This is where we can fine tune the treatment program to achieve better results. I often have to remind people that the body takes time to heal once it’s given the appropriate signal or stimulus for that to happen. For example, a fracture will need 8 to 12 weeks to be strong enough for the bone to be able to be used. This does not mean the healing process is finished, it is just a more usable body part. Magnetic therapy can speed the healing rate but it will not be instantaneous. This is an unreasonable expectation.

PEMFs do not drug the body into being painless or euphoric. I call that “numbing and dumbing.” Sometimes drugs are important during the therapy process. One of the goals of PEMFs is to be able to reduce the use of drugs if one can and accomplish less pain and improved function.
PEMFs work deep in the tissues to stimulate natural healing processes that have gotten stuck. It is the healing of the tissues that creates a reduction in pain, and improvement of function and health. This is ultimately the best solution and produces the most sustainable, least likely to regress, results. Unfortunately, we didn’t get here overnight with our problem/s and it will take time for the healing to work. Despite this, at the same time, other benefits begin to happen in the body, that were unexpected. For example, sleep, mood or vitality, or gut function, etc, may improve before the original problem improves.

So, what are some of the ways to improve results?

1. Setting expectations
Having proper expectations is really important. If one is depressed or very miserable in one’s life, small improvements in a problem may seem inadequate to improve the overall quality of one’s life. I see this particularly in the elderly who have so many health issues, among others, that it is hard for them to appreciate the benefits they may be getting. Important to setting expectations is understanding the nature of the problem the depth of the damage or dysfunction, the tissue involved and its ability to regenerate, the likely time it will take to recover even in favorable circumstances, and the age of the individual. It is clear that a 20-year-old will heal much faster than an 80-year-old. The body has more vitality and the genetics tends to support faster repair and recovery. 20-year-olds typically don’t have as many chronic problems and so acute injuries tend to resolve much faster than chronic problems, which have been around for decades. While often considerable funds are being spent on PEMFs we have a risk of setting expectations that are too high for what the technology can accomplish and the ability of the tissue to regenerate. When expectations are too high we are unfortunately often very likely to seek magic bullets, including surgery, expecting dramatic benefits. Rarely, miraculous things happen quickly, but this is not the norm. Still, PEMF therapies are a better solution than exposing the body to risky procedures or potentially toxic drugs/medications. PEMF therapies or a more natural solution, most of the time. Often, individuals will seek PEMFs as a solution after they have already been subjected to numerous procedures or surgeries. This unfortunately becomes a bit like putting Humpty Dumpty back together again. I have seen PEMFs work extremely well and quickly in patients who have very little damage in their bodies for multiple procedures. This can happen even in this last situation, if the circumstances are right. Most of the time, however, it takes time for healing to happen that is likely to be permanent or dependable. Often also, PEMFs may not cure or reverse the problem but are necessary on a continuing basis to maintain control of the problem. The same thing obviously happens with the use of medications, physical therapy, massage, etc.

2. Acknowledging the level of tissue damage/dysfunction
This is a critical piece to understanding how long it is likely to take for benefits to be seen in treating specific problems. Problems in the body have degrees of involvement and different tissues are involved in any given injury. The degrees of involvement can be considered in terms of layers or levels. One way to conceive of these levels is: the energetic level, the physiologic level, the pathophysiological level, and the pathologic level. At any given time there can be overlap in the tissues of all of these levels, and they can even all be simultaneously present.

Energetic level
The analogy I use is that of a common cold. When a cold is first beginning, many people feel a vague sense of disease, or uncomfortableness, without any specific sense of where or what the problem is. This is in the energetic level.

Physiologic level
Once a cold begins to produce a sore throat, a slight temperature, a runny nose, sneezing, etc., the infection has moved to the physiologic level.

Pathophysiologic level
If the infection continues in the body and progresses, it may begin to produce bronchitis, rhinitis, a significant cough, mental fogginess, with a green or yellow sputum, etc. This is the pathophysiologic level. In this level there are elements of a physiologic response to an infection and elements of cellular destruction (pathology) with color changes to the sputum indicating infection of the nose, sinuses or bronchial passages. Once the infection descends further into the body, acute sinusitis or pneumonia is possible. Most chronic problems are in the pathophysiologic level, with varying degrees of pathology.

Pathologic level
With significant cellular or organ damage, this level is considered pathologic. A substantial amount of tissue death can occur before an organ or the body as a whole will fail. At a minimum, a number of cells have died. At the extreme, there is either complete or partial organ failure or death of the person.

Responses to treatment at each level
Treatments directed at a problem that is at the energetic level are much more dramatic and likely to produce responses very rapidly, even in minutes. For physiologic level problems, treatments are more likely to produce responses in hours to several days. Once there is some level of pathology, that is, at a pathophysiologic level, the effects of treatment usually take longer, and can take days to weeks. The pathophysiologic level in these cases can be surprisingly affected by magnetic fields, with often dramatic results. At the pathologic level, treatments have very unpredictable results and may take months to years to produce results, if ever. True and complete organ death is unlikely to be reversible with magnetic fields. Magnetic fields do not create the “Lazarus effect”.
Once one knows what the probable level of damage to the organism is, it’s easier to predict how long it may take for these therapies to produce results. Miracles, that is, much better than expected results, are always possible, however. Treatment may be directed at a particular problem of interest but improvement may first be seen for a different issue, based on which layers are involved. Since more superficial layers will be more likely to respond quickly, these problems will respond regardless of where the MFs may be directed first. This is like peeling an onion; more superficial issues will be “peeled” away first, deeper next, etc. and deepest will be last. This is why holistic treatment may take months to years to clear all the layers.

As a physician, I always attempt to determine the level of damage that’s present in the person I am asked to help. Once I have a sense of the levels involved, I have a much better idea of how long it will take to achieve significant relief or improvement or cure. The level and extent of the problem seems to be more important than the strength of the magnetic fields applied, or the frequencies used or how much time is devoted to treatment each day. Optimizing these variables should shorten the process.

Beyond this, all bodies are different and all illnesses or diseases need to be well understood, along with some sense of the mind, body and spiritual states of the individual looking for treatment. All of these will determine how long treatments will take to produce expected or desired results. Without this sense of layers, both the individual seeking treatment and the therapist can experience unnecessary frustration. The body has its own wisdom and will respond in the layers and levels that make more sense to it than to our expectations or fantasies. We need to respect these layers of healing timelines and processes and work positively with them. What gets healed initially and in what order after that is mostly up to the body, not our expectations. The order of healing will follow the body’s own wisdom of what level/tissue should be cleared first, second, etc. Patience and acceptance of this natural order will aid the healing process.
The second aspect, beyond the levels of dysfunction, is the tissues involved. The body is constantly regenerating itself and we are informed that we are new bodies about every seven years. However, various tissues within the body have faster levels of regeneration and repair cycles than the overall body. For example, the cornea of the eye repairers itself 24 hours. Intestinal cells can repair within 72 hours. Skin and muscle cells may repair in 2 to 3 weeks. Bone can take up to seven years. Some tissues do not repair well, if at all, for example, ligaments, tendons, nerves, brain, spinal disks and possibly cartilage. The tissues that do not repair well generally do not have great blood supplies or have a low regenerative capacity. Since many problems for which PEMFs are used involve musculoskeletal tissues, these problems can be very stubborn to get results. Some problems are just very deep in the body and difficult to access without procedures to be able to produce benefits. This is one of the areas where PEMFs are especially useful, since they penetrate rate through the body. We cannot push the tissue to regenerate beyond its optimal capacity for regeneration. The optimal capacity is comparable to what would be seen in childhood. So, for example a fracture may take 8 to 12 weeks to heal to a point of functionality naturally. With the use of PEMFs this fracture may take half to three quarters of the usual time. It is known for example, with fractures that have not healed for over six months, that the use of PEMFs may be needed for upwards of 8 to 12 hours per day for as long as a year, depending on the fracture gap.

For tissues that do not have the capacity for regeneration, PEMFs are used in the circumstances to reduce pain, swelling in the tissues, improve circulation, and stimulate whatever regeneration is possible. Again, usually in any given problem there are multiple layers involved and multiple tissues. Since we never clearly know what the pain generator might be, the use of PEMFs can still be very valuable.

3. Adequate amount of use
Most of us are under significant time pressures. The amount of time for which treatments need to be applied, will depend on the levels of dysfunction, the tissue type and the particular magnetic system used. Generally speaking, faster results will be obtained with higher intensity PEMFs. Unfortunately, these are usually significantly more expensive PEMF systems. Therefore, if a lower intensity system is all that is affordable, longer treatment times will be needed for more extended intervals to achieve desired results. As mentioned above for nonunion fractures, treatments may need to be applied for upwards of 8 to 12 hours per day for upwards of a year. This is an unusual circumstance but generally, it may be necessary to use the PEMFs for 60 min. to three hours per day on average. It is generally better to break up the treatment times to give gentle nudges to the body to stimulate the healing processes. So, a common recommendation I make is to do 30 min. three times a day. If this is not possible at least an attempt should be made to do 30 min. twice a day and when possible add another 30 min. session in the middle of the day. When time is available better results may be achieved with 60 min. three times a day. No matter what, at least one treatment session should be done daily usually around 30 min. at a time. One of the most important aspects of treatment with PEMFs is consistent daily application until the problem has improved.

Occasionally frequencies become important and for some problems higher frequency systems will do a better job faster, even if less intense. The same rules for time of use applies to these systems.

4. Duration of use
How long should magnetic therapies be applied for? The short answer is – as long as it takes. Many people stop doing their treatments as soon as they feel comfortable enough. It should be understood that the healing process is not finished itself because symptoms are better. PEMFs work
at the cellular level and are repairing and regenerating cells and improving the function of cells at a level way below our awareness. So, healing can take a lot longer than simple symptom reduction. This is one of the reasons we get into trouble in terms of chronic conditions because we don’t appreciate that problems are developing until they become symptomatic. A good example of this is hypertension which is silent until a stroke or heart failure occur. A general rule of thumb would be to continue treatments at the same level prior to symptom improvement for least another month. Another caution is that when symptoms have improved we should not necessarily increase our activity level dramatically because it may reenter the tissues. Activity should be increased gradually and the body will instruct us what is tolerable. When symptoms recur we know that we have gone too far too fast and need to back off and continue treatment for a longer period of time.

A common example where PEMF therapy is not always achieve desired results is in bone on bone arthritis. This could be the knee or the hip. In this circumstance the damage is so extensive and so late in the history that a joint replacement is often inevitable. Even though in this situation the opportunity for PEMFs to make a huge difference is limited, I’m constantly surprised at the benefits people get. If however, there is minimal benefit or the benefit is not a sufficient level of reduction of pain, there is still the benefit of assisting the tissues to be as healthy as possible prior to having their joint replacement. After the surgery, the recovery time for the joint replacement may actually be shortened with a decreased risk of complications. In addition, some research and feedback from patients indicates that the prosthesis integrates better with the bone. In addition there may be long-term benefits in having this osteointegration decrease the likelihood for future breakdown and the need for re-doing a joint replacement. Redoing her joint replacement is much more difficult than the original procedure, and is to be avoided if possible. I have had one patient least whose recovery from hip replacement surgery was dramatically short and painless because she had been using her PEMF system for at least a year prior to the surgery. Her doctors and physical therapists were amazed at how quickly she recovered. This almost never happens with a hip replacement. Again, my point is that we never know what kind of benefits can happen with any given individual, even though not necessarily all of our objectives are met when purchasing the PEMF system.

I consider pulsed magnetic therapy to be a lifetime health care tool. Therefore, the way the system purchased can be used will obviously vary over time depending on circumstances. No matter what, we all need health maintenance, and therefore magnetic therapy should be a component of daily health management.

5. Proper placements
The usual placement of applicators is to the place of pain or discomfort. Often however, the pain is actually generated in another part of the body. For example, low back problems can be referred down to the knee or foot. Knee problems can be referred to the foot. Hip problems can be referred to the knee. Shoulder problems can be referred to the elbow or wrist/hand. Spasticity of the lower extremities is caused by a problem in the spinal cord. And so on. If it is known that the lesion is directly in the tissue experiencing the pain, then it is appropriate to apply the PEMF applicator to that spot. There is never any harm and placing it higher up, particularly the spinal cord because all sensory traffic from the lower extremities travels to the brain through the spinal cord. The brain will perceive the pain and send a signal back to the extremity or location of the pain. So, treating the spinal cord above the level of the problem can be very helpful. For example, if the problem is in the arm then it may be useful to also apply treatment to the neck. A problem in the lower extremities can be additionally helped by applying the applicator to the lumbar spine area, to get the lumbar spinal cord.

Not only is it important to place the applicators in the right locations, but also it may not be as useful to treat the entire body expecting specific areas to receive the same level of benefit. As mentioned above, to lie on your back will not necessarily help the front of your chest, because the field intensity may not be strong enough to treat the chest. So an application may be needed to the back as well as the front of the chest, in this case. Some magnetic systems allow two applicators to be used simultaneously on opposite sides of the body part. This often allows higher field intensity to be generated in the tissues between them, which I call a magnetic sandwich. Some applicators can actually be folded into a tube which also increases the intensity the field in the body part inside the tube. This can also be accomplished with a whole body pad turned sideways and wrapped around part of the body.

Depending on the magnetic system, a pillow applicator may be of higher intensity than a whole body pad. Even if not, a pillow applicator can be applied for much longer periods of time without the risk of over stimulating the body, as would happen with extended treatments with the whole body pad. Generally, tissues in body cavities, such as the abdomen, the chest and the skull, are more sensitive and may be easily overstimulated in some individuals. In this case, lower intensities and shorter periods of time may be necessary to reduce over-stimulation.

It is likely that different body parts need different periods of time of treatment, depending on the level of dysfunction, discussed above. Often, acute problems need less time than chronic problems. So, treatment times will need to be adjusted based on the circumstances.

6. Getting support
While often, a purchased PEMF system can be used out-of-the-box following the instruction manual, it may be possible that support is required from somebody who is well-informed about clinical conditions and understanding the technology being applied. Obviously, if the treatment is not going well or producing acceptable results, professional support may be necessary. Most medical personnel will have some significant degree of knowledge about clinical conditions but have very little understanding of PEMF technology and so they may not be able to provide useful advice. This is one of the key advantages that DrPawluk.com offers for those who purchase their magnetic systems through Dr. Pawluk.com.

7. Having adequate nutritional support
I instruct patients that you can’t build a house without bricks and mortar. It is well known in medicine that wounds won’t heal without adequate nutritional support. In fact, wounds will often stall or breakdown and become complicated because the nutritional state is inadequate. I know surgeons will not operate until patients have been on an adequate nutritional program for several months before elective surgery. We often run into trouble doing emergency surgery because the condition of the body is not up to the stress of the surgery and won’t support adequate recovery afterwards. So, for PEMF therapies to work best, individuals need to be on decent diets and using a reasonable number of supplements. At the very least most of us should be taking adequate levels of vitamin D3, omega-3 fatty acids, and a broad spectrum multidose, multivitamin. It may be desirable to get a consultation with a natural medicine clinician or nutritionist to get set up on appropriate nutritional program. Many people using PEMFs need extra magnesium. Some individuals need support with melatonin as well. A high carbohydrate, high fried foods diet, or what might be called the standard American diet (SAD) does not adequately support tissues to achieve the best results with PEMF therapies. Additionally, PEMFs will work better when the bodies adequately hydrated. It is often recommended that individuals should be drinking about half their body weight in ounces. For example, a 160 pound person may need about 80 ounces of fluid per day. Most of us should be getting minimally, about 64 ounces per day. Caffeinated drinks do not count as fluids since we tend to lose as much as we put in.

8. Effects of medications
Some medications are very challenging to the bodies energy systems. Some of them, particularly the antidepressants, neuroleptics and sedatives may change the way the body perceives pain signals. They may in fact the blunt some of the pain reduction benefit of PEMFs. I would never suggest that somebody should stop their medications without medical consultation. I raise this point only to inform you that occasionally pain reduction is not a successful. This is not to say that all the other benefits of PEMFs in healing and regeneration would not be happening. This only relates to the sensation or perception of pain. On the other hand, is not infrequent that the same medications may actually be improved in their results with reduction of pain symptoms by the simultaneous use of PEMFs and the medications. My experience indicates that medications and nutrients are absorbed better in the body with the use of PEMFs. On occasion, it is possible to reduce medications once PEMFs have been used. Again, this should be done with medical guidance.

9. Toxicity and sensitivity
Infrequently, some individuals are very sensitive to PEMFs and experience increased discomfort or other unpleasant symptoms. These individuals may have a condition called electrohypersensitivity.

When this happens, PEMF therapy would have to be used “low and slow.” We would need to use lower intensities, often the lowest possible on the system, and only extremely gradually increase the intensities and the time per treatment. Clearly, in this situation benefits may be more difficult to achieve because the appropriate and necessary intensities in time are not possible. Still, results can be dramatic given the opportunity with this treatment. Consultation with a clinician experienced in the use of PEMFs in this setting may be necessary. Most of these individuals need to be on a significant supplement and nutrition program to achieve the best results.

PEMFs can open cells and cell membranes to the point of unloading toxins stored in the tissues of the body. This type of response is in the long run a desirable action. However it may be unpleasant and will have to be managed by a clinician experienced in doing detoxification. The length of detoxification will vary from individual to individual. Rarely will PEMF therapy have to be stopped, whether temporarily or indefinitely while this is happening. Those individuals will multiple chemical sensitivity PEMF therapy may well be intolerable and may never be able to be used even in the most gentle fashion, at least until major detoxification can be achieved.

10. Psychological issues
Research at Hopkins, in their pain management program, found that some individuals with chronic pain have certain personality traits, that result in very poor treatment outcomes. These individuals often experience negative reactions to even placebo magnetic field devices. And when they are followed over time, some even complain that their problems continue to be worse due to the placebo treatment. In this situation it is not possible to ever please these individuals and PEMF therapy is not an appropriate treatment modality. Psychological counseling is necessary to help with any pain issues in this situation.

11. Wrong device
In the final circumstance, if results are not being achieved as desired, it is possible that the wrong device has been selected. It is often difficult to know in the first month or two months of use whether the device is appropriate or not. Since many health problems for which PEMFs are being used are stubborn and chronic, it may take 3 to 6 months to see desirable results. Usually, people see some degree of change even in the first month. If the treatment program is too gentle with too little time applied, then results may not be seen even in the first month. It would be easier to say with certainty that the device is inadequate after at least three months of intensive and proper use. When this happens, it is usually a matter of having inadequate field intensities. In this case, a much stronger device may be needed. My experience is that this is an uncommon situation.

Understanding and managing the above scenarios would usually lead to positive results with PEMF therapies. Adjustments in the treatment program will likely be necessary over time to address various problems in the body and also to properly handle the needs of any specific body area.

What we are hearing back from our “audience” is that Dr. Pawluk.com is just about the only place people can come to for advice on what the best PEMF system might be for their particular health needs and circumstances. This is precisely the reason I set up our website – to offer people options. As a physician, I go through the same process with my patients. I discuss the nature of their problems and the potential solutions, offering a range of options. It is then up to the patient to choose which options they would find acceptable based on their own personal factors. Therefore, at DrPawluk.com, we have a range of magnetic devices in terms of cost and features. And, I have personally used and tested every device I recommend. That allows me not only to assess how well they work but also to have a very good understanding of how to use them to get the best results for the circumstances.

Some health problems require higher field intensities. Some health problems do better with lower field intensities. Some problems require a broader range of frequencies, while others do better with a minimal number of frequencies. This at least has been my experience, garnered over 20+ years of working with various types of magnetic technologies. No one size fits all. By describing all of these different choices in one location, we make it easy for people to make comparisons and then to choose what they intuitively feel would work best for them. Also, I tell patients, that they can always buy a device from a manufacture, almost always for the same price as they can on DrPawluk.com. However, they will not usually get medical support from the manufacturer, as you would through DrPawluk.com. This type of medical support, by a holistically experienced physician can make a huge difference in how much benefit you get from the system you choose.

We are now getting feedback from people about the results of their use of their magnetic systems. Many people are getting tremendous results quickly and are very happy with their PEMF system. For some people the results don’t happen quickly. This is where we can fine tune the treatment program to achieve better results. I often have to remind people that the body takes time to heal once it’s given the appropriate signal or stimulus for that to happen. Dr. Oz pointed this out on his show. PEMFs do not drug the body into being painless. PEMFs work deep in the tissues to stimulate natural healing processes that have gotten stuck. It is the healing of the tissues that creates a reduction in pain. This is ultimately the best solution and produces the most sustainable results. Unfortunately, we didn’t get here overnight and it will take time for the healing to work. Despite this, at the same time, other benefits begin to happen in the body that were unexpected. And, a good part of the time everybody in the household can be using the PEMFs for their own general health maintenance or to manage other problems.

We are also hearing from people who have purchased PEMF systems, they are recommending them to their friends and relatives because of their satisfaction with the benefits they are seeing. This is very gratifying to me, to be able to reach out to more and more people who clearly have a need and are not well served by current medical approaches. This was also mentioned on the Dr. Oz show.

So what will happen next in 2012 on DrPawluk.com?

1. We will continue to develop and expand our communication to you to update you on new knowledge regarding pulsed magnetic fields and to generate greater expansion of the message about the benefits of PEMF therapies to a wider community. You can be ambassadors for helping to spread the message by forwarding our communications to friends, coworkers and family members.
2. I will also be introducing an e-book on magnetic therapies, with an emphasis on some of the history and science.
3. We will be introducing other devices to expand the number of options available. Some of these are very exciting new devices. (I’m sorry you’ll have to wait until we have done our research before we can tell you!).
4. We are also doing informational conference calls about specific devices that people have purchased. This is to further support you in getting the best use out of your device.
5. We are also in the planning stages of setting up two new sections to the website with a focus on pets and other animals and a specific focus on sports and athletics. It has long been my conviction that weekend warriors and semiprofessional and professional athletes are in desperate need of pulsed magnetic field preventive maintenance, if not actual therapy. Daily use of pulsed magnetic fields by athletes would go a long way to preserving their bodies and reducing injury risk and damage.

Personally, I am very gratified by your feedback and the opportunity to be able to help you and the community to achieve better health.

All the best in your health and best wishes for a great new year,

William Pawluk, MD, MSc

www.drpawluk.com

On Twitter: @drpawluk

On Facebook: Dr. William Pawluk

To learn more about the PEMF devices available through Dr. Pawluk, please click here.

The OrthoCor Knee System Basic is indicated for adjunctive use in the palliative treatment of post-operative pain and edema in superficial soft tissue and for pains, strains and arthritis of the knee.

The OrthoCor Active Therapy Systems use a specialized Pulsed Electromagnetic Field (PEMF) to relieve pain and reduce edema through safe, clinically proven and FDA-approved therapy. The PEMF signal is a low-level, time-varying electromagnetic field that penetrates superficial soft tissue, helping to accelerate the body’s natural anti-inflammatory and recovery responses.

To learn about using the OrthoCor before and after knee surgery, please click here.

Inside every Active System is the OrthoCor, a powerful microchip that delivers PEMF directly to the source of injuries. PEMF has been shown to stimulate reaction pathways that result in pain and inflammation reduction.

The OrthoCor Active System provides:

• noninvasive delivery of patented Pulsed Resonance Therapy (PRT)
• specialized PEMF technology reduces swelling and increases circulation to help relieve and manage pain
• completely drug-free pain relief
• rechargable battery-operation
• flexibility and freedom of movement during treatment

The following conditions have been successfully treated using PRT:

• arthritis
• knee swelling
• acute and chronic knee pain

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To purchase the OrthoCor device, please visit our store…

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The OrthoCor Active System at this time only offers a knee treatment system. The plans are to expand the number of systems to include treatments of the ankle, back, elbow and wrist.

The OrthoCor system is a portable, non-invasive device for providing therapeutic treatment to a joint to promote healing of the joint. It includes a cuff that is can be positioned around a joint. The cuff includes an electromagnetic stimulator configured to provide an electromagnetic field within the joint and a single-use heating element to provide temperature-based therapy to the joint.

It has a signal generator configured to generate pulsed electromagnetic signals within the joint along with temperature-based therapy to the joint. This is a unique feature of the OrthoCor system – PEMF and heat simultaneously.

The OrthoCor device is a portable, non-invasive device comprised of a multiple usage cuff and two single-use therapy units is designed to provide Electro-Magnetic Thermal Therapy (EMT²) for treating knee osteoarthritis. The EMT² provides both transcutaneous pulsed electromagnetic field stimulation and thermal therapy. The EMT² is designed to alleviate pain and increase range of motion without requiring direct skin contact to the afflicted joint. The single-use therapy units offer heat and PEMF stimulation when inserted into the cuff, which provides the power and control for the coils. The cuff is rechargeable and delivers a recommended amount of therapeutic charge. The cuff is fastened around the knee to direct the therapy to the inside and outside areas of the joint. The cuff is designed to be able to be worn during daily activities either over or underneath clothing.

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Technical aspects of the OrthoCor device

The average power input is less than about 300 mW during exposure. The device has two power sources–one to supply power to the signal generator and another to supply power to create the thermal exchange. The frequency generated is a 21.7 MHz carrier frequency; 2 msec burst duration (e.g., 2 msec burst on, and 498 msec burst off); 2 Hz burst frequency.

Thus, the OrthoCor Electro-Magnetic Thermal Therapy (EMT²) device is designed with a powerful electromagnetic stimulator created for the purpose of stimulating nerve, muscle, and/or other body tissues. Previous clinical studies have shown a high correlation between low-frequency PEMF and new cartilage growth for treating osteoarthritis. The OrthoCor device is easy-to-use and portable system that may have applications within a host of clinical and home health applications.

Heat is a natural remedy that may be used to both relieve pain and reduce discomfort. This is accomplished by stimulating the patient’s own temperature receptors which, in turn, aid in blocking the pain sensation from reaching the brain by relaxing deep muscles to reduce tenderness and pain. In order to attain a therapeutic heat transfer effect including increases in tissue temperature, blood flow, muscle lengthening, and metabolism, an intramuscular temperature of about 104 degrees F. (40 degrees Celsius) must be reached.

Numerous types of heat sources may be utilized to provide beneficial heat therapy in accordance with various implementations. For example, first and second thermal exchange components may be multi-use cartridges that require the patient to `re-heat` the cartridges before every use, such as by placing the cartridges in the microwave. Alternatively, first and second thermal exchange components may be one-time use cartridges that are designed to provide an irreversible exothermic reaction to provide a source of heat for a specified amount of time. In one embodiment, first and second thermal exchange components are cartridges that contain iron, carbon, sodium chloride, sodium thiosulfate, and water. When the CLLHW compound is exposed to air, it undergoes an exothermic reaction that produces heat. In other embodiments, heat may be provided through: a resistive based heating source; selective insulation; or “warmth” radiated from the battery during operation. As will be appreciated by one skilled in the art, first and second thermal exchange components may be heat sources designed such that they deliver heat therapy for any designated period of time ranging from a few minutes to the entire day. This designated period may or may not coincide with the electromagnetic field duration. In addition, first and second thermal exchange components may be pulsed such that the heat therapy is not constant.

The power source is a lithium-polymer, rechargeable battery.

It has a two coil arrangement with one coil on either side of the knee for generating the PEMF therapy. A voltage regulator is used to provide a constant supply voltage to the PEMF signal generator. A microcontroller triggers both coils, thereby generating accurate pulses at the pre-defined frequency. The triggering frequency is defined as the rate at which a set number of pulses occur. The switching frequency is the fundamental frequency of the individual pulses. Another parameter called the switching duty cycle is defined as the ratio of the pulse width over the switching period. The voltage of the pulses is equivalent to the strength of the PEMF therapy.

The required penetration depth of the PEMF generated by the signal generator will vary depending upon, for example, the size of the patient’s knee area. However, for an adult patient, the penetration depth is generally in the range of about 2 to 4 cm.

The magnetic field strength, “B”, applied to the body ranges from about 20 μT to about 100 μT.

The two-coil configuration uses about 20 times less power than a single-coil configuration because it requires a significantly smaller amount of energy to penetrate both sides of the knee.

The therapy is typically applied for up to 2 hours. The heating elements cannot be turned on and off, and so once activated they produce heat until they are exhausted.

It is designed such that it may be worn during normal daily activities without discomfort.

Even though it is approved for treatment of the knee joint, like any other PMFs it can be used to treat any joint or any other body part that might benefit from treatment with PEMF and thermal exchange. PEMF treatments can be carried out without the heating component, by simply plugging in the exhausted heating pods into their docking ports.

The stimulation device includes 2 disposable, single-use, air activated heating pods. The two pods are snapped into the docking ports or holders on both sides of the knee cuff. Therapy is only initiated once both parts are talked. When any pod is removed therapy is stopped.

PEMF therapy can occur through dressings, clothing, casts, compression garments, supports, or one or more other barrier between the knee cuff and the target tissue. The pods activate a switch that enables or turns on the heat and PEMF therapy.

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How the OrthoCor works for the approved indications

Osteoarthritis, also known as degenerative joint disease, is characterized by gradual loss of hyaline cartilage and, in extreme cases, cyst formation in and deformation of the subchondral bone. The hyaline cartilage lines the articular surfaces of the knee and provides cushion and lubrication for the joint. During osteoarthritis, the extra-cellular matrix of the cartilage is worn down at a greater rate than it is being synthesized, leading to a net reduction in the overall amount of cartilage at the articular surfaces of the knee. As the cartilage breaks down, symptoms such as pain, swelling, tenderness, stiffness, and eventual muscle atrophy are manifested. Chondrocytes, the cellular component of hyaline cartilage that is responsible for matrix synthesis and turnover, are also depleted, thus resulting in an inability to naturally recover from this disease. Additionally, cells present in osteoarthritic joints release catabolic cytokines and enzymes that suppress collagen synthesis.

To date, conventional therapies for osteoarthritis have aimed at reducing pain and the progression of joint damage in order to minimize disability and maximize quality of life. The current algorithm for the management of osteoarthritis includes diagnosing the disease, modifying patient activity, prescribing anti-inflammatory medications, injecting steroids into the knee, and as a last resort, surgery. Although this regimen does provide some benefit, it is by no means a cure all for patients with osteoarthritis.

Aside from the conventional therapies, there are currently a number of alternative therapies that may be used to treat osteoarthritis. Three of the forerunners in the non-invasive alternative therapy field include electric, static magnetic, and electromagnetic stimulation.

Electrical stimulation, such as transcutaneous electrical nerve stimulation (TENS), delivers mild electrical impulses across the skin and into regional nerves. In patients having osteoarthritis, pain impulses are transmitted to the spinal cord through small cutaneous fibers. TENS acts to stimulate large cutaneous fibers that subsequently transmit a faster impulse via C-fibers to inhibit pain signals from the small fibers. It is in this way that TENS masks the pain normally experienced by patients having osteoarthritis. It is also thought that TENS incites the secretion of endogenous opiates, the body’s natural pain killers, further reducing the pain experienced by patients with osteoarthritis.

Static magnetic stimulation has also been shown to provide medically relevant benefits. Various experiments designed to induce osteoporosis, fracture, and synovitis in animals have demonstrated faster bone repair, increased bone density, and decreased joint inflammation following magnetic treatments. It is thought that magnets can affect biological processes by: decreasing the firing rate of chronic pain neurons; modifying the rate of enzyme-mediated reactions; modulating intracellular signaling by affecting the functioning of calcium channels in the cell membranes; and enhancing blood flow. All of the above may provide some therapeutic benefit with respect to the symptoms of osteoarthritis.

Additionally, electromagnetic stimulation, a modality that generates a magnetic field by sending current through a coil, may also provide medical benefits for the treatment of osteoarthritis. It has been observed that physical stress on bone causes the appearance of tiny electric currents (piezoelectric potentials) that are thought to promote bone formation. In particular, studies of electrical phenomena in cartilage have demonstrated a mechanical-electrical mechanism resembling those described in bone, appearing when cartilage is compressed by the pressures generated through normal joint activity. Generating currents within cartilage is thought to stimulate cartilage cell activity, thus promoting the production of cartilage. New cartilage degeneration may work to combat the degeneration seen in osteoarthritis and therefore alleviate the symptoms of osteoarthritis.

The basic principle behind the concept of electromagnetic stimulation is that passing an electric current through a coil winding structure will generate an electromagnetic field. The electromagnetic field can, in turn, generate a current in any conductive material, such as nerves or other body tissues, within this field. The electromagnetically induced electric field created by properly oriented pulsed electromagnetic stimulation thus accomplishes the result of transferring charge to cells of the body. This induced current can lead to nerve firing, muscle contraction, stimulation of cell signaling pathways causing cell growth, and a number of other effects. In contrast to applications of electrical stimulation, pulsed electromagnetic stimulation does not require direct skin contact to induce nerve excitation. As a result, significantly higher levels of directed stimulation can be achieved through pulsed electromagnetic stimulation without the adverse effects of other technologies.

Pulsed electromagnetic fields generate small, induced currents (Faraday currents) in the highly conductive extracellular fluid, which thereby mimics normal internally generated electrical currents. These natural electrical currents are due primarily to movement of fluid containing electrolytes in channels of the bone containing organic material with fixed negative charges, generating what are called “streaming potentials.” Studies of electrical phenomena in cartilage have demonstrated a mechanical-electrical mechanism that resembles those described in bone, appearing when cartilage is mechanically compressed, causing movement of fluid and electrolytes over the surface of fixed negative charges in the proteins and collagen in cartilage. These mechanically generated electrical-type streaming potentials serve a purpose in cartilage similar to that in bone, and, along with mechanical strain, lead to signal changes that are capable of stimulating cartilage cell synthesis of matrix components.

In contrast to direct currents, PEMFs are able to penetrate all cell membranes and tissues in their path and either stimulate them or directly affect intracellular components. As a result, the effect of PEMFs on extracellular matrices includes increased production of cartilage molecules, thereby enabling a “remodeling” of the knee joint.

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OrthoCor Active Knee System Reference Guide

Indications for use

• · The OrthoCor Active Knee System is indicated for adjunctive use in the palliative treatment of post-operative pain and edema in superficial soft tissue.
• · Temporarily relieves minor muscle and joint aches and pain associated with overexertion, strains, sprains, and arthritis.

Contraindications

• · Do not use on patients with a cardiac pacemaker, cardioverter defibrillator, neurostimulator, infusion pump or any active medical implant.
• · Do not use on patients who have ANY implanted metallic lead or any type of wire coil implant, or any implanted system that may contain a lead.
• · Do not use on patients who are or may be pregnant.
• · Do not use on patients with an open wound at the area of application.
• · Do not use on patients not fully aware to the sensation of heat.
• · Do not use on patients with poor circulation or heart disease.
• · Do not use on patients with diabetes.
• · Do not use on patients under the age of 18 or individuals with open bone growth plates.

Warnings

• · WARNING: This device should be used under the continued supervision of a licensed health care practitioner.
• · WARNING: THIS PRODUCT CAN CAUSE BURNS AND SKIN IRRITATION. Your risk of burning increases as you age. Check skin frequently during use for signs of skin irritation or burns.
• · WARNING: Use carefully. Remove immediately if the knee becomes too hot or discomfort occurs.
• · WARNING: Do not use with pain rubs, medicated lotions, creams or ointments.
• · WARNING: Do not use with other forms of heat. This may cause burns.
• · WARNING: Precaution should be taken prior to using this device on patients with neoprene allergies.
• · WARNING: Precaution should be taken when using this device on the elderly or incapacitated persons. The unattended use of OrthoPods by these patients may be dangerous.
• · WARNING: Precaution should be taken when using this device on patients with sensitive skin. If the patient experiences skin irritation, discontinue the use of the device and consult your licensed health care practitioner before using the OrthoCor Active Knee System again.
• · WARNING: Equipment is not suitable for use in the presence of a flammable anesthetic mixture with air o r with oxygen or nitrous oxide or oxygen enriched atmospheres.
• · WARNING: Do not apply the OrthoPods directly to bare skin as it may cause burns.
• · WARNING: Do not open or puncture the OrthoPods.
• · WARNING: Do not let the contents of the OrthoPods make direct contact with your mouth or eyes. Immediately and thoroughly rinse with clean water, if contact with OrthoPods’ contents occurs.
• · WARNING: Do not ingest the contents of the OrthoPods. IMMEDIATELY CALL the nearest Poison Control Center if OrthoPods’ contents are ingested.
• · WARNING: Do not over-tighten the Knee OrthoCuff as this may restrict blood flow and result in injury.

Cautions

• · CAUTION: Use this device only in the prescribed manner and for the prescribed diagnosis.
• · CAUTION: KEEP AWAY FROM WATER. Use in dry environment.
• · CAUTION: The device is not indicated for treatment of deep tissue such as internal organs.
• · CAUTION: Do not use while the OrthoCor Active Knee System is charging.
• · CAUTION: Do not machine wash the OrthoCor Active Knee System.
• · CAUTION: Do not crush the OrthoSource or the Knee OrthoCuff as this may damage the electronics.
• · CAUTION: Do not reuse the OrthoPods.
• · CAUTION: Removing the OrthoPods will stop the treatment.
• · CAUTION: The AC adapter must be disconnected from the OrthoSource for treatment to occur.
• · CAUTION: Keep out of reach of children.
• · CAUTION: For external use only.
• · CAUTION: NEVER heat the OrthoCor Active Knee System or OrthoPods in the microwave as the system could catch on fire.

To purchase the OrthoCor device, please visit our store…