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PEMF fibromyalgia


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Original Article • DOI: 10.2478/rir-2022-0013 • 3(2) • 2022 • 77–83
Low-energy pulsed electromagnetic field therapy reduces pain in fibromyalgia: A randomized single-blind controlled pilot study
Massimo Giovale1, Lucia Novelli2, Luca Persico3, Francesca Motta2,4, Stefano Rampoldi5, Rossana Galli1, Patrizia Monteforte1, Marica Doveri1, Gerolamo Bianchi1, Carlo Selmi2,4,*,#, Luigi Carlo Bottaro6,#
1Division of Rheumatology, ASL3 Genovese, Genoa, Italy
2Rheumatology and Clinical Immunology; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy 3Department of Economics, University of Genova, Genoa, Italy
4Department of Biomedical Sciences, Humanitas University, Milan, Italy
5THS Therapeutic Solutions srl, Milan, Italy
6General Direction, ASL3 Genovese, Genoa, Italy
Abstract
Keywords
Background
Fibromyalgia affects between 0.4% and 8.8% of the general population, with a marked female predominance, and is characterized by chronic widespread pain associated with dysesthesia, paresthesia or sensation of burning, tingling or numbness, and stiffness, as well as fatigue, poor sleep quality, cognitive impairments in memory and concentra- tion, headache, mood disorders, and bowel alterations.[1] The diagnosis of fibromyalgia is predominantly clinical and does not exclude the presence of other causes for pain.[2] While the etiology and pathogenesis of fibromyalgia remain unknown,
#Carlo Selmi and Luigi Carlo Bottaro have contributed equally to this work.
Address for correspondence:
*Carlo Selmi, MD, PhD, Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital. Via Manzoni, 56, 20089, Rozzano, Milan, Italy. E-mail: carlo.selmi@hunimed.eu
Objectives: Fibromyalgia symptoms have a significant impact on the quality of life and respond poorly to medications. It has been hypothesized that the use of low-energy pulsed electromagnetic field (PEMF) induces neuroprotective effects that may interfere with pain perception. We explored the efficacy of PEMF in patients affected by fibromyalgia. Methods: Twenty-one females (median age 59 years, interquartile range [IQR] 16.5) affected by fibromyalgia were ran- domized to receive pulsed electromagnetic field-triple energy pain treatment (PEMF-TEPT) or placebo at T0 and at 4 weeks and 8 weeks. Fibromyalgia impact questionnaire (FIQ), widespread pain index (WPI), visual analog score (VAS) pain, symptom severity (SS) scale, and short form 36 (SF-36) health survey questionnaire have been evaluated. Results: Patients in the PEMF-TEPT group had a significantly higher reduction of WPI compared to placebo (mean difference –12.90 ± standard deviation [SD] 5.32 vs. –1.91 ± 4.55, difference in difference [DD] of –10.99; P < 0.001), of SS score (–4.10 ± 4.85 vs. –2.00 ± 2.32; DD = –2.1; P < 0.05), of VAS pain (–48 ± 30.75 vs. –16.82 ± 23.69; DD = –31.18; P < 0.01). They also reported a higher improvement of FIQ and SF-36, albeit not reaching statistical significance. Conclusion: In our pilot controlled study, PEMF-TEPT appeared to be safe and improved fibromyalgia symptoms.
Received January 11, 2022 accepted March 05, 2022
diffuse pain syndrome • fatigue • quality of life • widespread pain
some lines of evidence point to a role for the central nervous system in pain amplification and in the development of other symptoms. At the time of onset, some patients start complain- ing of regional pain and later develop widespread pain, even in the absence of an identifiable input, with a top-down process, while others have a definite disease (i.e., osteoarthritis) and pain becomes generalized afterward, with a bottom-up pattern, possibly related to altered nociception and nerve connectivity.
From a therapeutic standpoint, fibromyalgia management is aimed at improving quality of life but anti-inflammatory and analgesic drugs such as opioids have marginal effects and are generally not tolerated.[3] Despite the use of muscle re- laxants and antidepressants along with non-pharmacological treatments,[4] symptoms are often uncontrolled, not allowing a good quality of life.[5] Among alternative treatments, tran- scranial magnetic stimulation[6] and transcutaneous electrical nerve stimulation[7] have been proposed based on data com- ing from heterogeneous studies with high risks of bias.[8, 9]
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RHEUMATOLOGY AND IMMUNOLOGY RESEARCH

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