Randomised controlled trial of magnetic bracelets for relieving pain in osteoarthritis of the hip and knee
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7480.1450 (Published 16 December 2004) Cite this as: BMJ 2004;329:1450All rapid responses
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BMJ 2004;329:1450-1454 (18 December), doi:10.1136/bmj.329.7480.1450
The limits of medicine:
'Randomised controlled trial of magnetic bracelets for relieving pain in
osteoarthritis of the hip and knee'
Article response;
Upon reading this article I see it as being very short and sweet and
probably not
convincing enough for most skeptics. But the important thing to me is the
response this article has encouraged. It is obvious people are interested
in
magnetism but it threatens the dictating medical power mongers. Where
would
it stop after all? People treating themselves and not paying penance to
the drug
mega companies. The important point is the thirst for knowledge on the
public's part and any and all positive studies are welcome to counter the
constant flow of the negativity in blind panning. For this short article
to
promote such response is extremely promising to me. We need voices, all
opinions and as much facts as possible, testimonials and studies. I think
the tell
tale automatic response from mainstream shows a definite fear in them
towards
self prescribed pain relief. Or any self empowering.
Competing interests:
Owner of Vital Wonders Magnetic
Jewelry and Wearer of Magnetism
Competing interests: No competing interests
Dear Doctor,
We make and sell magnetic bracelets. This confusion with telsa and
gauss can be simplified.
A. If it is a metal watch band style with a strong magnet in each
link, then it should really stick to metal with a really good "click &
stick".
If it's a beaded piece of jewelry, it should likewise stick really
hard to ferrous metal such as steel. Obviously, magnets do not stick to
aluminum.
Try not to make jewelry into rocket science. For further
information, we suggest reading a book by Julian Whitaker MD "The Pain
Relief Breakthrough, The Power of Magnets to Relieve Arthritis, Carpal
Tunnel, Sports Injuries, Menstrual Cramps"
There are other books out there showing relief from fibromyalgia and
allergies with magnets. When it comes to magnets, stronger works the
fastest and the best. Weaker might work, but not as fast and not last as
long.
People with pacemakers and the like should not wear magnetic jewelry.
Always wear magnetic jewelry on the opposite wrist as your watch, so as
not to magnetize the watch or the battery. Strong ankle bracelets have
amazing results also. Strong necklaces work for neck pain.
Do not be fooled by look alike hematite which is not magnetized.
But remarkably enough, some people have non magnetic hematite and swear up
and down it works. Go figure.
Really good magnetic jewelry can work in as little as a few minutes.
Competing interests:
We make and sell magnetic bracelets.
Competing interests: No competing interests
I would like to congratulate the authors of this paper for their very
intriguing study, and BMJ for publishing it.
Two potential mechanisms of action of the magnetic bracelets deserve
investigation:
1. It is very likely that tiny amounts of the minerals in the
bracelet were deposited onto the skin and were absorbed. In the case of
neodymium, this raises a question of possible therapeutic effects or
damaging side effects. In the case of iron, it could well have played
some therapeutic role--e.g., in providing the ions for catalase that would
have quenched oxygen radicals in the joints and thereby reduced
inflammation and pain. Also, there is some theoretical basis for a
general tonic Transdermal Feeding effect (see
www.biophoton.com/microminerals/microminerals.htm and my book "Close-to-
Nature Medicine").
2. Red blood cells' ultrasensitivity to electromagnetic stimulation
(in this case, by the magnets) results in chemiluminescence that has a
general immunostimulatory effect, as in Biophotonic Therapy
(Photoluminescence--its very misleadingly suggestive old name was
Ultraviolet Blood Irradiation). Biophotonic Therapy's effectiveness
against inflammatory disorders has been demonstrated in scores of clinical
trials, mainly in the German and Russian medical literature (see my
"Healing Photons" and "Close-to-Nature Medicine").
I look forward to more studies.
Kenneth J. Dillon
Spectrum Bioscience, Inc.
Washington, D.C.
Competing interests:
Distributor of copper and copper/zinc bracelets; author of books on Biophotonic Therapy
Competing interests: No competing interests
A year ago I damaged my neck and over the next six months I started
to develop several side effects. I had a constant headache, loss of
feeling in my fingers and forearms, every step felt like my head weighed a
tonne on my shoulders and sleep meant constant spasms and waking up with
what felt like a hangover. The Consultant advised against an operation
unless I lost arm function and I took to various prescibed drugs from my
GP. Pain was reduced but the spasms became worse. I stayed up for days
until I slept through exhaustion. Roughly six months ago limping through a
market place one morning stressed out about how much my life had changed
through a stupid accident, I noticed an advert for magnetic therapy
bracelets. I read it laughed and walked off. In a fit of madness I
returned, found a bracelet and purchased it. The vendor tried to preach
the benefits but I told him it was for a friend and I thought it was
nonsense. I wore the thing straight away and felt nothing! I forgot about
it and moved on. Some two hours later I returned to my car, slid in,
started it up etc and released the handbrake!! This normally resulted in a
sharp pain in the elbow. I put the handbrake on and off a few times....no
pain. Damn..If this thing works I had a problem. I hate jewelery and
strappy things and had a "hard man" image to maintain. I continued to wear
the thing under very long sleeves for a week and felt less uncomfortable
every day. The following weekend I took the thing off to work on my car
and placed it on the side in my garage. Minutes later my dad was taken ill
and I raced to hospital. He was made comfortable and daily life resumed.
Over the next few days I started to limp again and lost feeling in my left
arm. I had a lot on my mind and put it down to stress. Then my son came in
from the garage and asked who the funny "girly" bracelet belonged to. THE
BRACELET THING!! I put it on and started to feel better within hours and
have never taken it off for more than half an hour since. Not a placebo!
they work. Symptoms and pain reduced dramaticaly. Don't knock it until
you've tried it, and you can't try it until you need it. Catch 22 for
critics!
Competing interests:
None declared
Competing interests: No competing interests
Harlow et al. reported the effects of magnetic bracelets for
relieving pain in osteoarthritis of the hip and knee. Although in their
randomized controlled trial blinding may not have been completely
successful, and some of the effect might be attributed to a placebo
effect, they claim that this effect (whatever it is based on) is
clinically useful.
For this claim they compare the effect reported in their trial with that
of three trials reporting on other interventions in osteoarthritis
(topical diclofenac[1], oral non-steroidal drugs[2], and exercises[3]).
The standardized effect sizes (difference in outcome between the
intervention and the control group, divided by the standard deviation of
this outcome in the total group) are not reported in those quoted studies,
but are estimated by us based on the outcomes and standard deviations
given in their tables. This resulted in standardized effect sizes of 0.4
for both the trial on topical diclofenac and the trial on exercises (home
exercises); for the trial on oral non-steroidal drugs we had no full-text
article available. We did the same for the trial of Harlow et al., and
based on the figures in table 2 for their primary outcome “WOMAC A” we
estimated an effect size (standard versus dummy) of 0.2 at 4 weeks, and of
0.4 at 12 weeks, indeed comparable to the trials quoted in their article.
However, in the EULAR recommendations 2003[4] the effect sizes for
the trials available reporting on effectiveness of topical diclofenac are
shown to range from –0.05 to 1.0, for exercises the effect sizes range
from 0.57-1.0, and for oral non-steroidal drugs the effect sizes range
from 0.47-0.96. It seems that the authors have chosen to selectively quote
trials with a similar effect size as found in their trial. Clinically, an
effect size of 0.2 is considered small, from 0.5 is moderate (and would be
recognized clinically), and greater than 0.8 is large[4]. Summarizing, we
argue that the clinical relevance of the reported effect by Harlow et al.
still is disappointing.
1. Bookman AA, Williams KS, Shainhouse JZ. Effect of a topical
diclofenac solution for relieving symptoms of primary osteoarthritis of
the knee: a randomized controlled trial. CMAJ. 2004 Aug 17;171(4):333-8.
2. Zhao SZ, McMillen JI, Markenson JA, et al. Evaluation of the
functional status aspects of health-related quality of life of patients
with osteoarthritis treated with celecoxib. Pharmacotherapy. 1999
Nov;19(11):1269-78.
3. O'Reilly SC, Muir KR, Doherty M. Effectiveness of home exercise
on pain and disability from osteoarthritis of the knee: a randomised
controlled trial. Ann Rheum Dis. 1999 Jan;58(1):15-9.
4. Jordan KM, Arden NK, Doherty M, et al.; Standing Committee for
International Clinical Studies Including Therapeutic Trials ESCISIT. EULAR
Recommendations 2003: an evidence based approach to the management of knee
osteoarthritis: Report of a Task Force of the Standing Committee for
International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann
Rheum Dis. 2003 Dec;62(12):1145-55.
Competing interests:
None declared
Competing interests: No competing interests
Clearly Dr Harlow has published an article that has stirred up
emotional arguments rather than scientific ones.
Perhaps this is because, unfortunately, assessment of pain is
subjective and quite difficult to do - even in oneself! If I think I feel
less pain then I do feel less pain - regardless of whether my response to
the wristbands is physiological or psychological. For example mild pain
may be there when I am awake but disappear when I am asleep. Has the pain
gone or just my perception of the pain? Furthermore, severe pain may keep
me awake. If it is reduced to mild pain (or I think it is) by wearing a
wristband and I get a good nights sleep has the pain completely gone or
has my perception of the pain gone?
I suspect there is more than a placebo effect involved - based on my
experience in other conditions.
Other contributors have cited articles in which magnets were shown to
reduce inflammation and promote wound healing. I have read through many
such reviews and studies and indeed many support the use of magnets.
I refer readers to a selection of such articles below.
But perhaps we should examine more closely the effect of pulsed
magnotherapy on the immune response and how it may affect the way in which
the body produces and circulates inflammatory mediators?
I ask this because I know people who have tried various prescription
creams, Chinese herbal remedies etc for eczema and their eczema has
remained - despite obviously wanting such therapy to work. The "placebo"
effect did not happen with such medications. Wearing a Bioflow caused this
eczema to disappear. Does a placebo effect works only for the Bioflow and
not the other therapies? I think not. Intriguingly the eczema returns
should the Bioflow be removed for more than a day or two.
I also know Bioflow has helped in many cases of asthma. One particular asthmatic gentleman, a trained pharmacologist, was sceptical about Bioflow and wanted to prove they did NOT work! He took months putting it on, taking it off etc. After such a personal quest to disprove the whole concept he is convinced it worked. He even started running, something he had not been able to do for a number of years!
Given the possible consequences of long term steroid inhalation
perhaps we should be looking into such responses more closely? Perhaps a
pulsed magnetic field over the blood vessels in the wrist can have an as
yet unknown affect on our intricate immunochemical messaging systems.
Should funding be made available so that we can look more deeply into
the science or would this only serve to silence the sceptics? - patients
are clearly seeking out such benefits for themselves.
Meanwhile, I do not mind being called a "sucker". A 10yr old boy no
longer gets taunted at school because now his eczema has disappeared. I
was the one who recommended this therapy to his mum. That makes me feel
good and no-one is going to convince me it was wrong.
References:
1. Evolution of Magnetic Therapy from alternative to traditional
medicine (Review)
Carlos Vallbona MD, Todd Richards PhD,
Complementary Therapies in Physical Medicine and Rehabilitation 10,3 (729)
1999 Baylor College of Medicine & University of Washington
This paper states 26/33 placebo controlled double blind trials in a
variety of disorders showed positive results using both pulsed
electromagnetic therapy and static magnets.Improvements were seen in
arthritis, bone healing,depression, MS, migraine, oedema, sleep, wound
healing
2. Response of pain to static magnetic fields in postpolio patients
Vallbona, Hazelwood & Jurida
Archives Physical & Medical Rehabilitation 78 (1200-1203) 1997
Active devices:
76% patients had significant pain improvement
24% no significant improvement
Placebo devices:
9% reported improvement
81% no improvement
3. Magnetic bio stimulation in Painful Diabetic Neuropathy: A novel
intervention – a randomised, double placebo crossover study
Weintraub MI
American Journal of Pain Management 9(1) 8-17, 1999
75% patients with diabetic neuropathy showed significant
improvement in symptoms after use of magnetic foot pads.
4.Use of thermo magnetic bandages and belts in cervical and lumbar
pain syndromes.
Porzio F
Clinica Terapeutica 151(3) 149-153 2000 (Italian)
-All patients stopped analgesic / anti inflammatory
treatment for 8 days before trial
- 30 (15/15) patients wore magnetic belts, 30 (15/15) wore placebo
belts 14 days
8hrs / day
-14/15 treated CPS & LPS showed improvement
- 3/15 CPS & 4/14 LPS placebo showed improvement
5. Supression of inflammation by static magnets
Weinberger A: Isr J Med Sci, 32(12):1197-201 1996
Synovitis was induced by bilateral intraarticular injection of
zymosan to the hind joints.
One group held in a cage with 3800 Gauss magnet on the bottom of the cage
(treated), while another group was held in a cage without a magnet
(control).
After 3 weeks the rats were killed and the hind joints tissues were
examined histologically.
Marked articular infiltrate, composed of lymphocytes and plasma cells with
some histocytes in 80% of the control animals
A small articular infiltration of the same nature was observed in 20% of
the treated rats.
Inflammatory score 3.4 +/- 1.1 in the treated animals vs 6.8 +/- 2.6 in
the control group (P = 0.002).
Showed synovitis and the inflammatory process are significantly suppressed
by a magnetic field.
6. Effects of static magnetic field on bone formation in rat
femurs.
Yan et al: Medical Engineering & Physics 20(6):397-402 1998
Magnetised & unmagnetized samarium cobalt rods implanted into rat
femurs
BMD and bone calcium content measured with X ray absorbtivity & CPC
respectively.
Post operative BMD & calcium content higher in magnetized group
Similar BMD to non operated rats
7. Effects of static magnets and pulsed electromagnetic fields on
bone healing.
Darendeliler et al
International Journal of Adult Orthodontics & Orthognathic Surgery
12(1):43-53 1997
30 guinea pigs split into control, static treated and PEMF treated.
Osteotomy performed in the mandibular postgonial area.
Over 9 days kept in cages for 8 hrs per day.
Histological finding showed accelerated bone healing in both static &
PEMF treated animals with new bone filling the osteotomy areas compared to
minimal connective tissue in the controls.
Competing interests:
I promote the use of Bioflow
Competing interests: No competing interests
Interesting response it is.
Did the GP get paid for his co-operation?
Even if he did not, the placebo devil is everywhere.
As to the observed increase in blood flow, I do hope you will refrain
from elaborating on this, describing in great detail how each individual
erythrocyte will raise its happy face toward the magnets and offer its
iron content .....
I can increase bloodflow by a multitude of things, not all of them
physical.
Bio-feedback, Hypnosis and other methods accomplish this too.
And at a lot less cost than the modern fad of magnetic healing.
Don't forget that D.D.Palmer, founder of Chiropractic, decided as early as
in the year 1895, that magnetic healing wasn't what he had thought it
would be. He called himself a magnetic healer.
So he "discovered" chiropractic and it has now become widely accepted that
that form of healing seems to be what it is cracked up to be.
Competing interests:
None declared
Competing interests: No competing interests
You may be interested at a trial done by a GP who tried the MagnaMax
(feel free to see more @ www.magnamax.co.uk)(new breakthrough in magnetic
therapy) on himself and his patients wrote a conclusion/evaluation paper
which have on file and is now using it on himself and suggesting to
patients. I guess this new device may be more effective then the ones you
have in encountered. How do you know it is definitely placebo when people
talk to you about their beneficial experience with the therapy? And if it
was possible to show the blood flow levels before the device was used and
then while it was being used and if it showed a change in blood flow would
this help you understand that it is not a placebo necessarily?
Thank you for your time
Best Regards
Chris Gill
Competing interests:
www.magnamax.co.uk
& Different trial underway
Competing interests: No competing interests
I just came across this exchange over the alleged benefits of
magnetic products.
To date, I have not seen any real results in patients with osteoarthritis
and/or any other painful conditions, other than what is obviously a
placebo effect.
A new angle has just been introduced in my neck o' the woods,
magnetic underlays PLUS, AND in addition (healing from the inside as well)
Bee Pollen is offered.
The package deal is heavily 'discounted' and people can further
reduce cost by being 'available' for radio and TV testimonials.....
I have recently discovered a new ray, which is very elusive and
required specialised instruments as well as very advanced knowledge to
even identify. This ray is what I call the magneto-flato-stasis ray. New
products are being developed as we speak. They all have been treated with
the ray and will undoubtedly eliminate most, if not all, pains and aches.
There is a sucker born every minute and at least three
'entrepreneurs' to attend them.
Competing interests:
None declared
Competing interests: No competing interests
Other responses of interest
It seems that this article has been used by magnetic product
manufacturers as 'Proof Positive' that their products actually work. They
give a link to this site, but how many believers would read and understand
the findings? I would implore the authors of this article to say
categorically that "Magnets don't work as an effective cure for pain" at
the heading and pursue any misuse of the data presented. As a physicist, I
would like to see that the mechanism of 'what these magnetic bracelets do'
be explained by researchers in para-, ferro- and dia-magnetism. If they
did work there would be Nobel(isible) research on the mechanism. What
physicist would not jump at the chance of this? The problem is,
unfortunately, that there is no effect on the body by non-ionising
electromagnetic radiation. If there were then there would be university
departments studying it for the obvious benefits to science and industry.
(The only groups saying that the use of magnetism is beneficial are those
peddling the myth. Magnets are beneficial but only to the seller of the
myth and merchandise.)
Benefits? - There just isn't and if the authors would please be clear in
their statements then we could leave this to die and get on with some real
science.
If magnets cure pain then just give everyone who suffers (including
myself- I may add) an MRI scan and tell them they are healed. QED.
If the authors do not make a clear statement then people will suffer by
the misleading claimants who are using the article erroneously.
Competing interests:
None declared
Competing interests: No competing interests