Pain relief: Is it in magnets or mind?
The San Diego Union - Tribune; San Diego, Calif.; Dec 4, 2000; Jane Brody;
Abstract: Is it the magnets or wishful thinking that is helping? Although magnets have been used for thousands of years for pain relief, neither I nor medical science can as yet be certain that the magnets are actually responsible for alleviating my symptoms or anyone else's symptoms.
Spurred by testimonials from athletes like football's Dan Marino, tennis' Lindsay Davenport and golf's Jim Colbert and John Huston, Americans are spending more than $300 million a year on therapeutic magnets for pain relief. There are devices for neck pain, back pain, knee pain, wrist pain, headache and generalized aches and pains associated with arthritis and fibromyalgia. Consumers are buying magnetic bracelets, insoles, wrist and knee bands, back and neck braces, pillows, mattresses and even water.
Faithful readers know that I've been plagued by arthritic pain in both knees for about a decade and that I've experienced significant symptomatic improvement after daily use of a dietary supplement that combines glucosamine and chondroitin.
About six months ago, I also began wearing magnetic knee sleeves when I played tennis and sometimes for my daily three-mile walk. In addition to being a lot more comfortable than those Neoprene knee braces I used to wear, the magnetic sleeves seem to have done more to minimize my discomfort during knee-stressing activities.
But is it the magnets or wishful thinking that is helping? Although magnets have been used for thousands of years for pain relief, neither I nor medical science can as yet be certain that the magnets are actually responsible for alleviating my symptoms or anyone else's symptoms.
Of course, I and millions of others with nagging aches and pains would be delighted to find an alternative to analgesic and anti- inflammatory medications, all of which can have unpleasant, even serious, side effects.
Spurred by testimonials from athletes like football's Dan Marino, tennis' Lindsay Davenport and golf's Jim Colbert and John Huston, Americans are spending more than $300 million a year on therapeutic magnets for pain relief. There are devices for neck pain, back pain, knee pain, wrist pain, headache and generalized aches and pains associated with arthritis and fibromyalgia. Consumers are buying magnetic bracelets, insoles, wrist and knee bands, back and neck braces, pillows, mattresses and even water.
But well-designed, placebo-controlled studies of magnet therapy have been rare. One such well-publicized study at Baylor College of Medicine in Houston suggested that magnet therapy significantly reduced knee pain in 50 patients with post-polio syndrome, although even those who received sham therapy also reported some improvement.
Yet little excitement was generated by a placebo-controlled study of 20 patients with chronic low back pain published in March in The Journal of the American Medical Association, which found no statistically significant difference in pain relief between those using real and sham bipolar magnets.
Even researchers who are among the leading proponents of magnet therapy concede that larger and better-controlled studies are needed before this approach can rightfully join the cadre of alternative therapies that are clearly effective.
Controlled studies supported by the National Institutes of Health are now under way at the University of Virginia among patients with fibromyalgia and at the University of Miami and University of Kentucky among patients with carpal tunnel syndrome.
Complicating the testing picture still further is the fact that not all magnets are alike; they differ in intensity, configuration and depth of penetration.
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magnet therapy
"I know of no scientist who takes this claim seriously...It's another fad. They come and go like copper bracelets and crystals and all of these things, and this one will pass too." --Robert Park of the American Physical Society.
Magnet therapy is a type of "alternative" medicine which claims that magnetic fields have healing powers. Some claim that magnets can help broken bones heal faster, but most of the advocacy comes from those who claim that magnets relieve pain. Most of the support for these notions is in the form of testimonials and anecdotes, and can be attributed to "placebo effects and other effects accompanying their use" (Livingston, 1998). There is almost no scientific evidence supporting magnetic therapy. One highly publicized exception is a double-blind study done at Baylor College of Medicine which compared the effects of magnets and sham magnets on the knee pain of 50 post-polio patients. The experimental group reported a significantly greater reduction in pain than the control group.
A less publicized study at the New York College of Podiatric Medicine found that magnets did not have any effect on healing heel pain. Over a 4-week period, 19 patients wore a molded insole containing a magnetic foil, while 15 patients wore the same type of insole with no magnetic foil. In both groups, 60% reported improvement.
Despite the fact that there has been virtually no scientific testing of magnetic therapy, a growing industry is producing magnetic bracelets, bands, insoles, back braces, mattresses, etc., and claiming miraculous powers for their products. The magnet market may be approaching $150 million annually (Collie). Magnets are becoming the gimmick of choice of chiropractors and other "pain specialists." Former potter, Marlynn Chetkof sells Russell Biomagnetic products, and advises that magnets are better than painkillers or living with pain (Collie). Even a bankrupt building contractor, Rick Jones, is trying to cash in on the current magnet craze. He has formed a company called Optimum Health Technologies, Inc. to market his "Magnassager," a hand-held vibrator with magnets retailing for $489. Jones claims his invention "isn't just another massage device." He says it uses an electromagnetic field to help circulate blood while it's massaging the muscles. Jones raised $300,000 from investors and spent it all on "product development and marketing." Not a cent was spent on scientific testing of the device, though he did give $20,000 to a physiologist to evaluate his device "to make sure that it was not gimmicky" (Kasler). Also, a massage therapist claims that the Magnassager eases "the pain from carpal tunnel syndrome." How the therapist knows this is not clear.
The claim that magnets help "circulate blood" is a common one among supporters of magnet therapy, but there is no scientific evidence that magnets do anything to the blood. Even though the evidence is lacking that magnets have anything other than a placebo effect, theories abound as to how they work. Some say magnets are like a shiatsu massage; some claim magnets affect the iron in red blood cells; still others claim that magnets create an alkaline reaction in the body (Collie). Bill Roper, head of Magnetherapy claims that "Magnets don't cure or heal anything. All they do is set your body back to normal so the healing process can begin" (Collie). How he knows this is not clear.
Some supporters of magnetic therapy seem to base their belief on a metaphysical assumption that all illness is due to some sort of imbalance or disharmony in energy. The balance or flow of electromagnetic energy must be restored to restore health, and magnets are thought to be able to do this.*
The most rabid advocates of magnet therapy are athletes such as Jim Colbert and John Huston (golfers), Dan Marino (football) and Lindsay Davenport (tennis). Their beliefs are based on little more than post hoc reasoning. It is possible that the relief a magnetic belt gives to a golfer with a back problem, however, is not simply a function of the placebo effect. It may well be due to the support or added heat the belt provides. The product might work just as well without the magnets. the relief might well be due to regression. However, athletes are not given to scientific testing any more than are the manufacturers of magnetic gimmickry.
Athletes aren't the only ones enamored of the power of magnets to heal. Dr. Richard Rogachefsky, an orthopedic surgeon at the University of Miami, claims to have used magnets on about 600 patients, including people who have been shot. He says that the magnets "accelerate the healing process." His evidence? He can tell by looking at X-rays. Dr. William Jarvis is skeptical. He says that "Any doctor who relies on clinical impressions, on what they think they see, is a fool" (Collie). There is a good reason scientists do controlled double-blind studies to test causal efficacy: to prevent self-deception.
Dr. Mark S. George, an associate professor of psychiatry, neurology and radiology at the Medical University of South Carolina in Charleston, did a controlled experiment on the use of magnets to treat depression. He only studied twelve patients for two weeks, however, so his results are of little significance.
While sales of magnetic products keep rising, there are a few scientific studies going on. The University of Virginia is testing magnets on sufferers of fibromyalgia. The Universities of Miami and Kentucky are testing magnets on people with carpal tunnel syndrome (Collie). At present, however, we have no good reason to believe that magnets have any more healing power than crystals or copper bracelets.
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The Skeptical Viewpoint
Magnet therapy represents just the latest in an endless line of snake oil, complete with the full list of unsubstantiated claims and testimonials about a wide variety of health claims. All of the proposed mechanisms for the effects of magnets are either at odds with physics, or has been disproven through direct experimentation. For example, the static magnetic field of most magnets sold for medical use have a field strength at their surface of about 500 Gauss. At one centimeter from the surface, however, the field strength drops off to only 1 Gauss, which is the field strength of the Earth's magnetic field. Another centimeter and the field strength is negligible. This is because electromagnetic fields fall off rapidly with distance. Even if such a magnet were placed directly over a painful wrist, therefore, it would be several centimeters away from the joint and the source of pain.
Some have proposed that the magnetic fields reduce pain by inhibiting nerve conduction. In order to reduce nerve conduction by 10%, however, a 24 Tesla static magnetic field would be required. One Tesla equals 10,000 Gauss. Static magnets, therefore, produce 1/240,000 the field necessary to accomplish a 10% decrease in nerve conduction 1cm from their surface. The claim that magnetic fields improve blood flow are similarly unlikely. For example, a 10 Tesla magnetic field would be required to have a 0.2% effect on blood perfusion pressure.
What about the clinical evidence? Well, proponents have touted the study conducted by researchers at Baylor College of Medicine in Houston, who conducted a double-blind test comparing the effects of magnets and sham magnets on the knee pain of 50 patients with post polio pain. The 29 who received an active magnet reported a significantly greater reduction in pain than the 21 treated with a sham magnet. This study is contradicted by another clinical study, however. Researchers at the New York College of Podiatric Medicine conducted a 4 week trial of patients with heel pain; 19 patients wore a molded insole containing a magnetic foil, while 15 patients wore the same type of insole with no magnetic foil. In both groups, 60% reported improvement, and therefore the magnetic foil conveyed no benefit. Both of these studies were small and came to opposite conclusions. Clearly, more, larger, and better designed studies are necessary to reach a firm clinical conclusion.
Why, then, do so many people swear by magnets? The mere fact that many people believe they are being helped by magnets is not compelling evidence that they work. Thousands have given testimonials extolling the healing power of treatments and devices that were later discovered to be either clear frauds, or harmful concoctions. For example, around the turn of the century it was popular to sell radioactive solutions as a healing tonic, and thousands swore by them even as they were slowly killing them.
Apparent benefit can be explained by many factors, such as the placebo effect. People will usually perceive some improvement in their health or symptoms just by taking action to help themselves. Also, many ailments are self-limiting, meaning that they will get better by themselves. Many people with temporary back pain which gets better on its own will therefore credit the magnets they used with their recovery. Also, many of the magnet products are contained in wraps or bandages, or sown into pads to sleep on or insoles for shoes. There is likely to be some benefit just from having a bandage around an aching elbow, or from the extra support provided by the sleeping pad or insole.
In the absence of adequate clinical evidence, however, companies continue to sell magnets with unsubstantiated claims. One such company, Magnetherapy, inc. was fined $30,000 for making health claims regarding their magnets, and signed a voluntary agreement to stop making such claims. Most companies, however, evade regulations by not making specific claims. Rather, they provide testimonials or make vague statements which avoid specific health claims.