Permanent Magnets for Low Back Pain
Clinical Briefs
With Comments from John La Puma, MD, FACP
Permanent Magnets for Low Back Pain
July 2000; Volume 3; 83-84
Source: Collacott EA, et al. Bipolar permanent magnets for the treatment of chronic low back pain: A pilot study. JAMA 2000;283:1322-1325.
Chronic low back pain is one of the most prevalent and costly medical conditions in the United States. Permanent magnets have become a popular treatment for various musculoskeletal conditions, including low back pain, despite little scientific support for therapeutic benefit.
To compare the effectiveness of one type of therapeutic magnet, a bipolar permanent magnet, with a matching placebo device for patients with chronic low back pain, we conducted a randomized, double-blind, placebo-controlled, crossover pilot study from February 1998 to May 1999 in an ambulatory care physical medicine and rehabilitation clinic at a Veterans Affairs hospital.
The trial included 19 men and one woman with stable low back pain of 19 years’ mean duration, with no past use of magnet therapy for low back pain. Twenty patients were determined to provide 80% power in the study at P < 0.05 to detect a difference of two points (the difference believed to be clinically significant) on a visual analog scale (VAS).
For each patient, real and sham bipolar permanent magnets were applied on alternate weeks for six hours per day, three days per week for one week, with a one-week washout period between the two treatment weeks.
We assessed pretreatment and posttreatment pain intensity on a VAS; sensory and affective components of pain on the Pain Rating Index (PRI) of the McGill Pain Questionnaire; and range of motion (ROM) measurements of the lumbosacral spine, compared by real vs. sham treatment.
Mean VAS scores declined by 0.49 (SD, 0.96) points for real magnet treatment and by 0.44 (SD, 1.4) points for sham treatment (P = 0.90). No statistically significant differences were noted in the effect between real and sham magnets with any of the other outcome measures (ROM, P = 0.66; PRI, P = 0.55).
We conclude that application of one variety of permanent magnet had no effect on our small group of subjects with chronic low back pain.
COMMENT
Magnets are everywhere—in belts, shoes, hair bands, and ace wraps. They have real attraction: they’re inexpensive to make, have a lot of flexibility, and are as available as the nearest home refrigerator, or Sports Authority.
For all the money that’s being spent and made on magnets, one would think that data would exist to prove their helpfulness. But alas, supportive data remain elusive, despite the NIH Center for Complementary and Alternative Medicine’s grant to investigators at the University of Virginia to study magnet treatment for fibromyalgia. They will get no help from these data.
Of course, this is only a pilot study. But relatively few Americans use magnet therapy for low back pain, and Consumer Reports suggests that those who do are less happy with it than just about everything else, from prescription drugs to herbal supplements to chiropractic treatment.
Recommendation
Patients with low back pain attracted to magnets should save their money. Advise them to spend it on exercise: If exercise were a pill, it would be called penicillin. Weight management, chiropractic treatment, and physical therapy are the next best options.
July 2000; Volume 3; 83-84
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