title: Pulsed electromagnetic fields in knee osteoarthritis: a double blind, placebo-controlled, randomized clinical trial.
abstract: OBJECTIVE
  This trial aimed to test the effectiveness of a wearable pulsed electromagnetic fields (PEMF) device in the management of pain in knee OA patients.
  
  
  METHODS
  In this randomized [with equal randomization (1:1)], double-blind, placebo-controlled clinical trial, patients with radiographic evidence of knee OA and persistent pain higher than 40 mm on the visual analog scale (VAS) were recruited. The trial consisted of 12 h daily treatment for 1 month in 60 knee OA patients. The primary outcome measure was the reduction in pain intensity, assessed through VAS and WOMAC scores. Secondary outcomes included quality of life assessment through the 36-item Medical Outcomes Study Short-Form version 2 (SF-36 v2), pressure pain threshold (PPT) and changes in intake of NSAIDs/analgesics.
  
  
  RESULTS
  Sixty-six patients were included, and 60 completed the study. After 1 month, PEMF induced a significant reduction in VAS pain and WOMAC scores compared with placebo. Additionally, pain tolerance, as expressed by PPT changes, and physical health improved in PEMF-treated patients. A mean treatment effect of -0.73 (95% CI - 1.24 to - 0.19) was seen in VAS score, while the effect size was -0.34 (95% CI - 0.85 to 0.17) for WOMAC score. Twenty-six per cent of patients in the PEMF group stopped NSAID/analgesic therapy. No adverse events were detected.
  
  
  CONCLUSIONS
  These results suggest that PEMF therapy is effective for pain management in knee OA patients and also affects pain threshold and physical functioning. Future larger studies, including head-to-head studies comparing PEMF therapy with standard pharmacological approaches in OA, are warranted.
  
  
  BACKGROUND
  ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT01877278.
authors.affiliation: Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy gbagnato@unime.it.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Bagnato
authors.affiliation: Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Miceli
authors.affiliation: Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy.
authors.forename: Natale
authors.initials: N
authors.lastname: Marino
authors.affiliation: Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Sciortino
authors.affiliation: Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy.
authors.forename: Gian Filippo
authors.initials: GF
authors.lastname: Bagnato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D055909:Magnetic Field Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000628:therapy*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: OA; clinical trial; knee; pain; pain threshold