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Source: Weintraub MI. Magnetic bio-stimulation in painful diabetic peripheral neuropathy: A novel intervention. Am J Pain Management 1999;9:8-17.
Context: The pathophysiology of diabetic peripheral neuropathy (DPN) is complex and poorly understood. Typically, it begins insidiously, producing symptoms of numbness, tingling, and/or burning and progressing to pain and disability. Given poor results with con-ventional pharmacological treatments, alternative therapies directed at slowing or halting the process are becoming attractive.
Objective: To test the effectiveness of magnet therapy in neuropathic pain and also to assess the role of placebo. Secondary objectives were to quantify nerve conduction, electrophysiologic changes, and neurologic examination changes over a four-month period.
Subjects: There were 24 initial patients; 19 completed the four-month trial. Ten patients had advanced refractory DPN and nine had non-DPN. All patients had failed to improve with various conventional pharmacologic treatments (e.g., analgesics, NSAIDs, anticonvulsants, tricyclites). Acupuncture was also tried by a few individuals. In the control group, individuals had peripheral neuropathies secondary to multiple myeloma, alcoholism, or ischemia.
Design: A randomized, double-placebo crossover study that entailed four phases.
Intervention: Patients randomly received an active magnetic foot insole (475 gauss) for one foot and a sham insole for the other. Subjects scored their complaints of burning, numbness, and tingling pain independently in both feet twice a day using a standardized visual analog scale (VAS) scoring system. After 30 days, the sides of the active and sham magnetic insoles were switched for an additional four weeks. At the end of a month, the subjects received two new active magnetic foot insoles (475 gauss) and continued for eight weeks rating their levels of pain twice a day.
Results: Improvement was significantly more pronounced in the diabetic cohort, 90% vs. 33%, at the end of the four months (P < 0.02). During the first month, the placebo response was noted to be the same in both groups (22%) for symptoms of burning, numbness, and tingling. In the second month, the placebo effect was greater in the DPN cohort (38% vs. 22%). At the end of four months, improvement was significantly more pronounced in the diabetic cohort for burning (P < 0.05), numbness, and tingling reduction (P < 0.05). Neuropathologic differences identified severe axonal damage principally in the diabetic cohort, whereas mild demyelinating changes were seen principally in the non-DPN group.
Conclusion: These findings are predictive of success in use of magnet therapy for DPN. The constant wearing of magnetic devices was able to dramatically suppress the neuropathic symptoms of burning pain, numbness, and tingling in the diabetic cohort (90%) as compared to the non-diabetic cohort (33%).
Comment: A number of studies have been conducted using magnets to abate pain, but this is the first randomized, placebo-controlled study to demonstrate a therapeutic benefit from magnetic foot pads in human diabetic polyneuropathy. Although the response was palliative, not curative, the results are impressive and suggest that a legitimacy exists for magnet therapy as a safe approach in symptom management in neuropathic diabetic foot pain. These preliminary data need to be validated by larger longitudinal studies and warrant further investigation into magnet use for other conditions.