Many facts are known about body electricity and magnetism. Most of these facts, however, have little established practicality relative to pain treatment.
We know enough, however, to provide a scientific rationale for the various electromagnetic measures being used today.
This paper attempts to set out what we do and do not know so that practitioners can use the electromagnetic measures that best fit their brand and style of practice, pocketbook, and patient profile.
Definition of EMT
Basic electromagnetic measures have been used for centuries and are of 2 types:
- those that remove or mobilize body electricity and
- those that administer an electronic current or a derivative of a current
(see Table 1).
The former includes such simple measures as mineral soaking in hot water, copper bracelets, hot water, and needle insertion. The latter embraces the use of electric currents or a derivative of a current in the form of a sound or an acoustic wave or an electromagnetic energy wave.
Administered electric currents or their derivatives have 2 attributes:
- immediate pain relief and
- regeneration of tissues.
we now have a good understanding, within some scientific limits, of why magnets, acupuncture, electric currents, acoustic waves, and electromagnetic energy waves have much to offer patients with pain
electromagnetic measures are complementary and not a substitute for the time-tested treatments of pharmacotherapy, nutrition, exercise, and surgery.
Opposite electrical charges attract each other. This is the first basic principle in understanding electromagnetic measures.
All living tissue contains biologic electricity and has varying proportions of electrons (negative charges), protons (positive charges), and neutrons.
An excess of either positive or negative charges in tissue attracts the other and causes a flow of electrons.
We do not know why, where, or how body tissues make electricity or change polarity from positive to negative or vice versa.
Metal elements such as copper, magnesium, and iron are positively charged and attract negative charges (electrons).
This simple principle of electron attraction is the basis for many age-old electromagnetic measures. They include the use of copper bracelets or necklaces and needle insertion such as acupuncture or “dry” needling of a trigger point.
Water is an excellent conductor of electricity. Water has a slightly negative charge because oxygen is slightly more negative than is hydrogen, which is slightly positive.
Pure water at its normal temperature is not very effective in extracting electricity from the body. When heated, however, water will speed up conduction of electricity in the body.
If a salt with a positive charge, such as sodium or magnesium, is added to warm water, it will immediately attract negative electric charges. The combination of warm water and positively charged salts has been the basis of pain relief by mineral bath soaking for centuries.
A hot bath with a commercial salt-like magnesium sulfate (Epsom-salt) is inexpensive, effective, relives pain, and is a good adjunct to just about any pain treatment regimen.
Because electrons are physical matter, they can be moved by any number of measures. Heat, whether administered by a heating pad, lamp, or hot water, will cause electrons to move.
Anything that increases blood flow, including an increase in heart rate caused by exercise or heat, will move electricity. Massage or vibration will also move the body’s electricity, just as you can squeeze water out of a washcloth.
Pooling of Electricity
Damaged nerves emit electricity.
If the wound is open to the air, the emitted electricity merely escapes into the atmosphere. If the injury is under the skin, however, the emitted electricity will collect and pool around the damaged nerves as their normal flow or circuit is interrupted.
It is axiomatic that if a nerve is damaged, its blood supply and lymph drainage will also be damaged. This tissue damage therefore produces a pooling of electricity, blood products, lymph drainage, and inflammatory mediators.
Basically, a pain site is a wound under the skin that is simply not visible. The pain site will become warm to the touch as inflammation, which is biologic waste heated by electricity, evolves.
Interestingly, opioid receptors propagate in an inflammatory pain site, and it is theorized that these receptors are there to attract circulating endorphins to enhance the inflammatory response and relieve pain
What is not known, however, is whether patients with severe pain due to severe, intractable nerve damage retain electricity throughout their entire bodies.
Although there are a lack of case studies in the literature, some patients with severe, intractable pain anecdotally relate that they retain electricity and, in effect, become a capacitor filled with electricity.
These patients relate stories of burning out light bulbs, computers, and wristwatches when they touch them. They can’t touch other people without causing a severe shock, and they may complain that they can’t kiss their spouse.
It is unclear how the body naturally excretes its electricity.
Magnets Mobilize Electricity
We have known since the scientific work of Faraday in 1831 that a magnet brought perpendicular to an electric current in a wire will depolarize the ends of the wire and cause the electric current to move.
Because pain is, to a great extent, caused by “pooled” or “trapped” electricity, a magnet or magnetic energy wave brought near a pain site causes pooled electricity to mobilize. Magnets also likely attract iron in red blood cells and increase blood flow into a pain site, which promotes mobilization of pooled electricity and inflammatory mediators.
Electric Currents Promote Regeneration and Healing
Temporary pain relief produced by an electric current device is well established, but it is less widely known that electric currents and their derivatives may heal and regenerate tissue.
Sinyukhin cut off one branch from each of a series of tomato plants. At the wound site, he measured the electricity emanating from the wound, which was a stream of electrons (negative charge).
A “current of injury” is emitted from all damaged nerves in animals, as first determined by Galvani in the 1790s.
After a week, a callus formed over the cut surface, and a new branch began to form. In addition, the electric current changed its polarity to positive. As the positive current increased, cells in the area more than doubled their metabolic rate, became more acetic, and produced more vitamin C.
Amazingly, and most cogently for pain practitioners, Sinyukhin applied an electric current to some of the plants. The electricity-assisted plants restored their branches up to 3 times faster than the control plants.
The currents were small—only 2 to 3 microamperes administered for 5 days. Larger amounts of electricity killed the cells and had no growth-enhancing effect.
It is worth noting that there is now a great interest in using microcurrents to treat painful conditions, and there is a growing number of reports showing good results.
How Does Electricity Relieve Pain?
If one administers an electric current or one of its derivatives to a pain site, pain relief may occur within seconds or minutes. The reason for this is not entirely known.
The prevailing thinking propagated by Melzak and Wall in 1965 is that administered electric currents block the gates that control afferent and efferent impulses in the spinal cord, thus preventing pain impulses from reaching the brain. Others have postulated that endogenous endorphins are released, giving pain relief
It is this writer’s conviction that an electric current and its derivatives disperse pooled electricity and/or change the polarity of pooled electricity to reduce pain.
Painful, pooled electricity can be either dispersed into the surrounding tissue or channeled into intact nerves. The dispersion theory is enhanced by the clinical observation that pain may be relieved for hours or days after a single administration of electricity, but the pain will recur.
The pain returns when electricity emitted from the damaged nerves again recollects and pools. In summary, we must labor with an incomplete understanding of the precise mechanisms by which an electric current or one of its derivatives produces short-term pain relief.
Derivatives of Electric Currents
An electric current that passes through a wire will produce electromagnetic energy around the wire. The unit of measurement is the photon
Of the waves in the electromagnetic spectrum, laser, infrared, and radio are currently used in pain treatment. Radio waves are very long—about the size of a building—and laser waves are about the size of a protozoan
In addition to electromagnetic energy waves, scientists found a way to make an acoustic or sound wave from an electric current. Ultrasound, the first innovation, has been a mainstay of electomedicine for more than 5 decades. It has found great use in acute injuries to soft tissue structure such as muscle and fascia. It can also diffuse medications through the skin
Regeneration of Tissue
An exciting area of current research has been the use of electrical currents to regenerate tissue—and even “cure” a pain site.
The regenerative effects on tissue are well documented and are summarized in Table 2. They include growth of cells, angiogenesis, reduction of edema, and clearing of inflammatory mediators.
Use With Other Therapies
All of the electromagnetic measures mentioned here can be used in combination with the standard pharmacotherapy agents, including anti-inflammatory agents, antidepressants, neuropathic drugs, opioids, and topical medications. The simultaneous use of drugs and electromagnetic measures is highly complementary and enhancing.
Some pain treatment drugs directly or indirectly act to control electrical activity.
- Opioids suppress electrical activity.
- The antidepressants and neuropathic agents attempt to curtail electrical transmission at synapses.
- Anesthetics and some oral agents aim to retard the transmission of electronic signals by blocking sodium or calcium channels in nerve membranes.
- Topical treatment agents, including opioids, anti-inflammatory agents, and homeopathic solutions, can be used simultaneously with or even diffused through the skin into a pain site by many of the electromagnetic devices that administer an electric current or an electromagnetic energy wave.
Electromagnetic measures can produce side effects. Even a simple magnet or piece of copper may cause pain in some patients as it mobilizes the body’s electricity.
Electric currents and electromagnetic energy waves are actual matter. When administered into pain sites, they may cause rather than relieve pain. This author has particularly observed this in patients with intractable pain who have very old, scarred, and contracted pain sites.
The revelations that severe chronic pain may induce brain atrophy and cause the memory of severe pain to become imbedded in the neurons and/or glial cells of the spinal cord and/or brain are a major challenge facing pain practioners.
Electricity of some form is likely responsible for abnormal central neuroplasticity and brain atrophy that may occur with severe pain. The question of whether pooled electricity or abnormal electronic impulses generated by damaged nerves reach the brain and cause neuroplasticity or atrophy is a most serious one.
- The precise mechanisms by which electric currents and their derivatives relieve pain is uncertain.
- Apparently, they involve blocking of the afferent-efferent gates in the spinal cord, activation of endogenous endorphins, dispersion of pooled electricity into surrounding tissue, or change in polarity of pooled electricity.
- In addition to immediate pain relief, the administration of electricity or its derivatives may assist tissue healing and regeneration by cell stimulation, removal of edema and inflammatory mediators, and angiogenesis.