PEME and its use for managing arthritic pain
The documented effects of using PEME include: increased circulation, acceleration of tissue healing, reduction in arthritic pain and reduction in oedema. PEME can be applied through a variety of methods including: mats, wraps, boots or rugs. The mat is useful to place under bedding of un-ambulatory patient and in cat carrying boxes but it may prove difficult to keep an energetic patient stationary on the mat for the duration of the treatment. The wraps may increase the compliance of the patient if it is suitable for the area of treatment (We often used the wraps for fetlocks/hocks etc.)
PEME is often used within veterinary clinics prior to assessment for anxious patients as it is believed to have a calming effect (particularly useful for feline patients). Although very few side effects have been reported, PEME must be used with caution; it shouldn’t be used on epilepsy patients, around tumours, on pregnant or lactating animals and is contraindicated around pacemakers.
So how does it work?
PEME targets cell surface receptors by electromagnetic induction, increasing activity of the transferring growth factor gene and increasing glycosaminoglycan levels. Most scientific evidence is taken from human literature. However, this does not necessarily make it any less effective for veterinary patients as many studies may be transferable.
Within the last 30 years, the veterinary industry has recognised the need for further clinical evidence regarding the use of PEME and has begun to investigate the uses of PEME in more depth.
A popular topic is the use of PEME to reduce the symptoms of pain associated from osteoarthritis (OA). The PEME device is non-invasive and a convenient portable device to use hence why many professionals may opt to use them during treatments, especially when visiting OA patients at their home.
Below are a few important facts pulled from relevant journals
A significant reduction in pain was found for patients with knee OA when treated with PEME (Nelson et al., 2013).
A randomised clinical trial found the use of PEME to reduce pain and increase knee function within humans with OA (Bagnato et al., 2016).
Both of these human studies reduced pain and inflammation after 1 month of PEME treatment even despite different stages of OA and treatment method!
Further to Bagnato et al., a canine study reported PEME to have superior effects long term when compared to NSAID (Pinna et al., 2012). 20 sessions of 18 minute PEME treatment reduced arthritic signs in the 25 canine patients. These effects were still noted when re-assessed 4 and 12 months later compared to the 10 canine patients who received only NSAID. These 10 patients showed signs of their original pain when reassessed.
A shorter clinical trial was conducted on 60 canine patients over 9 days. The patients had moderate-severe symptoms of OA. PEME treatment lasted 1 hour each day to half the group, the other half had an hour of rest. A significant reduction in pain was noted to the PEME treated group. However, this was examined by their owners filling out questionnaires and therefore, further studies are recommended to avoid biased results (Sullivan et al., 2013).
To conclude...
PEME has become a popular device used within the veterinary industry due to the beneficial effects and being conveniently easy to use. Most patients tolerate the therapy; it is even used within some practices to calm the patient prior to assessment. The large range of available applicators ensures the physiotherapist can accurately target the desired area. Although the industry is lacking in large scale scientific studies, the huge volume of successful case studies available for various animals and conditions should drive further clinical PEME studies in the future. The importance of minimising long term NSAID, steroid and opiod treatment for chronic OA canine patients and the findings from Bagnato et al and Pinna et al should alone encourage the industry to complete further clinical trials to potentially enhance the quality of life for all OA patients.
References
F.R. Nelson, R. Zvirbulis, A.A. Pilla. 2013. Non-invasive electromagnetic field therapy produces rapid and substantial pain reduction in early knee osteoarthritis: a randomized double-blind pilot study. Rheumatol, 33. pp. 2169-2173.
G.L. Bagnato, G. Miceli, N. Marino, D. Sciortino, G.F. Bagnato. 2016. Pulsed electromagnetic fields in knee osteoarthritis: a double blind, placebo-controlled, randomized clinical trial. Rheumatology, 55. pp. 755-762.
M.O. Sullivan, W.J. Gordon-Evans, K.E. Knap, R.B. Evans. 2013. Randomized, controlled clinical trial evaluating the efficacy of pulsed signal therapy in dogs with osteoarthritis. Veterinary Surgery, 42. pp. 250-254
S. Pinna, F. Landucci, A.M. Tribuiani, F. Carli, A. Venturini. 2012. The effects of pulsed electromagnetic field in the treatment of osteoarthritis in dogs: Clinical Study. Pakistan Veterinary Journal, 33. pp. 96-100.
