also seems to be good for tennis elbow too from my experience with 3 different people so far. however, for more lasting effect, they need to keep using it beyond just the first day of having the pain go away
I believe this is generally true: to get lasting results, continue use of ICES beyond the point where pain subsides, to allow the tissue to more fully recover. I generally recommend continuing use for 2 to 3 weeks beyond the reduction or elimination of pain.
Hi @bob, Looks like I’ll be collecting data I’m 6 weeks into a leg and knee injury. Just got my MRI report a couple of days ago:
Medial meniscus: There is a horizontal tear through the entirety posterior horn which surfaces at the free edge along its inner margin and propagates to the inferior surface as it extends towards the periphery. There is a tiny para meniscal cyst existing posterior to the posterior horn and originating from this tear. This cyst measures 2 x 3 x 3 mm (AP by ML by CC). Degenerative signal changes are present in the posterior horn body junction of the meniscus. Borderline extrusion of the body segment. Unremarkable anterior horn.
I’m currently hitting it from every side with PEMF with my M1 (Omni-8 level 13 stacked coils) and 3 of the A9 knock-offs (Omni-8 level high stacked coils, and side-by-side/opposite side coils). Stacked coil I use on the backside of the knee and non-stacked on the sides and top of the knee. I wear these at night for 8-10 hours during sleep. I’ve recently been wearing only the M1 with non-stacked side-by-side coils on the meniscus area for an additional 4-8 hours a day.
As a “pro tip” I cut open a pair of dress socks so I have a tube, then I can just pull it up over my knee. Since it’s long enough, I pull up the bottom end of the tube over the upper part creating a fold and half length of the sock tube. Then, since it is just snug enough, I slip in the coils in desired positions between the fold and it holds nicely in place even when walking around lightly (jogging wouldn’t keep it in place, and I can’t anyway at this time ). This folded sock works great for sleeping with the coils on too.
At night I use all 4 PEMF devices plugged in with USB (all around my knee), and during the day I run on batteries (swapping every 3-5 hours) with only the M1 currently.
Briefly, I have really not had much pain, swelling nor discomfort of the knee joint (I’m very fortunate) since the injury. As such, I don’t have much info nor data in terms of improvement. That said, walking and stairs are getting better and more natural. I’m seeing my ortho for a consult in 4 weeks to figure out next steps. I’ll be keeping up on PEMF treatment in the meantime and beyond. Hoping to get another MRI then to see how things are looking and signs of healing. I’ll chime back in at that time with an update.
From my reading and physio and myofascial practitioners, blood flow to support healing is key for meniscus healing to take place. To that end, exercise that can be done with minimal discomfort is specified as well as heat cycles to get blood flowing to the area (once any swelling/inflammation has been brought down and under control). I was advised not to ice in order to avoid flushing the blood out of the already low blood supplied area. Since PEMF helps in reducing inflammation and promotes circulation, this is working very well in avoiding swelling and discomfort.
Hope my journey and non-typical treatment approach helps you and provides you with ideas as well as guidance/confidence to try things
DIG
really good information, thanks. I think your strategy is very reasonable given your injuries, and I am very interested to hear how well you will you recover. I think things will turn out well, much better than a typical ortho prognosis for your type of injuries.
The pro tip is excellent: it’s easy to modify standard gloves, socks, etc. to tailor-make garments to hold the coils and device. Lately I have taken to collecting a variety of inexpensive compression sleeves (from amazon) for wrist, ankle, forearm, leg, etc. At this point I always have one that fits what I need.
power at 13 is ok considering all the coils applied and over duration mentioned?
well, individual responses vary, but I would suggest using lower power (it is about 95% likely to work much better). It’s really hard to say, but some people really need the extra power (about 5%), whereas decades of crappy medical devices have forced all of us into the habit of thought that “more power is better”. It really takes good observation and judgement.
My reasoning for using higher intensity is to provide biological effect depth of the magnetic field (field strength reduces very fast with distance) [quotes below]. The knee joint (not to mention the hip that I’ve treated) is not a superficial area to be treated. Therefore, my high intensity reasoning.
I’ll go off on a limb here (pun intended) and engineering assumptions/judgements in the absence of biological background (feel free to poke holes and correct me as needed). The knee joint and tissues being targeted (meniscus and joint cartilage in my case) are deep and dense tissues. Depth/distance to be reached requires much higher intensity/strength for magnetic field biological effectiveness (field rate of change). Tissue density, which I assume would imply high number of cells, would require a higher magnetic field density, thus intensity/strength again, to effectively “treat” all cells. Imagine a flock of ducks being shot at, many munitions (density) would be more effective to hit most of them. Density and intensity I’m pretty sure go hand in hand in magnetics for a given coil size. I imagine that there are tradeoffs in design and ideal effective combinations of magnetic field density and intensity versus depth, not to mention the rate of change being the key factor for biological stimulation, for effective treatment of the area desired. @Bob, is there a field strength and/or density at which the cell is “overloaded” and damaged that you are aware of? Is the M1 capable of such a condition with stacked coils at the highest level?
Additionally, I used this illustration as a reference as a basis for my experimenting with coil configurations, placements and intensity levels.
@Bob, would it be possible for you to provide a table with approximate/rough biologically effective field distance for high/medium/low level settings for the different coil configurations for the M1/C5/B5/A9? This would be extremely helpful in fine tuning the coil configuration vs positioning vs intensity level for treating certain areas. Or is that too much “secret sauce” detail?
With a knee, one strategy you can use is coils on opposite sides. This will pull the magnetic field lines through both coils with a football-shaped field between the coils. The shape is not linear and its not simple, but this can give better depth of penetration than any configuration with coils on one side only.
The challenge (to put it mildly) with just giving a table of depth/intensity is that the magnetic field interacts with tissues as it passes through them. Based on my measurements and calculations, I think you have the density/intensity relationship inverted. I think this is because your intuition of density as it relates to the passage of a magnetic field may be incorrect. To a magnetic field, density of mass is relatively unimportant. Density and conductivity of conductive paths that enable the establishment of induced Eddy currents is what matters to a magnetic field. This is where magnetic fields impart energy to matter, and it is presumably where they will have their biological effects.
In living tissue, the magnetic fields pass through the tissues more like this:
Dry skin: almost no interaction with (attenuation of) the magnetic field
Dense intact cells: very little interaction with (attenuation of) the magnetic field
Areas with dense and/or continuous regions of non-ionic or lipid layers and masses: low magnetic field interaction.
Damaged tissues or tissues with larger volumes of uninterrupted extra- and intra-cellular ionic fluids: Large interaction with (attenuation of) magnetic fields, so there is likely to be a lot of magnetic energy transferred to these areas.
Highly disrupted tissues, areas of high inflammation with disrupted cell-cell membrane junctions: Very large interaction with (attenuation of) magnetic fields, so there is likely to be a lot of magnetic energy transferred to these areas.
Also keep in mind, depending on how magnetic energy is transferred to matter, its depth of penetration will be changed, so you would need to calculate the integral of all energy attenuation along the field line. When the field runs out of energy, that will be its limit.
So, if you map the tissue architecture into those guidelines I list above, you will find that the magnetic field energy will generally be dissipated right where it is needed, namely in areas with a lot of cellular disruption and inflammatory tissue damage.
Add to this the fact that “biologically effective” depends on many other factors, such as individual sensitivity to PEMF, and also very importantly, magnetic field line vector orientation with respect to the tissues involved and the injury.
Important note: magnetic field vector relates directly to the induced field vector. The effective electrical field directions for tissue recovery has only been studied for very few tissues, mostly long bone fracture recovery in the 1960-1970’s.
So, mostly we have to work in the dark when it comes to knowledge about coil placements and field vector alignments with respect to tissues and injuries.
Of course I understand that everyone really wants to know the simple answer: How much intensity for a depth of X?
That’s the answer I want to know, but it remains elusive and may be unanswerable.
Take my word for it, it really is not quite that simple.
Any simplified table would be immediately oversimplified and misleading. Since I am evidently the one person on this planet who is committed to not misleading people on the subject of PEMF, I’ll refrain from generating misleading tables, apologies. As Einstein says: “Everything should be made as simple as possible, but no simpler”
And, as I always point out: any fine tuning of coil placement and settings will be the result of test, careful observation, re-test, etc.
So, I think it must come down to our general advice:
generally start with default settings
If superficial, try less intensity
If deeper, try more
Observe carefully, record your observations, try different coil orientations, intensity and pulse pattern settings, keep detailed records of your responses, adjust, and fine tune this way.
Unfortunately a simple answer does not really exist in any form, but generally those guidelines steer almost everyone to a good solution for their individual needs.
interesting… while there is no direct evidence of magnetic energy charging cells, you note there is more magnetic energy transferred where there is more cellular activity/ionic fluid. i wonder if there’s a way to measure magnetic charge of cells before and after pemf exposure.
from a layperson’s (my) perspective, pemf is akin to “magnetic vitamins” or magnetic field supplements… there’s definitely added benefit supplementing just as there is supplementing with vitamins and minerals - whether injured or not.
continuing with the analogy, it’s a matter of regular dosage and frequency that we need to figure out as a general standard. i believe everyone would benefit from pemf even if they don’t have some health issue they need to resolve. when your mattress/pad is available, I’m definitely looking to get that for my parents and family. for now, it may have to be multiple c5s under the sheets to get my daily dose!
Well, my explanation is pretty prosaic: cell membrane disruption and tissue inflammation lead to larger volumes of continuous conductivity in ionic fluids**. This allows more paths (closed loops) for induced currents, thus more energy transfer, Basic physics. I view the induced current at the correct range of slew rates (dB/dt) as a signal that cells interpret as “pro growth, anti-inflammatory”, as we showed way back in the original NASA study with cultured human neuronal cells.
What I mean by " larger volumes of continuous conductivity in ionic fluids" is that cell walls and cell junctions are basically insulators (lipid layers), so they interrupt conductive loops for induced eddy currents. Think of it this way:
Fill a bunch of water balloons with salt water.
If you pile them up, you can not conduct electricity from one side of the pile to the other, even though salt water conducts electricity. This is because the rubber balloon membranes insulate between the salt water in each balloon…
BUT, if you pop some of the balloons and make a puddle of salt water (to simulate cellular injury), you can easily conduct electricity across the entire pool of spilled salt water. Since the balloons (cell membranes) are no longer intact, they can not block the electrical current flow.
Maybe I was not 100% clear (I am trying not to write too much):
I do not think that it is magnetism somehow charging cells. I could be wrong, but I think it is simply cells responding to electrical current, which is well-described in the scientific literature for more than a century.
To complete my theory on this, since it gives a better picture of my thinking on this topic, the cell membrane damage or inflammation opens up conductive ionic solution paths for induced electrical currents, but actually it could be any source of electrical current. Bioelectric currents are widely used for many different types of signals and purposes in living systems, and it has been known for many decades that direct currents of the correct polarity will induce bone healing in long bone fractures, for example.
So, my theory goes that bioelectricity is one important factor in living organisms that induces tissue healing, and this makes sense to me because these currents will naturally tend to be concentrated in the path of least resistance (injured tissues with inflammation and cell membrane disruption, for example). This is not such a far stretch: hypotheses from the 1960’s and 1970’s for bone and muscle tissue adaptation invoked the concept of “streaming currents”, which arise from the flow of ions in solution, presumably in and around injuries, promoting the functional adaptation of bone and muscle to exercise, for example.
I hypothesize that this may be in fact the main signal used by organisms to detect structural injuries, and to subsequently activate growth, healing, and even to attract stem cells to sites of injury.
I further hypothesize that this signal is muted with age of the organism, and works less well as we age, and may even be an important mechanism of aging (the loss of this signal, or the reduced sensitivity to this signal with age).
Conveniently, by applying PEMF, we can artificially induce microcurrents which will emulate these natural bioelectric signals and focus preferentially in damaged or inflamed tissues, thus amplifying or triggering this natural, ubiquitous signalling mechanism of cellular recovery and healing.
Getting hyper-nerdy on the subject, this is a testable scientific hypothesis, but it will be extremely technically challenging to test. But it involves signalling (probably new mechanisms, not yet discovered), and does not involve cell “charging” since no net charge is transferred through this inductive mechanism.
I could of course be wrong about all of this, but for me, the hypotheses checks off all of the engineering and scientific boxes, and needs to be tested experimentally. That is a lifetime and a career of scientific work, not anything easy to do. It will probably result in two Nobel prizes: one for discovering an entirely new class of cellular signalling, and another one for developing the instruments to make the critical cellular measurements, which will be far more challenging than anything like a patch clamp, for example. Probably beyond the scope of my ability, but that’s my thinking.
The Chinese Chi (Qi) theory is used when discussing microcurrent devices. There are also acupuncture accessories on these.
What you are discussing here fits fairly well into that theory.
I started with microcurrent years ago. My latest device could be on for 10 hours.
When I got into red light that worked better than microcurrent.
PEMF at the intensity I use, does not do the same thing for me. It helps with inflammation, but doesn’t help tired muscles, unlike red light.
Red light isn’t applied for as long as microcurrent or PEMF. There’s a biphasic dose response, so you need to stay within the sweet spot. For that reason I don’t get enough time to make a lasting response on helping inflammation, unlike PEMF.
I am new to the forum and realize this is an older post that I am responding to. Was recently reviewing a medical paper with some very positive indications for PEMF and cartilage injury/treatment. You will find said paper attached. Hope it helps.
I read that paper when it came out last year. It is good info, thanks.
Of particular interest, almost unique to this paper, is the fact that they compared the effects of two different PEMF pulse waveform shapes:
1 - No PEMF control (Gcon)
2 - Treatment with a classic signal PEMF (Gclassic)
3 - Treatment with a high–slew rate signal PEMF (GHSR) (most similar to ICES-PEMF)
They had overall better effects when measured by several biological indices with GHSR than with the classic PEMF waveform (Gclassic) or no PEMF (Gcon).
Before I get a lot of requests from people who “have not read the memo” yet:
No, I will not completely redesign ICES-PEMF waveforms to look like the waveforms that they used in this study. The converse is the correct viewpoint IMO: as the waveforms being studied in academia approach the waveform already built into all ICES-PEMF devices, the biological effects and results that they publish steadily get better.
Agree completely. You have intimate knowledge of the science. And while it does not answer the questions of why some people respond to one protocol for a given condition, and others respond with a completely different protocol, the underlying results are still the same.
When I started out using Low Level Laser on my patients I soon came to the same conclusion. I was advised by the manufacturer that low frequency laser settings (5-50 Hz) were appropriate for chronic and degenerative conditions, while higher frequencies (1k-3k) were best used for acute conditions with inflammation.
In the end, I found some correlation but that one remaining variable called “the patient” ultimately determined how the condition would respond. I had the confidence in the technology, so we used that as our starting point.
To add more data to my aforementioned knee injury, I just last night switched to Schuman(n)? 1 for overnight treatment. I had received about 8 hours of treatment during the day yesterday of Omni 8 protocol and went to bed with Schumann 1. Detected subtle differences in improvement. But as you’ve suggested many times, I intend to mix it up and see what my body responds best to. As of this morning, I could do a full squat, where as I haven’t been able to do that since the original injury several months ago.
I am enjoying reading through the forum posts to see what others have discovered. I am most likely looking at a B5 purchase in the near future to have more control over multiple regions of treatments with varying protocol settings.
This is all very exciting to me Dr. Bob. I have been referring colleagues to you for their own clinical needs as I am profoundly surprised by how quickly and how effective this is working.
I will continue with periodic updates. Many thanks again.
I also agree completely: individual differences between PEMF users is most important. Everything else is at best a starting point guideline. This also puts the lie to any PEMF marketing claims of “special secret frequencies”, and other such nonsense. But broadly, PEMF is generally broadly effective, so a little experimentation usually leads people quickly to a satisfactory solution.
B5: you might want to consider a C5 instead. In both cases (C5 and B5), all four outputs are synchronized, so they do not put out different pulse protocols, for example. But the C5 is much easier to use unless you are doing scientific experimentation. I only use a B5 when working on a research paper. For personal use, I use a C5.
I most likely have the two confused. At this point I am using for personal concerns so a C5 it is. I have discussed your M1 with a friend who has been dogged by a chronic heel spur. His lower extremity biomechanics are a mess from complete knee replacement (gone surgically wrong) which has left him with 30-40% ROM in that knee. Both hips have been resurfaced and his lumbar spine displays marked degenerative changes throughout. Needless to say his feet take a beating with all the compensatory changes. He’s been getting cortisone shots with only temporary relief.
In about two weeks I will be lending him my M1 and showing him how to use, coil placement etc. I will be recommending a stacked coil arrangement directly over the painful spur region which is approximately the circumference of a quarter. Also, Omni 8 to start with B5-C5 thereafter.
Any suggestions or other reports of heel spur treatment??
It sounds to me like you are right on target. With bone spurs, there might be a short initial period of more pain, so he should be ready for that possibility.
Not at all unlike ultrasound, but still effective. Thanks for the info!