Nowadays, pain and pain-related diseases are largely treated with drugs. However, the downside of many modern drugs is the great number of side effects and interactions with other medicines. Recently, a new way of dealing with pain started to receive attention – the use of Pulsed Electromagnetic Fields.
The sources in this literature review include studies of modern drugs and antidepressants, randomized control trials, and general information about the use of Pulsed Electromagnetic Fields. All sources either represent or are based on randomized control trials and peer-reviewed literature. Information about both the modern drugs and the PEMF methods is important for the scope of this research, as it enables us to analyze and compare their overall effectiveness, and weight in the benefits and tradeoffs of both.
Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain
Morris Maizels and Bill McCarberg conducted the study of the effectiveness of antiepileptic drugs and depressants for chronic pain in 2005. This study analyzes the effectiveness of first and second-generation antiepileptic drugs, as well as tricyclic antidepressants against a variety of chronic and neuropathic pains. The causes presented in the source include complex regional pain syndrome, idiopathic peripheral neuropathy, nerve compression and entrapment, phantom limb pain, postherpetic neuralgia, diabetic neuropathy, multiple sclerosis, and post-stroke pain, as well as many sources of non-neuropathic pain, such as arthritis, and chronic pains (Maizels, & McCarlberg, 2005).
This source contains information about diabetic neuropathy and the effectiveness of drugs used to treat it. The source outlines many faults of such treatment, in particular, the varying effectiveness of various drugs, which depends on the patient’s tolerance to it, as well as on interaction with other medicaments. Also, the source presents many side effects of these drugs, weight gain, and sedation being universal to all of them (Maizels, & McCarlberg, 2005).
The source presents a strong and well-rounded analysis of pain treatment practices. Its major downside is that the study was conducted in 2005, which is roughly a decade ago. References and data used in this study are even older than that, meaning that some information and conclusions provided may not be up to date (Maizels, & McCarlberg, 2005).
Effects of Pulsed Electromagnetic Fields on Postoperative Pain
Per Heden and Arthur A. Pilla conducted this double-blind randomized study in 2008. The study is dedicated to the subject of post-operative pain, particularly among patients who had received breast augmentation. The study included a test group and a controlled placebo group, to measure and compare the effectiveness of the pulsed electromagnetic field. Forty-two patients participated in the experiment (Heden & Pilla, 2008). The results of the experiment show that low-emission pulses are effective at dealing with post-operational pain. No notable side effects of the treatment were detected.
The results of this experiment are important enough to be included in our research. They could be used in comparison with medical data from the previous source on post-operational pain treatment, to identify which one works better. One of the strong points of PEMF therapy is its non-invasiveness and lack of any noticeable side effects (Heden & Pilla, 2008).
The trial was conducted in 2008, which is 8 years ago. However, this does not diminish the significance of its findings, as it is unlikely that the results of the trial could be misinterpreted or viewed in a different light, with regards to new information on the subject.
Pain Management with Pulsed Electromagnetic Fields
This research was conducted by William Pawluk in 2003, and it covers a vast array of Pulsed Electromagnetic Field treatment techniques and their application in modern medicine. The research states that PEMF therapy sees use in many countries in Eastern Europe, which means that conclusive studies could be made relying on that data. The document states that PEMF is used to treat such diseases like diabetic Neuropathy, chronic back and muscle pains, endometriosis, post-operative pain, pelvic inflammatory disease, post-herpetic neuralgia, osteoarthritis and many others (Pawluk, 2003). This research also gives the readers information about possible side effects of the PEMF treatment, such as its effects on balance, skin reddening, and some others. The methods used to treat patients involve differentiating the intensity of the electromagnetic pulse field, from low to high.
The research concludes that in most cases, the effectiveness of treatment of patients was significantly improved by PEMF therapy. These conclusions are supported by various peer-reviewed sources like medical journals and the results of randomized control trials (Pawluk, 2003).
This paper is very important for this research. It provides specific information about how can diabetic neuropathy in patients be treated with the use of PEMF therapy. There are a lot of comparison points between this source and the article about antidepressants and antiepileptic drugs for chronic non-cancer pain (Pawluk, 2003). The article was published in 2003, meaning that more than 13 years have passed since its publication. However, the information could still be used to illustrate a point, and as a point of comparison with the article written in 2005.
Pulsed Electromagnetic Fields to Reduce Diabetic Neuropathic Pain and Stimulate Neuronal Repair
This randomized control trial was conducted in 2009 by a group of medical doctors, totaling five in number. This trial is relatively fresh when compared to other sources implemented in this research. This source is of critical importance to our research, as it reflects on the subject of this study, and provides fresh, dedicated, and trustworthy data. The study was meant to determine whether repetitive and cumulative exposure to low-frequency pulsed electromagnetic fields targeting painful feet can reduce neuropathic pain, influence sleep in symptomatic diabetic peripheral neuropathy, and influence nerve regeneration (Weintraub, Herrmann, Smith, Backonja, & Cole, 2009).
The source’s conclusions differ from all others, as they state that the low-emission electromagnetic field was ineffective in reducing NP. However, other factors, such as reduced itching scores, indicate that higher dosimetry and longer duration may affect. This source conflicts with the previous source. In the scope of this research, it can be quoted to provide an opposite point of view, which does not completely negate the initial hypothesis.
The burden of illness in painful diabetic peripheral neuropathy: the patients’ perspectives
This article was written by a group of researchers and published in The Journal of Pain in 2006. Its purpose is to reflect on the effectiveness of drug treatment of diabetic neuropathy, particularly on short/long action opioids, anticonvulsants, serotonin reuptake inhibitors, and some others (Gore, Brandenburg, Hoffman, Tai, & Stacey, 2006). The study is a randomized control trial that studied 255 patients aged 40 to 76 years old (Gore et al., 2006). The results of the study reflect on the effectiveness of these treatments and high costs. Usage of multiple painkillers causes polypharmacy, reduced capacity to move and work, health resource use, and very little change in pain levels experienced by the patient.
The information provided by this article serves as a justification for our research. A large number of side effects of drugs used to treat diabetic peripheral neuropathy means that other methods must be tried to deal with it. It indirectly supports the hypothesis. However, it contradicts the first source at certain points. Also, the source is relatively old – the patients that were involved in this study were recruited in 2003 (Gore et al., 2006).
Effects of treatments for symptoms of painful diabetic neuropathy: a systematic review.
The last source reviewed in this list was written in 2007 by a trio of Chinese researchers in Hong Kong. The paper reflects on methods, characteristics of studies and patients, efficacy, and side effects of most common treatments for diabetic neuropathy. The study revised numerous randomized control trials and analyzed the effectiveness of antidepressants, opioids, ion blockers, and anticonvulsants (Wong, Chung, & Wong, 2007). The source concludes that antidepressants and anticonvulsants remain an effective tool for treating diabetic neuropathy. However, the report also mentions numerous side effects and withdrawals from the treatment.
This source provides a more dedicated view of the efficiency of numerous drugs when treating diabetic neuropathy. While the previous source was more dedicated to the patient’s point of view, this one is focused on the objective efficiency of the treatment. This information should be used in our research both independently and as a point of comparison with other sources, to provide a wholesome overall picture.
Conclusions
Overall, the sources provide conclusive data on which the research could be based. Literature includes the results of numerous randomized control trials, and the information provided covers the topic completely, both in general and in specifics. While the sources are relatively old, they are still viable due to a lack of more recent research available on the subject. Some sources contradict one another, but not in any major way, and do not disprove the hypothesis of the research.
References
Gore, M., Brandenburg, N.A., Hoffman, D.L., Tai, K.S., & Stacey B. (2006). Burden of illness in painful diabetic peripheral neuropathy: the patients’ perspectives. Journal of Pain, 7(12), 892-900.
Heden, P., & Pilla, A. A. (2008). Effects of pulsed electromagnetic fields on postoperative pain: A double-blind randomized pilot study in breast augmentation patients. Aesthetic Plastic Surgery, 32, 660. Web.
Maizels, M., & McCarlberg, B. (2005). Antidepressants and antiepileptic drugs for chronic non-cancer pain. American Family Physician, 71(3), 483-490.
Pawluk, W. (2003). Pain management with pulsed electromagnetic fields (PEMF) treatment. Web.
Weintraub, M., Herrmann, D. N., Smith, A. G., Backonja, M.M., & Cole, S. P. (2009). Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: a randomized controlled trial. Archive of Physical Medical Rehabilitation, 90, 1102-1109.
Wong, M.C., Chung, J.W., & Wong, T.K. (2007). Effects of treatments for symptoms of painful diabetic neuropathy: systematic review. British Medical Journal, 335 (7610): 87.