Type of Article:  Original Research

Volume 5; Issue 2 (April 2017)

Page No.: 1930-1936

DOI: https://dx.doi.org/10.16965/ijpr.2017.105


Mohamed Salaheldien Alayat *1, Mohamed Mohamed Ibrahim Ali 2, Amir Abdel Raouf El Fiky 3, Mansour Abdullah Alshehri 4.

*1 Assistant Professor of Physical Therapy, Department of Basic Science, Faculty of Physical Therapy, Cairo University. Egypt.

2 Assistant Professor of Physical therapy, Department of Orthopedic Physical Therapy, Faculty of Physical Therapy, Cairo University, EGYPT.

3 Lecturer Physical Therapy, Physical Therapy for Neurological Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.

4 Lecturer Physical Therapy, Physiotherapy and rehabilitation department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia.

Address for Correspondence: Dr. Mohamed Salaheldien Alayat., PT PhD., Assistant Professor of Physical Therapy, Department of Basic Science, Faculty of Physical Therapy, Cairo University. Egypt. E-Mail: mohsalahpt@hotmail.com


Background: Mechanical neck pain (MNP) is a common neck disorders affecting middle-aged population. Magnetotherapy is considered as a safe and non-invasive physical therapy modality used in the treatment of musculoskeletal pain.

Objective: The purpose of this study was to investigate the effect of pulsed electromagnetic field (PEMF) on pain and functional improvement in chronic MNP.

Subjects and Methods: A total of 60 male patients participated in this study. Their mean age, weight, height, body mass index (BMI) and duration of illness were 23.03 (2.239) years, 63.43 (5.195) Kg, 1.662 (5.1092) cm, 22.98 (1.879) Kg/m2, 4.483(1.228) months respectively. They were randomly assigned in to two groups. Group I (30 Patients) was treated with PEMF plus exercises (PEMF+EX) group and group II (30 Patients) treated with placebo magnetic plus exercises (PL+EX) group. Exercise program included active range of motion, muscle stretching and strengthening exercises applied two sessions/week for 6 weeks. PEMF was applied with 20 Hz, 0.8 mT for 20 minutes two sessions/week for 6 weeks. Pain level was measured by visual analog scale (VAS) and neck functions were measured by neck disability index (NDI). The level of significance was set at < 0.05.

Results: Wilcoxon matched-pairs signed-ranks test revealed significant differences in VAS and NDI in PEMF+EX and PL+EX groups (p <0.0001). Mann-Whitney (MW) Test showed significant decreased in VAS and NDI scores both treatment (p <0.0001) with more significant decrease in PEMF group than PL+EX group.

Conclusion: PEMF combined with exercise was effective more than exercises alone in decreasing the scores of VAS and NDI in Chronic MNP.

Key words: Chronic MNP, Exercise, Neck disability index, Pain, Pulsed electromagnetic field.


  1. Bogduk N, McGuirk B. Management of acute and chronic neck pain : an evidence-based approach. 2006;Elsevier, Edinburgh; New York.
  2. Wood TG, Colloca CJ, Matthews R (2001) A pilot randomized clinical trial on the relative effect of instrumental (MFMA) versus manual (HVLA) manipulation in the treatment of cervical spine dysfunction. J Manipulative Physiol Ther 2001;24 (4):260-271. doi:10.1067/mmt.2001.114365.
  3. Falla D, Farina D. Muscle fiber conduction velocity of the upper trapezius muscle during dynamic contraction of the upper limb in patients with chronic neck pain. Pain 2005;116 (1-2):138-145. doi:10.1016/j.pain.2005.03.038.
  4. Gonzalez-Iglesias J, Fernandez-de-las-Penas C, Cleland JA, Gutierrez-Vega Mdel R. Thoracic spine manipulation for the management of patients with neck pain: a randomized clinical trial. J Orthop Sports Phys Ther 2009;39(1):20-27. doi:10.2519/jospt.2009.2914.
  5. Viljanen M, Malmivaara A, Uitti J, Rinne M, Palmroos P, Laippala P. Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial. BMJ (Clinical research ed) 2003;327(7413):475. doi:10.1136/bmj.327.7413.475.
  6. Jull GA, O’Leary SP, Falla DL. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther 2008;31(7):525-533. doi:10.1016/j.jmpt.2008.08.003.
  7. Falla D, Bilenkij G, Jull G. Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine (Phila Pa 1976) 2004;29(13):1436-1440.
  8. Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine (Phila Pa 1976) 2004;29 (19):2108-2114.
  9. Celenay ST, Akbayrak T, Kaya DO. A Comparison of the Effects of Stabilization Exercises Plus Manual Therapy to Those of Stabilization Exercises Alone in Patients With Nonspecific Mechanical Neck Pain: A Randomized Clinical Trial. J Orthop Sports Phys Ther 2016;46 (2):44-55. doi:10.2519/jospt.2016.5979.
  10. Bongers PM, Ijmker S, van den Heuvel S, Blatter BM. Epidemiology of work related neck and upper limb problems: psychosocial and personal risk factors (part I) and effective interventions from a bio behavioural perspective (part II). Journal of occupational rehabilitation 2006;16 (3):279-302. doi:10.1007/s10926-006-9044-1.
  11. Cote P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, Carragee EJ, Haldeman S, Nordin M, Hurwitz EL, Guzman J, Peloso PM. The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976) 2008;33(4 Suppl):S60-74. doi:10.1097/BRS.0b013e3181643ee4
  12. Seo BK, Lee JH, Kim PK, Baek YH, Jo DJ, Lee S. Bee venom acupuncture, NSAIDs or combined treatment for chronic neck pain: study protocol for a randomized, assessor-blind trial. In: Trials 2014;15. England, p 132. doi:10.1186/1745-6215-15-132.
  13. Akhter S, Khan M, Ali SS, Soomro RR. Role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain. Pak J Pharm 2014;Sci 27 (6 Suppl):2125-2128.
  14. Bakar Y, Sertel M, Ozturk A, Yumin ET, Tatarli N, Ankarali H. Short term effects of classic massage compared to connective tissue massage on pressure pain threshold and muscle relaxation response in women with chronic neck pain: a preliminary study. J Manipulative Physiol Ther 2014;37(6):415-421. doi:10.1016/j.jmpt.2014.05.004.
  15. Markov MS. Pulsed electromagnetic field therapy history, state of the art and future. The Environmentalist 2007;27(4):465-475. doi:10.1007/s10669-007-9128-2.
  16. Weintraub MI, Cole SP. Pulsed magnetic field therapy in refractory neuropathic pain secondary to peripheral neuropathy: electrodiagnostic parameters–pilot study. Neurorehabilitation and neural repair 2004;18(1):42-46. doi:10.1177/0888439003261024.
  17. Shupak NM, McKay JC, Nielson WR, Rollman GB, Prato FS, Thomas AW. Exposure to a specific pulsed low-frequency magnetic field: a double-blind placebo-controlled study of effects on pain ratings in rheumatoid arthritis and fibromyalgia patients. Pain research & management 2006;11(2):85-90.
  18. Zdrodowska B, Leszczynska-Filus M, Leszczynski R, Blaszczyk J. Comparison of the effect of laser and magnetic therapy for pain level and the range of motion of the spine of people with osteoarthritis lower back. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego 2015;38 (223):26-31.
  19. Mikesky AE, Hayden MW Effect of static magnetic therapy on recovery from delayed onset muscle soreness. Physical Therapy in Sport 2005;6(4):188-194. doi:10.1016/j.ptsp.2005.08.004.
  20. Cepeda MS, Carr DB, Sarquis T, Miranda N, Garcia RJ, Zarate C (2007) Static magnetic therapy does not decrease pain or opioid requirements: a randomized double-blind trial. Anesthesia and analgesia 2007;104(2):290-294. doi:10.1213/01.ane.0000230613.25754.08
  21. Schall DM, Ishee JH, Titlow LW (2003) Effect of magnetic therapy on selected physical performances. Journal of strength and conditioning research / National Strength & Conditioning Association 2003;17(2):299-302.
  22. Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 1983;16(1):87-101.
  23. Wlodyka-Demaille S, Poiraudeau S, Catanzariti JF, Rannou F, Fermanian J, Revel M. The ability to change of three questionnaires for neck pain. Joint, bone, spine: revue du rhumatisme 2004;71(4):317-326. doi:10.1016/j.jbspin.2003.04.004.
  24. Shaheen AA, Omar MT, Vernon H (2013) Cross-cultural adaptation, reliability, and validity of the Arabic version of neck disability index in patients with neck pain. Spine (Phila Pa 1976) 2013;38(10):E609-615. doi:10.1097/BRS.0b013e31828b2d09.
  25. Yao M, Sun YL, Cao ZY, Dun RL, Yang L, Zhang BM, Jiang HR, Wang YJ, Cui XJ. A Systematic Review of Cross-cultural Adaptation of the Neck Disability Index. Spine (Phila Pa 1976) 2015. doi:10.1097/brs.0000000000000788.
  26. Omar AS, Awadalla MA, El-Latif MA. Evaluation of pulsed electromagnetic field therapy in the management of patients with discogenic lumbar radiculopathy. International journal of rheumatic diseases 2012;15 (5):e101-108. doi:10.1111/j.1756-185X.2012.01745.x.
  27. Turan Y, Bayraktar K, Kahvecioglu F, Tastaban E, Aydin E, Kurt Omurlu I, Berkit IK. Is magnetotherapy applied to bilateral hips effective in ankylosing spondylitis patients? A randomized, double-blind, controlled study. Rheumatol Int 2014;34 (3):357-365. doi:10.1007/s00296-013-2941-7.
  28. Collacott EA, Zimmerman JT, White DW, Rindone JP (2000) Bipolar permanent magnets for the treatment of chronic low back pain: a pilot study. In: JAMA, 2000;283(10):1322-1325.
  29. Winemiller MH, Billow RG, Laskowski ER, Harmsen WS (2003) Effect of magnetic vs sham-magnetic insoles on plantar heel pain: a randomized controlled trial. In: JAMA, 2003;290(11):1474-1478. doi:10.1001/jama.290.11.1474
  30. Borsa PA, Larkin KA, True JM. Does phototherapy enhance skeletal muscle contractile function and postexercise recovery? A systematic review. Journal of athletic training 2013;48 (1):57-67. doi:10.4085/1062-6050-48.1.12.
  31. George MS, Wassermann EM, Kimbrell TA, Little JT, Williams WE, Danielson AL, Greenberg BD, Hallett M, Post RM. Mood improvement following daily left prefrontal repetitive transcranial magnetic stimulation in patients with depression: a placebo-controlled crossover trial. The American journal of psychiatry 1997;154 (12):1752-1756. doi:10.1176/ajp.154.12.1752
  32. Vallbona C, Hazlewood CF, Jurida G. Response of pain to static magnetic fields in postpolio patients: a double-blind pilot study. Arch Phys Med Rehabil 1997;78(11):1200-1203.
  33. Shupak NM, Prato FS, Thomas AW. Human exposure to a specific pulsed magnetic field: effects on thermal sensory and pain thresholds. Neuroscience letters 2004;363 (2):157-162. doi:10.1016/j.neulet.2004.03.069.
  34. Kanat E, Alp A, Yurtkuran M (2013) Magnetotherapy in hand osteoarthritis: a pilot trial. Complement Ther Med 2013;21(6):603-608. doi:10.1016/j.ctim.2013.08.004.
  35. Trock DH. Electromagnetic fields and magnets. Investigational treatment for musculoskeletal disorders. Rheum Dis Clin North Am 2000;26(1):51-62.
  36. Bachl N, Ruoff G, Wessner B, Tschan H. Electromagnetic interventions in musculoskeletal disorders. In: Clin Sports Med, 2008;27(1):87-105. doi:10.1016/j.csm.2007.10.006
  37. Valentinuzzi ME. Magnetotherapy, alternative medicines, Hippocratic oath. In: Biomed Eng Online, 2008;7:1. doi:10.1186/1475-925x-7-1
  38. Weintraub MI, Wolfe GI, Barohn RA, Cole SP, Parry GJ, Hayat G, Cohen JA, Page JC, Bromberg MB, Schwartz SL. Static magnetic field therapy for symptomatic diabetic neuropathy: a randomized, double-blind, placebo-controlled trial. In: Arch Phys Med Rehabil, 2003;84(5):736-746.
  39. Holcomb RR, Worthington WB, McCullough BA, McLean MJ. Static magnetic field therapy for pain in the abdomen and genitals. In: Pediatr Neurol, 2000;23(3):261-264.
  40. Panagos A, Jensen M, Cardenas DD. Treatment of myofascial shoulder pain in the spinal cord injured population using static magnetic fields: a case series. J Spinal Cord Med 2004;27(2):138-142.
  41. Trock DH, Bollet AJ, Markoll R. The effect of pulsed electromagnetic fields in the treatment of osteoarthritis of the knee and cervical spine. Report of randomized, double blind, placebo controlled trials. J Rheumatol 1994;21 (10):1903-1911.

Cite this article: Mohamed Salaheldien Alayat, Mohamed Mohamed Ibrahim Ali, Amir Abdel Raouf El Fiky, Mansour Abdullah Alshehri. EFFICACY OF PULSED ELECTROMAGNETIC FIELD ON PAIN AND FUNCTION IN CHRONIC MECHANICAL NECK PAIN: A RANDOMIZED CONTROLLED TRIAL. Int J Physiother Res 2017;5(2):1930-1936. DOI: 10.16965/ijpr.2017.105