Intervertebral disc degeneration has few effective treatments that target the underlying mechanisms of the condition. Many non-invasive approaches such as acupuncture, physical therapy, chiropractic care, or medications can help manage symptoms. However, surgery is often the only option offered to more definitively address the underlying problem. This may be due to the complex nature of disc degeneration, which is heavily intertwined with inflammation and the aging of the disc. Yet Pulsed Electromagnetic Field (PEMF) therapy, a technology that has been used successfully to treat other health issues in the past, is now being applied to effectively address the underlying mechanisms of intervertebral disc degeneration in a pain-free and non-invasive manner. What is PEMF, and how can it possibly treat or attempt to resolve disc degeneration?
The “Normal” Spinal Disc
In the spinal column, the discs provide a cushion between the individual bones of the spine, called the vertebra. When we’re young, our discs are plump and moist, providing shock absorption between 33 vertebrae for the up and down motions of walking, running, and other movements. Largely made up of water inside layers of different types of tissues, discs are subject to dehydration, injury, inflammation, and aging among other things.
The inner tissue in a disc is the nucleus pulposus (NP), a jelly-like material that fills the interior space and provides shock absorption. It is surrounded by a tough, dense tissue that is a cross between fibrous connective tissue and cartilage, or “fibrocartilage,” called the annulus fibrosis (AF). The AF layer transitions to the cartilage that is attached to the vertebra both above and below the disc. This helps keep the vertebrae of the spine cohesive as a unit.
The cells of the disc secrete and are surrounded by the extracellular matrix (ECM), which is comprised of a lattice of proteins that provide structural and biochemical support. As with other cell lifecycles in the body, intracellular debris is consumed by a process called “autophagy,” where the debris is broken down and recycled if possible.
As we age, there is a natural tendency for discs to lose their plumpness. This degradation, or desiccation, can allow the disc to become misshapen. The misshapen disc can shrink so that it doesn’t properly cushion, or perhaps causes a bulge in places, allowing it to be pinched by the vertebra above and below it. This situation can be quite painful. At times, a disc can bulge into and compress nerves that are exiting the spine, resulting in nerve pain and/or compromised nerve function.
Understanding the Nature of Intervertebral Disc Degeneration
Although it is still used frequently as a generic term, “degenerative disc disease” is a little misleading. It causes people to assume that there is a disease that is degenerative, meaning an illness that continues to get worse. The “degenerative” part refers to the breakdown of physical structures in the spinal discs rather than an illness that continues to degenerate (1). Some people prefer using the term “Intervertebral Disc Degeneration,” since it leaves out the potentially misleading word “disease.” Regardless, “disc degeneration” is a general term that encompasses the natural, age-related processes that lead to the breakdown of the disc such as drying out, thinning, or cracking (1, 2) which, in turn, can cause pain.
Closer scrutiny of disc degeneration in various studies shows that some of the underlying processes involved are (3):
dysregulation in the extracellular matrix, (breakdown of the proteins or lack of creation of ECM)
changes in the process of cellular death and aging
an increase in the breakdown of tissue
Two big contributors to disc degeneration are extracellular matrix dysregulation, and changes in the aging of the cell. These are important because PEMF therapy acts on both of these. Before we get into the nitty-gritty details of how PEMF therapy acts on these underlying mechanisms of intervertebral disc degeneration, let’s review what PEMF therapy is.
What is PEMF therapy?
The acronym “PEMF” stands for “Pulsed Electromagnetic Field.” PEMF devices can deliver bursts of low-level electromagnetic energy through the skin, with the ability to reach the underlying muscles, tendons, bones, intervertebral discs, and even organs. Different devices have different ways to deliver electromagnetic pulses to a specific body part, such as paddles or pads. Previous studies had shown that these invisible PEMF waves successfully treated such conditions as chronic wounds and broken bones that were not growing back together (4) and PEMF devices have been in use since the 1970s.
What is notable about electromagnetic energy is that it can be directed into human tissue in a non-invasive way, without generating heat or negatively affecting muscle function. Indeed, there are very few, rare side effects, while study after study shows positive outcomes for a variety of conditions, including pain and inflammation (4).
The sensations generated by the PEMF devices can differ amongst people. However, if something can be felt during a session, it might be interpreted as tingling or buzzing. Considering the pain-free treatments, positive outcomes, and low level of risk for negative outcomes, over time PEMF has been studied as a remedy for more and more conditions. Not only that but studies have been directed at understanding the mechanisms of action the PEMF employed to achieve positive results.
PEMF Repairs the Extracellular Matrix (ECM) of the Disc and Prevents Further Degeneration
One mechanism of action discovered was the ability of PEMF to increase the creation of ECM. Remember the extracellular matrix of protein that gets broken down in intervertebral disc degeneration? PEMF encourages ECM creation! This directly reverses a physiological mechanism that underlies disc degeneration. Studies outside of the body (in vitro) and inside mammal bodies (in vivo) both reflected this amazing ability (3). Not only that, there is evidence that short-term treatments can arrest or inhibit the degeneration of a disc (3).
PEMF Positively Impacts Cell Aging
As cells age, parts of the cell can begin to malfunction. That’s when a process called “autophagy” kicks in. Autophagy means “self-eating,” which describes how the cell destroys the failing part of the cell and recycles or consumes (eats) the failing part if it can. Sessions of PEMF encourage cells to address their failing parts through increased autophagy (3), allowing a renewal to occur. This can prolong the life of the cell, making it healthier and allowing it to live longer. Some might even say it reverses or slows the aging of the cell.
You can see that combining a repair of the ECM with prolonging the health of cells is a powerful combination for addressing two of the hallmarks of intervertebral disc degeneration. However, that’s not all PEMF therapy can do!
There are numerous documented positive effects of PEMF therapy, such as (4):
reducing post-operative pain and swelling
reducing the pain of whiplash
increasing range of motion
increasing blood flow (in both diabetic and non-diabetic people)
reducing lymphedema (reduces a build-up of lymph fluid)
reducing inflammation (5)
PEMF therapy is extremely versatile, unlikely to cause pain, and non-invasive. When applied to intervertebral disc degeneration, it can alleviate pain and address the mechanisms of disc degeneration in a very direct way. For some, it may make the difference between being bedridden from pain and leading an active life. If you have suffered from back pain that you think may be disc degeneration, please do not hesitate to make an appointment for an evaluation. PEMF may be the healing alternative you’ve been looking for.
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
Columbia University Irving Medical Center. Degenerative Disc Disease. Retrieved July 26, 2022 from https://www.neurosurgery.columbia.edu/patient-care/conditions/degenerative-disc-disease
Cleveland Clinic. Degenerative Disk Disease. Retrieved July 26, 2022 from https://my.clevelandclinic.org/health/diseases/16912-degenerative-disk-disease
Zheng Y, Mei L, Li S, Ma T, Xia B, Hao Y, Gao X, Wei B, Wei Y, Jing D, Luo Z, Huang J. Pulsed Electromagnetic Field Alleviates Intervertebral Disc Degeneration by Activating Sirt1-Autophagy Signaling Network. Front Bioeng Biotechnol. 2022 Mar 21;10:853872. doi: 10.3389/fbioe.2022.853872. PMID: 35387300; PMCID: PMC8978825.
Strauch B, Herman C, Dabb R, Ignarro L, Pilla A. Evidence-Based Use of Pulsed Electromagnetic Field Therapy in Clinical Plastic Surgery, Aesthetic Surgery Journal, Volume 29, Issue 2, March 2009, Pages 135–143, https://doi.org/10.1016/j.asj.2009.02.001
Aguida B, Pooam M, Ahmad M, Jourdan N. Infrared light therapy relieves TLR-4 dependent hyper-inflammation of the type induced by COVID-19. Communicative & Integrative Biology, March 2021, 14:1, pages 200-211.