Pulsed Electromagnetic Field (PEMF)

Chang et al. (Medicina, 2026; PMID 42075549): 9 randomized trials, 457 patients with knee osteoarthritis; no significant improvement in VAS pain or total WOMAC at one month, WOMAC pain better only at 18 to 21 days, stiffness and daily activity better only at one month, objective function unchanged, overall risk of bias high. Chen et al. (J Rehabil Med, 2019; PMID 31583420): 8 sham-controlled trials, 421 patients; function score improved, no advantage on WOMAC pain, VAS pain or stiffness. Wu et al. (BMJ Open, 2018; PMID 30552258): 12 sham-controlled trials; pain and function improved in knee and hand osteoarthritis, not cervical. Yang et al. (Phys Ther, 2020; PMID 32251502): 15 placebo-controlled trials across osteoarthritis sites; pain standardized mean difference 1.06, the strongest positive synthesis, including non-knee sites. Vigano et al. (Cartilage, 2021; PMID 32508140): 13 trials, 914 patients; short-term pain benefit against placebo, activity scores not significant, not superior to other conservative therapies, effect shrinking with follow-up. Lau et al. (J Cachexia Sarcopenia Muscle, 2026; PMID 41588476): 60 patients with refractory mild to moderate knee osteoarthritis, double-blind sham-controlled, 30 minutes three times a week for 8 weeks, publicly funded; knee extension torque higher at 6 months, no difference in WOMAC, 6-m walk, 30-second chair stand, lean mass, cartilage thickness or joint space. Grade C: inconsistent pooled self-reported results, heterogeneous devices.