Short-Term Efficacy of Peripheral Magnetic Stimulation in Reducing Pain in Knee Osteoarthritis: A Randomized Controlled Trial


  • Apisara Keesukphan Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ramathibodi Hospital Mahidol University
  • Thitiporn Phakdepiboon Department of Physical Medicine and Rehabilitation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok
  • Apiphan Iamchaimongkol Department of Physical Medicine and Rehabilitation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok


repetitive peripheral magnetic stimulation, knee osteoarthritis, myofascial pain syndrome


Objectives: To investigate the short-term efficacy of repetitive peripheral magnetic stimulation (rPMS) on pain reduction in knee osteoarthritis.

Study design: Randomized controlled trial.

Setting: Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Subjects: Knee osteoarthritis patients with Kellgren-Lawrence classification (KL) 2-4 and Visual analog scale (VAS) > 4.

Methods: Participants were allocated into two groups. The rPMS group received 6,000 pulses of magnetic stimulation of the knee joint at a frequency of 20 Hertz for one session, and the sham group received a sham stimulation for one session. All the participants received conventional treatment. The result was measured by VAS and the Thai version of the modified Western Ontario and McMaster Universities Arthritis Index (WOMAC) score.

Results: The KL 2, 3, and 4 grades of the 30 participants, average age 62.83 years (SD 6.38), were 16, 11, and 3, respectively. The median (Q1, Q3) decrement of VAS between baseline and immediately after treatment and between baseline and one week after treatment of the rPMS group were 47 (38, 59) and 21 (9, 46). The median (Q1, Q3) decrement of VAS between baseline and immediately after treatment and between baseline and one week after treatment of the sham group were 41 (29, 50) and 17 (3, 30). The median (Q1, Q3) decrement of modified WOMAC between baseline and one week after treatment of rPMS and sham group were 25 (7, 53) and 2 (1, 15). The study found improvement of VAS and modified WOMAC in both groups, but the change in VAS was not statistically significant while modified WOMAC in the rPMS group showed statistically significant.

Conclusions: rPMS provides no significant additional therapeutic effect in a short-term improvement of pain in primary knee osteoarthritis patients compared with sham treatment.


Kuptniratsaikul V, Tosayanonda O, Nilganuwong S, Thamalikitkul V. The epidemiology of osteoarthritis of the knee in elderly patients living an urban area of Bangkok. J Med Assoc Thai [Internet]. 2002 [cited 2019 Jan 4];85:154-61. Available from:

Hussain SM, Neilly DW, Baliga S, Patil S, Meek R. Knee osteoarthritis: a review of management options. Scott Med J [Internet]. 2016 [cited 2019 Jan 4];61:7-16. Available from: doi: 10.1177/0036933015619588

Mahir L, Belhaj K, Zahi S, Azanmasso H, Lmidmani F, El Fatimi A. Impact of knee osteoarthritis on the quality of life. Annals of Physical and Rehabilitation Medicine [Internet]. 2016 [cited 2019 Jan 4];59:e159. Available from: doi: 10.1016/

Bagnato GL, Miceli G, Marino N, Sciortino D, Bagnato GF. Pulsed electromagnetic fields in knee osteoarthritis: a double blind, placebo-controlled, randomized clinical trial. Rheumatology (Oxford) [Internet]. 2016 [cited 2019 Jan 4];55:755-62. Available from: doi: 10.1093/rheumatology/kev426

Ciombor DM, Aaron RK, Wang S, Simon B. Modification of osteoarthritis by pulsed electromagnetic field--a morphological study. Osteoarthr Cartil [Internet]. 2003 [cited 2019 Jan 4];11:455-62. Available from: doi: 10.1016/s1063-4584(03)00083-9

Kanjanapanang N, Chang K-V. Peripheral Magnetic Stimulation (Transcutaneous Magnetic Stimulation) [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 [cited 2019 Jan 4]. Available from:

Beaulieu L-D, Schneider C. Repetitive peripheral magnetic stimulation to reduce pain or improve sensorimotor impairments: A literature review on parameters of application and afferents recruitment. Neurophysiol Clin [Internet]. 2015 [cited 2019 Jan 4];45:223-37. Available from: doi: 10.1016/j.neucli.2015.08.002

Lim Y-H, Song JM, Choi E-H, Lee JW. Effects of repetitive peripheral magnetic stimulation on patients with acute low back pain: a pilot study. Ann Rehabil Med [Internet]. 2018 [cited 2019 Jan 4];42:229-38. doi: 10.5535/arm.2018.42.2.229

Zarkovic D, Kazalakova K. Repetitive peripheral magnetic stimulation as pain management solution in musculoskeletal and neurological disorders - a pilot study. International Journal of Physiotherapy [Internet]. 2016 Dec 1 [cited 2019 Jan 18];3(6). Available from:

Kim J, Yoon SH, Rah UW, Cho KH, Hong J. Effect of repetitive magnetic stimulation and transcutaneous electrical nerve stimulation in chronic low back pain: a pilot study. Journal of the Korean Academy of Rehabilitation Medicine [Internet]. 2010 [cited 2019 Jan 4];34:725-9. Available from:

Lo YL, Fook-Chong S, Huerto AP, George JM. A randomized, placebo-controlled trial of repetitive spinal magnetic stimulation in lumbosacral spondylotic pain. Pain Med [Internet]. 2011 [cited 2019 Jan 4];12:1041-5. Available from: doi: 10.1111/j.1526-4637.2011.01143.x

Massé-Alarie H, Flamand VH, Moffet H, Schneider C. Peripheral neurostimulation and specific motor training of deep abdominal muscles improve posturomotor control in chronic low back pain. Clin J Pain [Internet]. 2013 [cited 2019 Jan 4];29:814-23. Available from: doi: 10.1097/AJP.0b013e318276a058

Massé-Alarie H, Beaulieu L-D, Preuss R, Schneider C. Repetitive peripheral magnetic neurostimulation of multifidus muscles combined with motor training influences spine motor control and chronic low back pain. Clin Neurophysiol [Internet]. 2017 [cited 2019 Jan 4];128:442-53. Available from: doi: 10.1016/j.clinph.2016.12.020

Smania N, Corato E, Fiaschi A, Pietropoli P, Aglioti SM, Tinazzi M. Therapeutic effects of peripheral repetitive magnetic stimulation on myofascial pain syndrome. Clin Neurophysiol [Internet]. 2003 [cited 2019 Jan 4];114:350-8. Available from: doi: 10.1016/s1388-2457(02)00367-x

Smania N, Corato E, Fiaschi A, Pietropoli P, Aglioti SM, Tinazzi M. Repetitive magnetic stimulation: a novel therapeutic approach for myofascial pain syndrome. J Neurol [Internet]. 2005 [cited 2019 Jan 4];252: 307-14. Available from: doi: 10.1007/s00415-005-0642-1

Pujol J, Pascual-Leone A, Dolz C, Delgado E, Dolz JL, Aldomà J. The effect of repetitive magnetic stimulation on localized musculoskeletal pain. Neuroreport [Internet]. 1998 [cited 2019 Jan 4];9:1745-8. Available from: doi: 10.1097/00001756-199806010-00014

Haefeli M, Elfering A. Pain assessment. Eur Spine J [Internet]. 2006 [cited 2019 Jan 4];15:S17-24. Available from: doi: 10.1007/s00586-005-1044-x

Kuptniratsaikul V, Rattanachaiyanont M. Validation of a modified Thai version of the Western Ontario and McMaster (WOMAC) osteoarthritis index for knee osteoarthritis. Clin Rheumatol [Internet]. 2007 [cited 2019 Jan 4];26:1641-5. Available from: doi: 10.1007/s10067-007-0560-y

Thai Rheumatism Association. Guideline for the Treatment of Osteoarthritis of Knee [Internet]; 2553 [cited 2019 Jan 18]. Available from:

Beaulieu LD, Schneider C. Effects of repetitive peripheral magnetic stimulation on normal or impaired motor control: a review. Neurophysiol Clin [Internet]. 2013 [cited 2019 Jan 4];43(4):251-260. Available from: doi: 10.1016/j.neucli.2013.05.003

Lee D-Y, Nam S-M. Effects of Repetitive Peripheral Magnetic Stimulation and Exercise on Pain, Leg Muscle Strength, and WOMAC index in Knee Osteoarthritis Patients. J Magn [Internet]. 2021 [cited 2023 Jan 30];26:341-6. Available from: doi: 10.4283/JMAG.2021.26.3.341

Tubach F, Ravaud P, Baron G. Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: the minimal clinically important improvement. Ann Rheum Dis [Internet]. 2005 [cited 2019 Jan 4];64:29-33. Available from: doi: 10.1136/ard.2004.022905

Bellamy N, Hochberg M, Tubach F, Martin‐Mola E, Awada H, Bombardier C, et al. Development of Multinational Definitions of Minimal Clinically Important Improvement and Patient Acceptable Symptomatic State in Osteoarthritis. Arthritis Care & Research [Internet]. 2015 [cited 2019 Jan 4];67(7):972-80. Available from: doi: 10.1002/acr.22538






Original Article