Pulsed electromagnetic fields (PEMFs) in complex regional pain syndrome type I (CRPS-I) of the foot: a randomised controlled trial

This small RCT randomized 32 patients with chronic CRPS-I of the foot or ankle (all previously treated with IV neridronate but still symptomatic) to either standard rehabilitation exercise alone or the same exercise plus a home pulsed electromagnetic field device (I-One, 4h/day for 60 days). Over 12 months of follow-up, both groups improved from baseline, but the PEMF group had significantly greater reductions in pain (VAS 1.8 vs 5.5 at 12 months), better AOFAS scores (89 vs 64), and more resolution of allodynia and hyperalgesia. Oedema and NSAID use improved in both groups without significant between-group differences at most timepoints.

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersCRPS-I of the foot/ankle is a difficult, disabling condition with limited proven adjuncts, so evidence about a home-use, non-invasive PEMF device is relevant to orthopedic and rehabilitation practice even though this trial is small and unblinded.

Presenting this at rounds? Start here

• ?If a patient remains symptomatic with CRPS-I pain (VAS ≥5) after IV neridronate, would you now add a home PEMF device to their rehabilitation plan, and how would you counsel them about the strength of the evidence?
• ?Given that oedema and NSAID use did not differ significantly between groups, would you use PEMF specifically to target pain and allodynia rather than as a broad anti-inflammatory therapy?