Magnets

Chapter 16 Magnets





CASE


Susan is a 21-year-old female student and singer who presents with a gradual onset (approximately 1 year) of pain in both sides of her jaw, clicking when opening her mouth very wide, and “cracking” in her neck. More recently, Susan is experiencing numbness in the left TMJ region when singing. She was referred to a physical therapist by her dentist. Upon examination by a physical therapist, it is determined that Susan has musculoskeletal impairments consistent with temporomandibular joint (TMJ) syndrome. After two sessions of standard physical therapy the therapist decides to add static magnets to Susan’s plan of care.



image Initial Examination


Medical History: Right wrist fracture 3 years ago; extraction of four wisdom teeth 1 week ago


Client Report: The client’s primary complaint is pain in the TMJ region bilaterally, clicking at end range opening of opening her mouth, and “cracking” in the neck. She denies episodes of jaw locking. Susan reports that her dentist made an intraoral splint to address her complaints and then referred her to physical therapy.


Client Goals: Eliminate pain and increase mouth opening


Employment: Receptionist involving computer entry; student


Recreational Activities: Church choir


General Health: Good


Medications: None


Musculoskeletal: Posture and alignment: forward head alignment, rounded shoulders with increased lumbar lordosis. Left shoulder, eye, and cheek bone higher on the right. With teeth closed, mandible was slightly deviated to the left. ROM: Cervical AROM limited in lateral flexion right 0 to 30 degrees, lateral flexion left 0 to 35 degrees, rotation right 0 to 65 degrees, rotation left 0 to 40 degrees. Mandibular depression was limited to 25 mm of opening with a slight deviation to the left. Lateral mandibular deviation was asymmetrical: 7 mm right, 13 mm left; protrusion was WNL with a slight deviation to the left. A mild click was noted in the left TMJ at the end of opening. AROM in both UE’s was WNL. TMJ loading was negative for reproduction of symptoms.


Palpation: Trigger nodules and pain were noted at suboccipitals, cervical paraspinals L > R, left masseter, left internal pterygoid, and mylohyoid bilaterally. Tenderness was noted upon external palpation of the TMJ bilaterally with teeth together and apart.


Neuromuscular: Force generation: Bilateral upper extremities=4+/5 throughout; cervical musculature=4+/5, with the exception of the right sternocleidomastoid=3/5. (See Function for pain status.)


Function: Jaw pain has interfered with singing and eating.


Pain: Jaw pain, at rest=2-3/10; when singing and eating=4-5/10





After a total of five sessions, the client subjectively reports a “100%” improvement in her condition. She has no complaints of the pain (0/10) that she had been experiencing for a year and is now able to eat and sing without discomfort (pain=0/10). The client presents an improved posture as compared with the initial examination and she appears to be concentrating on correcting her forward head alignment tendency. With the teeth closed, mandibular alignment is only very slightly deviated to the left and mandibular depression is increased to 40 mm of opening. Lateral mandibular deviation is only slightly asymmetrical, with more deviation to the right. Cervical muscular strength was 5/5 and cervical active range of motion was within normal limits throughout.



INVESTIGATING THE LITERATURE


The therapist uses two strategies to investigate the literature. The first is a detailed approach in which preliminary reading is performed on magnets. This may be especially important for therapists unfamiliar with the proposed therapeutic benefits of magnets and the theories or principles that underlie their use in medicine and rehabilitation. Background reading is then followed by a search of the databases for critical reviews and primary research reports on magnets and pain. A second strategy is to use the PICO format for a focused search to answer the clinical question generated by the case.



Preliminary Reading


Books about the healing and therapeutic effects of magnets can be found in libraries, in bookstores, and on various consumer websites.15 Magnetic therapy includes a variety of approaches, which can be divided into electromagnetic or pulsed fields (PEMF) and static magnetic fields (SMF). PEMF requires an electronic circuit or power source to alter electromagnetic fields and has been demonstrated to facilitate a variety of biological effects.2 SMFs are produced by strong static magnets of varying size, polarity, and strength, which do not require an electrical current. In Susan’s case the therapist added static magnets to her plan of care, so the preliminary readings and literature reviews will focus on this type of magnet therapy.



History


The history of magnet therapy dates back thousands of years, although the use of static magnets for health and healing is classified as a complementary approach of energy medicine by the National Center for Complementary and Alternative Medicine (NCCAM). The Yellow Emperor’s Book of Internal Medicine,6 recorded around 2000 bc and considered to be the world’s earliest medical textbook, describes the application of lodestone, the Earth’s only natural magnet, to the body’s energy channels or meridians to treat imbalances. Vedas, the religious scriptures of the Hindus, is another ancient text that includes descriptions of using instruments such as a siktavati or ashmana for healing. Both devices are thought to have been made of lodestone.3,4 Ancient Greeks and Egyptians also have provided evidence through their writings and drawings of their belief in the healing properties of magnets and their use of magnets in treating a variety of disorders.2


In the sixteenth century, a Swiss physician by the name of Paracelsus proposed an interconnectedness between the mind and body through a life force that he called “archaeus.” According to Paracelsus, this life force or energy was influenced by the forces found in magnets. Magnets could therefore be used to treat illness and promote self-healing. Paracelsus used magnets to treat a wide range of ailments, including inflammation, bleeding, diarrhea, and epilepsy. He also had developed ways of preparing lodestones for different client applications and conditions.3,4


During the next century, William Gilbert, physician to Queen Elizabeth I, perpetuated the use of magnets to promote health and treat illness. He described in his book, De Magnete, the differences between static electricity, magnetism, and electricity.7 Gilbert suggested that the Earth is a giant magnet, and within his text explained the directions of the Earth’s magnetic lines of force and the compass variations they create.7


By the middle of the eighteenth century, carbon-steel magnets were readily available in Europe, and the public’s interest in the healing properties of magnets grew. Maximilian Hell, a Hungarian-born Jesuit priest and astronomer, shaped magnets to resemble structures of the body that needed treatment and offered magnetism to clients with good results. Hell’s ideas and work significantly influenced Franz Anton Mesmer, a colorful physician and scientist who was trained in medicine, mathematics, and law. Like Paracelsus, Mesmer believed in a universal life force and coined the term “animal magnetism” to describe this force in living creatures. Energy concentrated in magnets was defined as mineral magnetism. Mesmer suggested that bodily fluids possessed polarity and that misalignment of these negatively and positively charged poles could result in illness.8 Mesmer used external magnetic (mineral) forces in addition to animal magnetism emitted from his hands to cure clients from a variety of ailments, including deafness and seizures. Mesmer also believed he could “magnetize” water, wood, almost anything, with his own animal magnetism and that mineral magnets enhanced conduction of universal energy from his hands to the client.4 Although Mesmer was popular with the general public and treated many clients, the medical community was critical of his work and findings. They successfully portrayed animal and mineral magnetism as nothing more than a sham. Medical authorities advised the public that magnetic healing was due simply to the power of suggestion and was not the result of an observable or measurable biological process.


As Mesmer’s popularity in Europe faded, interest in magnet therapy grew in the United States. In 1795 Elisha Perkins, a physician from Connecticut, got a patent for his “magnetic tractor,” a magnetic device that could remove the cause of an illness by drawing out noxious energy.4 Perkins was able to convince three medical facilities in the United States and surgeons of the Royal Frederick Hospital in Copenhagen that the magnetic tractor had healing properties and eventually reported 5000 cured cases. The Connecticut Medical Society, however, determined the tractors to be nothing more than a sham.9 Proponents of magnet therapy and makers of magnetic products including hats, belts, and insoles continued into the early twentieth century with little support from the established medical community (Figure 16-1). After the successes of antibiotic therapy and advances of surgical procedures, magnet therapy moved even further into the shadows of quackery. Now, in the twenty-first century, magnet therapy has once again gained some interest, mainly for chronic conditions and disorders that have not been addressed adequately by standard medical interventions.




Current Use


The United States Food and Drug Administration (FDA) requires that manufacturers of medical devices receive marketing clearance from the FDA before the devices may be put on the market for purchase or use. To date, the FDA has not cleared static magnets for any medical use, which makes it illegal for magnet manufacturers to advertise that magnets can be used for medical purposes. Nonetheless, magnets are sold and marketed widely in drug stores, in health food stores, and through on-line vendors and direct mail. Costs can range from a few dollars to thousands, depending on the strength of the magnet and the type of product.


Lack of FDA approval has not prevented physicians and other health care professionals from writing books on the use and health benefits of magnets. Although most contemporary authors warn readers that acute or undiagnosed illness or pain requires an examination by a physician and that magnet therapy will not “cure” disease and illness, they have suggested that static magnets be used in combination with other modalities to promote health and healing. In particular, most authors suggest that static magnets are an effective modality for treating a range of pain conditions arising from arthritis, tension, carpal tunnel syndrome, sciatica, post-polio syndrome, fibromyalgia, traumatic injuries, and unknown etiologies.15 Anecdotal reports and endorsements for the use of static magnets for other conditions such as depression1,3,5 and hypertension3,5 also can be found in texts about magnetic therapy. Precautions for the use of magnets therapy include the following:








Although some authors have attempted to report on the scientific literature that supports the application of static magnets in a variety of conditions, details such as research design and study limitations have not been well described.3,5 In addition, many of the papers and conference reports purported to support the application and positive outcomes of static magnets have not been published in peer-reviewed journals. Research studies that have been published in scientific journals are reviewed in the section on searching the databases later in this chapter.


Mar 11, 2017 | Posted by in MANUAL THERAPIST | Comments Off on Magnets

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