open access

Abstract

PEMF can be understood to mean either Pulsed Electro-Magnetic Fields or Pulsed Electro-Magnetic Frequency, and goes by several other names as well (1). Electro-medicine, and by association PEMF, has been marginalized as “quackery” ever since the publication of the Flexner Report of 1910 (2). Thus, PEMF is both confusing and controversial. As PEMF rapidly grows in popularity, people often ask:

Can you show me a scientific paper that proves that PEMF really works?

Can you tell me the specific health benefits of PEMF?

Is there a paper or a book or a web page that explains exactly how PEMF works? What PEMF (device, product, or protocol) works best for (a disease or condition)?

The short and honest answer is that we do not have simple answers for any of these questions, even after more than half a century of PEMF research. PEMF has been approved by the FDA (3) for several different conditions, so by definition the FDA must view these devices as safe and effective for at least the approved indications. So, where are the clear answers? There are indeed many papers and books on the topic of PEMF, but to the non-specialist they seem strangely incoherent in a sea of deafening confusion. Even with a body of scientific literature amounting to about a thousand papers affirming the effectiveness of PEMF for a wide range of conditions, and with FDA-approved devices on the market, PEMF still remains widely discounted as pseudo-scientific nonsense. This arises in part from the Flexner Report that resulted in the marginalization of most forms of alternative medicine and the closure of all colleges in electrotherapy (4), and in part due to the incoherence of the scientific and clinical research within the modern scientific field of PEMF itself. With the resurgence of interest in PEMF comes an opportunity to correct the historical mistakes that have handicapped the entire field for many decades.

Introduction

PEMF can be understood to mean either Pulsed Electro-Magnetic Fields or Pulsed Electro-Magnetic Frequency, and goes by several other names as well (1). Electro-medicine, and by association PEMF, has been marginalized as “quackery” ever since the publication of the Flexner Report of 1910 (2). Thus, PEMF is both confusing and controversial. As PEMF rapidly grows in popularity, people often ask:

Can you show me a scientific paper that proves that PEMF really works?

Can you tell me the specific health benefits of PEMF?

Is there a paper or a book or a web page that explains exactly how PEMF works? What PEMF (device, product, or protocol) works best for (a disease or condition)?

The short and honest answer is that we do not have simple answers for any of these questions, even after more than half a century of PEMF research. PEMF has been approved by the FDA (3) for several different conditions, so by definition the FDA must view these devices as safe and effective for at least the approved indications. So, where are the clear answers? There are indeed many papers and books on the topic of PEMF, but to the non-specialist they seem strangely incoherent in a sea of deafening confusion. Even with a body of scientific literature amounting to about a thousand papers affirming the effectiveness of PEMF for a wide range of conditions, and with FDA-approved devices on the market, PEMF still remains widely discounted as pseudo-scientific nonsense. This arises in part from the Flexner Report that resulted in the marginalization of most forms of alternative medicine and the closure of all colleges in electrotherapy (4), and in part due to the incoherence of the scientific and clinical research within the modern scientific field of PEMF itself. With the resurgence of interest in PEMF comes an opportunity to correct the historical mistakes that have handicapped the entire field for many decades.

Background

Two decades ago I was hired as a consultant for NASA to design and build PEMF systems for use in biological research at the Johnson Space Center in Houston. The data from this study was compelling (5). Though initially I was a stern skeptic, since then I have been researching, writing, and speaking on the topic of PEMF. Most of the emails I get every day, for many years now, are from people asking about PEMF, and their questions refer to a very wide range of health conditions. These emails are not just from the afflicted but also from their caregivers, including clinicians. Most people do not ask me for medical advice; they know I cannot offer that. People share their personal stories with me as a prelude to their urgent requests for reliable information on PEMF. I am not a clinician, so with my professional training as a scientist I was utterly unprepared for this vast unmet human need. As a scientist trained to focus on one problem at a time, I have been absolutely stunned by the diversity and severity of health conditions for which mainstream medicine has no adequate treatment.

In his recent book Rigor Mortis (6), Richard Harris has pointed out that there are about 7000 recognized medical conditions, that mainstream medicine only offers treatments for about 500 of these, and that many of these treatments offer only marginal benefit. And it is not just the “exotic” diseases for which we lack treatments and cures. Chronic pain, the most widespread medical condition of all, with nearly 1 in 3 adults in its grip, has no satisfactory treatments within mainstream medicine (7). Increasingly, PEMF is viewed by many as a safe and effective alternative to ineffective and dangerous mainstream medical treatments for chronic pain that have given rise to, among other problems, the opioid epidemic.

Many people have researched PEMF for hundreds of hours by the time they contact me, and most confess that they feel more confused about PEMF than when they started. This is true even for clinicians. There is a clear need for reliable information about PEMF, as there is for more, better, and deeper health information in general. “See your doctor” is not helpful advice for the legions of afflicted who have already been written off by their physician and ejected from the mainstream medical system. I understand this all too well. As a sufferer of untreatable chronic pain, I was eventually ejected from the system as a “drug seeker”. This is the note I saw scribbled in my medical file years ago, back when those were still kept on paper. I had been seeking relief for a serious back injury sustained as a firefighter on a rescue call in Durham, NC. The prescribed treatment: bed rest and oxycodone. Seeking durable relief from the ceaseless crippling pain, I was eventually ejected from the mainstream medical system. Therefore, I stand firmly with those who are underserved and abandoned by mainstream medicine. For me, this is not a theoretical discussion. As we say here in the South, I have a dog in the fight. Fortunately for me, my earlier research for NASA on TVEMF (PEMF) allowed me to begin an intense program of scientific research and technology development spanning two decades on PEMF. Now drug and (mostly) pain free, I would like to share my findings.

A Very Brief History of PEMF

While PEMF goes by several names, including PMF, PEMFT, TVEMF, and TMS, the original references to these seem to originate in the modern scientific literature that stems from a Nature paper in November

1964 (8), in which implanted devices were used to promote bone growth by applying microcurrents. This paper references a very few earlier works involving the use of directly applied electric micro-currents in biology, published in Japan in the late 1950’s, which appear to be the very beginnings of the use of micro-currents for the treatment of bone tissue injuries, though there are unsubstantiated references to the use of electricity in an attempt to aid bone healing as early as 1841 (9). Thereafter, the same authors (Bassett et al.) along with Arthur Pilla published a paper in Science in 1974 (10) in which they used inductively coupled pulsed electro-magnetic fields, not direct electrical stimulation, to overcome the problems posed by direct electrical stimulation.

This is the intellectual leap of PEMF over direct electrical stimulation: Inductive coupling by means of electro-magnetic pulses can use non-invasive coils of wire, external to the skin, to transmit electro- magnetic energy effortlessly through skin and other intervening tissues to reliably deliver energy and information signals to deep tissues. This was the crucial technological step away from using directly- applied electrical current by means of conduction, to using the much safer and more efficient indirectly applied electrical current by means of electromagnetic induction (11).

At about the same time, scientific interest in PEMF took hold in Eastern Europe. A book by Jerabek and Pawluk in 1998 (12) comprehensively reviews the early PEMF literature from this scientifically-isolated region, because most of the research was done by scientists that were at the time living and working in Eastern Bloc countries behind the Iron Curtain of the Cold War. For this reason, and the obvious language barriers, this work was largely overlooked by researchers in the West. In this body of work the earliest reference to what we now know as PEMF was from 1969.

The number of references to PEMF in the scientific literature in the West started to increase sharply in the mid 1970’s. Interest in PEMF was widespread by the 1980’s, and since then, there has been a steady increase in the rate of publication of scientific papers on PEMF, with numbers beginning to increase very rapidly in the 21st century. The beneficial effects of PEMF have been demonstrated so many times in so many ways, and have been published in virtually all possible scholarly and clinical formats, that it is no longer reasonable to discount PEMF out-of-hand as nonsense. The Flexnerian (13) notion of electro- medicine as simple quackery is simply wrong.

Current Status and Uses of PEMF

If it were any other topic more acceptable to the mainstream, PEMF would already be firmly established and widely accepted science. In his 2017 book Power Tools for Health (14), Dr. Pawluk cites more than 500 published scientific references on PEMF, about half of these being published in the 21st century. The scope of our rapidly growing knowledge of PEMF can be seen in the titles of the various sections of this book. Pawluk lists 25 basic classes of biological treatments and effects (15) of PEMF, and then 45 different classes of diseases and conditions (16), and their treatment with PEMF, each supported by published research. It is important to note that in many cases these were classes of diseases, not just specific diseases. One class of disease was listed simply as “Cancer”, another as “Pain Management”, and just these two alone cover many diverse specific medical conditions. It is clear from this list that PEMF may be beneficial for many hundreds of individual diseases, when one considers specific conditions, not just classes of disease, and the fact that clinical experience supports the use of PEMF for many conditions for which there is, as yet, no published scientific verification, and as such were not represented on Dr. Pawluk's list. Further, many of the 45 classes of conditions listed by Dr. Pawluk were ones for which mainstream medicine has few, if any, effective treatments. If Richard Harris (17) is correct, and if modern mainstream medicine offers treatments for only about 500 of the 7000 recognized diseases, then it is reasonable to think it might be possible for mainstream medicine to double the number of afflictions for which it has satisfactory treatments, in a single dramatic flourish of wisdom, simply by embracing PEMF. As a student of history, I do not hold my breath.

PEMF is unique in many important ways. It seems to have no discernable adverse effects other than mild ones that dissipate with lower intensity or discontinuance of treatment, and these are very rare in any event. Effective doses of PEMF seem to be below internationally accepted power/frequency levels that are considered safe for human environmental exposure (18), though the safety of many of these environmental electromagnetic fields is now in doubt, especially those unlike PEMF which are at much higher frequency and power than low-frequency clinical PEMF (19). Unlike environmental electromagnetic "smog", clinical PEMF does not seem to cause significant numbers of health complaints.

PEMF also appears uniquely effective in the sense that many of the conditions it treats are not rare, they are tremendous health challenges often afflicting millions, or in some cases billions of people, and these conditions often have no effective mainstream treatments. Perhaps the best example is that PEMF has been shown many times to be effective in the treatment of idiopathic chronic pain, which, according to (20) afflicts about one in three adults, has no effective (mainstream) treatments, has been the driving force behind our current National Health Emergency (the opioid crisis), and costs the United States about $600B per year, or about 3% of the entire US GDP, in lost productivity.

Another startling observation about PEMF often discussed by clinicians but rarely noted in time-limited scientific studies is that the beneficial effects of PEMF seem to linger, long after treatment has stopped. In the few scientific studies where long-term outcomes were reported, the effects of PEMF were shown to last for 16 months (21) to 3 years (22) after cessation of treatment. Such long-term effects are also often discussed, but not formally reported, in the clinical management of pain. With repeated PEMF treatments, people sometimes find that idiopathic pain often simply goes away, never to return. Contrast this with the “pain blocking” strategy employed by mainstream pain management. The fallacy of such an approach is clear: pain is a real signal from the body, and like any real warning signal, it should be heeded, not ignored. Any child could tell you that the proper response to a fire alarm is certainly not to insert ear plugs. PEMF clearly does not simply block pain, or its effects would always fade quickly after cessation of treatment. Any approach to pain that amounts to ignoring the alarm is doomed to fail, and will likely cause much more harm to already injured tissues in the long run than the much wiser approach that addresses the underlying cause of pain, which PEMF evidently does in many cases.

Given the demonstrated safety, the non-invasiveness and effectiveness of PEMF over a wide range of diseases and conditions, the fact that it has no significant side effects, that the complexity and price of PEMF systems has dropped to the point where PEMF is now accessible for in-home use, and the emerging observation that, when used properly, even very severe medical conditions can be permanently mitigated, it is indeed surprising that PEMF is not viewed more favorably. PEMF remains relegated to use as a treatment last resort for very severe conditions with poor prognosis, often only after destructive and irreversible procedures such as back surgery, and yet it has still been deemed effective in many such cases. If assessed fairly, any reasonable person would conclude that PEMF should be considered a treatment of first resort, not last resort.

But not everyone has missed the ball. This emerging opportunity is not lost on big pharma. Glaxo Smith Kline recently set aside $714 M to develop what it calls “electroceuticals” (23). Evidently this electromedicine “quackery” is starting to look like a good investment to those who have an insider’s perspective into the limits of mainstream drugs.

And yet, after about a thousand published scientific reports demonstrating the efficacy of PEMF for a wide range of conditions, and with very strong clinical evidence of the effectiveness of PEMF, the perception of its effectiveness remains “equivocal” in the minds of most clinicians (24), scientists and policy makers. Why is this so? We could point the finger at Flexner, or Big Pharma, or the inertia of mainstream medicine and the narrowness of academic researchers, and all of that probably does contribute, but I feel that a lot of the deficiencies in our understanding of PEMF stem from the highly variable quality of the research that has been published, creating a self-inflicted handicap for the field as a whole. While it is possible, perhaps even likely, that PEMF has been held back by dark conspiracies or groups with hidden agendas, it is useful in this case to recall Hanlon's Razor, which admonishes us to "Never attribute to malice that which is adequately explained by stupidity." And from a practical standpoint, because in either case, there is not much we can do directly to change the entrenched malice or stupidity against PEMF, we should focus on the way PEMF research is carried out and reported, which is something we certainly can improve.

General Problems with the Quality of Scientific Research

Before venturing into this field as a scientific consultant for NASA in 1996, I carefully reviewed over 650 scientific publications that dealt either directly with PEMF or individually with magnetic or electrical micro-stimulation of tissues. For me that turned out to be a very disappointing exercise in the study of a scientific field gone wrong. This was especially true for the papers that focused on PEMF. While on the surface most of these papers blithely reported positive results from the use of PEMF, upon closer examination, it became clear that only a very few papers, less than 3%, had adequate detail in the methods used, specifically the PEMF waveform, to be able to replicate the experiment independently. Thus, I conclude that much of the early literature on PEMF, before about 1996, fails the basic test of scientific replicability. Strictly speaking, it does not really qualify as science.

Should any PEMF nay-sayers feel vindicated, I would like to point out that mainstream medical research has the same deficiency, and it is much more widespread and recent. To begin with, John Ioannidis makes a strong statistical argument to support his assertion that most published research findings are false (25). But beyond the statistical deficiencies, there is a growing realization that we face a vast problem with the basic replicability of medical research in important fields such as cancer. This “replicability crisis” in medical science is widely acknowledged by scientists (26), and when polled, about two thirds or more say they have had trouble replicating some of their own studies (27). Some estimates, based on careful attempts to replicate important studies on cancer, suggest that the replicability for the most important findings, from the leading laboratories, published in the top medical and science journals, is only about 11% (28). In simple terms, this means that if you try to replicate a scientific experiment from the published literature, there is an 89% chance you will not be able to get the same results. Looking at it more bluntly, one could say that published medical research is about 89% unreliable. The problem of course is that we cannot tell which 11% can be trusted, and which 89% cannot. We are faced with the realization that we have no firm basis upon which to form our beliefs when turning to the published scientific literature in any major field within medical research.

Similar studies (29) carried out at the German drug manufacturer Bayer have estimated the scientific replicability of important biomedical research at 25%. While a replicability of 25% is better than 11%, the issue remains deeply alarming. This means that the vast majority of peer-reviewed academic medical research reports simply cannot meet the most basic criterion for science: independent verification, i.e. replicability. Consider that even a child trying the experiment of flipping a coin twice to get the same result will discover that their work has a replicability of 50%. And yet when scientific replicability in the mainstream peer-reviewed literature is critically examined, we find the replicability of the peer-reviewed, top-notch, most modern work in leading domains of medical research is well below 50%. And one such field, cancer, is generally viewed as one of the finest, most reliable, evidence-based fields in all of medicine. If this is the case, then society would be better off to use coin flipping rather than federally sponsored academic research in the search for scientific medical truth.

There seem to be many reasons that have driven the replicability crisis. Chief among them are the perverse incentives in academic research, the pressure to publish and get NIH funding, and the pathologic competitiveness in academia that comes with dwindling resources which leads to a downward spiral in integrity and transparency. Mainstream medical research, unlike any other form of scientific and technological development, is steadily getting worse, less productive, and less reliable over time. People study this phenomenon; it is called Eroom’s Law (30), which is “Moore’s” Law spelled backward. Moore’s law (31) describes the exponential growth in the performance of technologies, such as computers, memory, and everything else we have access to every day. Eroom’s Law, in contrast, describes the unique decrease in performance of medical science and technology year by year, going against the trend of all other technologies, getting less and less productive and useful with each passing year. As but one example: new drug approval rates have fallen steadily since the 1950’s. Perhaps this is a good thing, but this downward spiral in the rate of drug development comes with skyrocketing costs.

This woeful state of affairs in mainstream medical research does present a unique opportunity. Now is the time for researchers in alternative and integrative medicine to acknowledge and learn from these mistakes that plague the mainstream. Let us consider PEMF as a but one instructive case, to see where specific improvements can be made.

Specific Problems with PEMF Research

Among all modern technologies there is a problem unique to PEMF, that has spiraled out of control and caused many additional problems. The problem begins here:

PEMF has no accepted standards. The problem is that the production of PEMF systems as well- characterized scientific instruments for the use by other scientists never really happened. By contrast, research telescopes are built by professional scientists and engineers to incredibly high standards in a field that matured over 3 centuries; microscopes and gene sequencers and other devices used in medical research are typically built to similar standards with clear procedures for testing and calibrating their performance. Technical commercial products typically spin out from this highly mature body of scientific expertise and technology. But PEMF products are different, they are mostly produced by unskilled profiteers seeking to exploit a large, underserved, and desperate market. Most PEMF manufacturers have no scientists on staff (32). Compounding this is the federal over-regulation of PEMF devices, effectively driving them into a black market where science, integrity, quality, and accountability take a second seat to marketing. Honest voices find themselves at a major disadvantage in this environment, and reliable scientific progress using such technologies is nearly impossible.

As a result of the above fundamental problem:

PEMF researchers tend to use whatever PEMF system is readily available, erroneously assuming that PEMF is one single, well-defined thing and that it either works, or it does not work. Consider an analogy: this would be like running a study on vitamins by just using whatever you had handy on the shelf without regard to quality, dosage, purity or even the basic type of vitamin. After testing one random vitamin for one random condition, the erroneous conclusion might be that “vitamins do not work”. It is essential to correlate well-defined PEMF parameters to both verified and disproven clinical effects, and to make comparisons to the relevant mechanisms of health and disease, so that it becomes possible to formulate hypotheses that will allow us to build a very specific understanding of how different types of PEMF might be most useful for different classes of disease. This is wholly lacking in the PEMF literature, only appearing piecemeal, here and there, without coherence. Any knowledge of this is mostly embedded in the minds of skillful and experienced clinical practitioners with decades of experience using different PEMF technologies for a wide range of illnesses. And most of it has never been published.

Inaccurate manufacturer specifications are a great hindrance to the advancement of PEMF as a science. Many of the manufacturer specifications for PEMF products are highly inaccurate, often by a factor of 10 or more. This is especially true when it comes to the advertised power they generate, usually expressed as “peak Gauss”. PEMF manufacturers realize very few people are in a position to challenge their claims, so there seems to be a tacit agreement among PEMF manufacturers to refrain from calling each other out on their performance specifications, and they more or less advertise specifications they believe to be most advantageous in their respective markets. Of equal concern is that PEMF manufacturers do not state, nor even acknowledge, the key performance parameters for PEMF, specifically the details of the PEMF pulse shape. For example, there is no such thing in reality as a “square” pulse. All “square” pulses have a finite slope on both the rising and falling edges of each pulse. And it is the slope and duration of the edges of PEMF pulses that are crucial for understanding their biophysical effects.

The resources to characterize PEMF waveform and performance are not readily available. The reality is that it is very difficult to characterize the electromagnetic parameters of any given PEMF system, so much so that most PEMF manufacturers do not really know what their products do. Such detailed electro-magnetic characterization requires highly specific skills and equipment. This is a major deficiency in PEMF research that we can collectively ameliorate. As I own the equipment and have taken the decades to cultivate the skills required, I offer to the serious PEMF researcher the possibility of a collaborative effort, in which I could render assistance by providing technical support gratis with this aspect of their experiment (33).

And finally, PEMF research is especially subject to a problem that plagues science in general:

The publication of results in PEMF is subject to many forms of bias. Chief among these are publication bias (34) and confirmation bias (35). People, even scientists, are much more likely to publish that which they already believe to be true (confirmation), and journals are much more likely to publish a positive result (when something works) rather than a negative result (something just didn’t work, and, invariably, we are not quite sure why). PEMF has been notoriously unreliable, but to clear up the problem we need complete knowledge of what works as well as what does not work. I estimate, based on discussions with PEMF researchers who withheld or were denied publication of negative results, that these unpublished but important negative results constitute at least 80% of the work in the field of PEMF. That means 80% of what we should know about PEMF never gets published. When the researcher retires or passes on, that information is lost forever. These valuable negative findings need to be reported together, along with positive findings, in comparative studies. Failing this, researchers in the field of PEMF will be doomed to eternally repeating, then not publishing, most of the important information they have discovered: findings which show clearly the difference between that which works well, and that which does not work well. In the span of time during which I wrote this letter, three different PEMF researchers have told me that they had decided to refrain from publishing their results because they “did not see what they wanted to see”. In each case I know their results to be important. In each case they shed light on PEMF from different angles. But my exhortations to publish fall on ears deafened by bias.

The good news is that, in some respects the quality of PEMF research has taken a sharp turn for the better in the last decade or so. But to a large extent, the field remains plagued by these very serious deficiencies. All of these deficiencies are eminently correctable. It requires only the will and the determination to do so.

Bob Dennis

References

1. PEMF = Pulsed Electro Magnetic Fields (or frequencies); PMF = Pulsed Magnetic Fields, PEMFT = Pulsed Electro Magnetic Field Therapy; TVEMF = Time-Varying Electro-Magnetic Fields, TMS = Transcranial Magnetic Stimulation. Note that while TMS is clinically considered to be distinct from other therapeutic PEMF devices, from a technical standpoint TMS is one specific form of PEMF, designed specifically for use on the human brain:

2. https://en.wikipedia.org/wiki/Flexner_Report https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178858/

3. FDA approvals for PEMF devices: in 2004 for cervical fusion for patients at high risk of non-fusion, in 2006 for treatment of depression and anxiety, and in 2011 for brain cancer.

4. Ibid

5.

6. Richard Harris, Rigor Mortis: How sloppy science creates worthless cures, crushes hope, and wastes billions (Basic Books, New York, 2017), 2.

7. General information about chronic pain is available from two sources (accessed 24 January 2018):

8. The painmed.org website cites figures for the incidence in the United States ca. 2010 of the top four major medical conditions: Diabetes (25.8 million sufferers), Coronary Heart Disease (16.3 million sufferers), Stroke (7 million sufferers), and Cancer (11.9 million sufferers). The total for the top four major diseases in the United States was thus about 61 million sufferers ca. 2010. By comparison, the number of adults suffering some form of chronic pain in the United States was about 100 million, nearly twice as many as all four major medical conditions combined. The cost to the United States of unrelieved chronic pain was estimated to be about $600 billion annually, which is about 3% of US GDP. This is approximately the same cost as the annual Defense Budget for the United States, according to wikipedia.org ().

9. Bassett et al. Effects of Electric Currents on Bone in vivo, Nature, v.204, p 652-54, November 1964 ix

10. Bassett et al, Augmentation of bone repair by inductively coupled electromagnetic fields, Science, New Series, v. 184, No. 4136, pp. 575-77, May 3, 1974

11.

12. Jerabek and Pawluk, Magnetic Therapy in Eastern Europe: A review of 30 years of research. Published by William Pawluk, MD, ISBN 0-9664227-0-8, 1998.

13. https://en.wikipedia.org/wiki/Flexner_Report https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178858/

14. Pawluk and Layne, Power Tools for Health: How pulsed magnetic fields (PEMFs) help you. Friesen Press, 2017.

15. Ibid, from the Table of Contents, Section Two: acupuncture; antibacterial, antifungal, and antiviral actions; anti- coagulant effects; anti-edema effects; anti-inflammatory response; anti-spasm activity; ATP and mitochondrial effects; autophagy; circadian rhythm; circulation; collagen, hyaluronic acid, and GAGs; detoxification; growth factors and nitric oxide; healing and regeneration of tissue; heart; immunology; nerves and nerve conductivity; oxygen; pain; psychological and cognitive function; red blood cells; skin; stem cell stimulation; stress; water

16. Ibid, from the Table of Contents, Section Three: addiction; adhesions; alkaline balance; anxiety, panic, and PTSD disorders; arthritis; back pain; bladder conditions; bone healing; bruising; cancer; chronic fatigue; concussion and TBI; dental; depression; diabetes; erectile dysfunction; eye conditions; fibromyalgia; heart conditions; hepatitis; intestinal function; joints; keloids; liver; migraine; MS; NMO; obesity; osteopenia and osteoporosis; pain management; pancreatic conditions; paraplegia and spinal cord injury; Parkinson’s disease; PMS; BPH; PSS; shingles; skin conditions; sleep; smoking cessation; stroke; testosterone; tremor; wounds

17. Ibid

18. ICNIRP Guide: http://www.cei.ie/pdf/icnirp%20guide.pdf

19. https://en.wikipedia.org/wiki/Electromagnetic_hypersensitivity

20.

21.

22. Fenn, JE, Effect of pulsed electromagnetic energy (Diapulse) on experimental hematomas, Can Med Assoc J, v. 100(5); (1969), PMC11945558,

23. https://www.inc.com/associated-press/alphabet-google-signs-joint-venture-714-million-gsk-bioelectronic- medicine.html https://www.reuters.com/article/us-gsk-alphabet/gsk-and-google-parent-forge-715-million-bioelectronic- medicines-firm-idUSKCN10C1K8

24. In a recent discussion, after reviewing data from a certified independent testing laboratory that showed conclusively that PEMF reduces edema in an industry-standard drug testing animal model used to screen for new NSAIDs, my colleague, chair of a surgical department at a major medical university, replied in a very disparaging tone: “Well, the placebo effect is up to about 70% now.”

25. Ioannidis, Why most published research findings are false. PLOS Medicine, v. 2: 8 e124, August 2005

26. ASCB Member Survey on Reproducibility, ASCB, 2015,

27. Mobley et al., A survey on data reproducibility in cancer research provides insights into our limited ability to translate findings from the laboratory to the clinic, PLOS ONE 8, no. 5 (2013): 3-6, doi: 10.1371/journal.pone.00063221.

28. Begley CG, Ellis LM, Drug development: Raise standards for preclinical research. Nature 483, no. 7391, (2012): 531-533, doi: 10.1038/483531a

29. Prinz F, Schlange T, Asadullah K, Believe it or not: How much can we rely on published data on potential drug targets? Nature Reviews Drug Discovery 10, no.9 (2011): 712, doi: 10.1038/nrd3439-c1

30. Scannell JW et al., Diagnosing the decline in pharmaceutical R&D efficiency. Nature Reviews Drug Discovery 11, no.3 (2012): 191-200, doi: 10.1038/nrd3681

31.

32. Some PEMF manufacturers try to give the appearance that they have scientists on staff and that they engage in active research, but most of these companies simply post the names of scientists on their web page as staff members. Many of these are scientists who have long passed away or who have no affiliation with the manufacturer. For example, my name has been posted on the websites of numerous PEMF manufacturers without my knowledge or consent, variously claiming that I am a consultant or scientific director or a member of their scientific advisory board. In some cases, I only discover this when people email me to ask about a product that they are misled to believe I had developed for the manufacturer.

33. For the serious PEMF researcher wishing to enter into a collaborative effort that involves the detailed characterization of the electromagnetic performance of a PEMF system, contact the author, Robert Dennis: bob@bobslab.com. This collaboration will involve sending the PEMF system to Dr. Dennis for detailed analysis before the experiment is conducted.

34.

35.