Disclaimer 00:00
A quick disclaimer before we begin. The PEMF Podcast does not contain any medical advice, and the content provided is for informational purposes only. If you have any health concerns, please visit a healthcare professional.
Andy Smith 00:17
Welcome back to the PEMF Podcast, and today we are in our half-finished studio, but we're talking all about bone health and how PEMF may support bone formation, remodeling, and repair.
Joshua Roberts 00:29
And yeah, PEMF has been studied for many different effects on types of bone cells and bone healing, and it is a huge part of PEMF's history, which we'll get into in this episode.
Andy Smith 00:38
In this episode, we'll look at how PEMF can influence bone-forming cells, stem cells, and blood flow, as well as the conditions it has been researched for and what to look for in a device, including intensity, frequency, application, and session length.
Joshua Roberts 00:54
And when it comes to bone health, what are we actually kind of referring to here?
Andy Smith 00:58
Yeah, when talking about bone health, we're really referring to the strength, the structure, the ongoing maintenance of the skeletal system. Bone health is influenced by several factors, including age, hormonal changes like menopause, physical activity, nutrition, blood supply, certain health conditions, and medications. Bone is not fixed or inactive material. It's living tissue that is constantly adapting, repairing, and renewing itself. So if bone is broken down more quickly than it's rebuilt, bone density and structural strength can actually gradually decrease over time.
Joshua Roberts 01:31
And when it comes to bone health, there's two kinda main areas, obviously bone density and bone quality. What are the kinda two differences between these two?
Andy Smith 01:39
Bone density measures how much mineral is present in the bone. Bone quality, which also considers the bone structure, organization, and ability to withstand stress. Both are maintained through an ongoing process called bone remodeling, where older or damaged bone is removed and replaced with new bone. This process is primarily controlled by two types of cells. You've got osteoblasts, which help form new bone, and then you've got osteoclasts, which break down and remove older or damaged bone tissue. Healthy bone depends on maintaining the correct balance between these two processes.
Joshua Roberts 02:16
And later on in this episode, we'll get into more on how PEMF can affect those two kinds of cells.Um, but just in general, can PEMF actually have a positive effect for bone health?
Andy Smith 02:26
Yeah. So PEMF has been studied for its potential to support several biological processes involved in bone formation, remodeling, and repair. So the basic principles of this is basically bone naturally responds to mechanical and electrical signals. When bone is placed under physical load, small electrical signals are created within the tissue. These signals help communicate with bone cells and influence how bone adapts to physical stress. Researchers have also investigated whether induced signals from PEMF can interact with some of the natural cellular pathways involved in bone repair, which we'll get into later in the episode.
Joshua Roberts 03:02
Yeah, and those were kinda some of the fundamentals that were kind of thought about when bone healing was initially used for PEMF, which I think we should talk about first, um, before we kinda get into some of the studies and everything, because PEMF and bone healing is actually kind of where PEMF started. So what is the history here?
Andy Smith 03:19
Yeah, so bone repair is one of the most important areas in the early development of modern PEMF technology, where interest in electrical stimulation for bone began long before modern PEMF devices actually existed. And it was in the 1970s that Dr. Andrew Bassett and Dr. Arthur Pillar became one of the, uh, well, both the leading figures in the early development of PEMF for specifically bone repair. Their work focused particularly on nonunion fractures, where a broken bone fails to heal despite conventional treatment. Unlike earlier forms of electrical stimulation in the, at the time, PEMF could actually be applied without surgically implanting electrodes into the body. So their work in the 1970s actually led to FDA approval for PEMF for nonunion bone fractures, and it was this point that people really started to take seriously PEMF technology.
Joshua Roberts 04:11
And one of the studies they actually did was they grew back part of a rabbit bone using PEMF, which is obviously quite insane that you actually can do something like that with PEMF. Um, but talking about that and new bone formation, we spoke about osteoblasts earlier on. What does the research say about PEMF and osteoblasts and kind of new bone formation?
Andy Smith 04:29
So osteoblasts are essentially the cells responsible for producing and mineralizing new bone tissue. The research suggests that PEMF can influence osteoblast proliferation, which is the big word for today, and that is essentially the spread, growth, and multiplication, and the development into fully functioning bone-forming cells, as well as the production of proteins involved in building the bone matrix itself. So PEMF has also been shown to influence calcium signaling and three pathways involved in osteoblast development. There was one study involving human osteoblasts, and they used PEMF for 30 gauss, 20 hertz, and a really random 135 minutes per day for three days, and that showed an increase in the expression of markers associated with bone formation and osteoblast development.
Joshua Roberts 05:23
And with osteoblast, the osteoclasts, um, a lot of people seem to forget these ones, but they do play a equally as important role.Um, but what are they, and what does the research in PEMF show?
Andy Smith 05:34
Yes. So osteoclasts are responsible for breaking down and removing old or damaged bone so that it can be replaced. So you got osteoclast activity is not necessarily a bad thing, even though it's removing the bone. Healthy bone depends on the correct balance between osteoclast removing bone and osteoblasts rebuilding it. So it's like refreshing, if that makes sense. So the research suggests that PEMF may reduce excessive osteoclast formation, maturation, and bone resorbing activity. So there was a study involving human osteoclasts using 15 hertz for four hours per day, I don't know why they use them for so long, but they do, over eight days, and also reported reducing of osteoclast formation and maturation.
Joshua Roberts 06:24
So now we covered the main two kind of bone cells that PEMF can help influence. Uh, we also know about obviously stem cells can have an influence on bone and kind of forming new cells across the body as a whole. Um, what is osteogenic differentiation when we look at PEMF, and what does the research say?
Andy Smith 06:43
So osteogenic differentiation's a process for which a stem cell begins developing into a bone forming cell essentially. Researchers have investigated whether PEMF can help encourage this process and increase the expression of genes and proteins associated with bone formation. There was a study in 2018 which exposed human cell, sorry, human stem cells to PEMF at 20 gauss or 75 hertz for 10 minutes a day for 28 days, so essentially a month. The PEMF treated cells showed increased expression of four early and late bone related markers, one of which being type one collagen, which accounted for about 90% of all collagen. So we talk about bone health, but people don't actually realize that also PEMF can influence collagen a super amount, and that's why I look so young, obviously.
Joshua Roberts 07:34
And you've actually had quite a few people say you do actually look younger than you are, so you're not lying. Um, but if you wanna learn a little bit more about PEMF and stem cells, make sure to go back to episode 52, uh, where we spoke all about PEMF and stem cells. Um, there was also another kind of process in the body that bone health and bone formation relies on, and that's blood flow. Um, what do we know about PEMF and blood flow and how PEMF can influence blood flow?
Andy Smith 08:00
Yeah, so with any kind of repair, bone's no different. It requires oxygen, nutrients, immune cells and building materials to be delivered to the damaged area. So as we talk about on this podcast quite frequently, it's all about creating the perfect environment in the body to heal. And we've also done a whole episode on blood cells. It's no different in the same aspect where we see the blood carrying around the body stacked together. When you apply PEMF therapy, it separates it. Again, that is carrying more oxygen around the body because it's widening the surface area on each cell. Another word for today is angiogenesis. It's a formation of new blood vessels, and it's an essential part of fracture healing and bone regeneration. The other way that PEMF, and something that we know quite a lot, we talk about, is about calcium and nitric oxide pathway and delivery through PEMF therapy. So nitric oxide can help blood vessels relax and widening, uh, uh, widen, sorry, so that's also supporting circulation through something called vasodilation. You might have heard of vasoconstriction when you get in an ice bath. Vasodilation is a widening of those bl- blood vessels, and this could potentially help create a more supportive environment around healing bone alongside PEMF effects on osteoblasts and other bone related cells.
Joshua Roberts 09:16
Exactly. So PEMF has many different ways it can affect blood flow and circulation throughout the body, which is obviously important for repair and which bone health is no different. Um, but we've kind of now spoken about all the ways that PEMF can actually affect bone healing or affects more the cells related to bone healing, but now when we look at this in a more practical sense, what kind of conditions or real world use cases can PEMF for bone health actually be used for, uh, and maybe what areas or conditions has it actually been researched for?
Andy Smith 09:47
Yeah. So the most established use of PEMF is for non-union bone fractures, which we've spoken about already on this, and that's essentially a fracture that either doesn't heal at all or doesn't heal within the kind of recommended time in which it should be healing. So PEMF can be applied to that area and actually speed up the recovery and speed up the healing for non-union bone fractures. But PEMF has also been researched for general fracture healing, osteoporosis, osteopenia, bone loss following menopause, so after menopause women have a lack of estrogen and that tends to lead to conditions like osteoporosis, but also for bone healing following surgery and spinal fusion. But we don't probably say it enough on this podcast, you know, the evidence is not equally as strong for every condition, and PEMF should be considered as an additional support, so a complimentary therapy and not a replacement for conventional medical treatment. If you've been given medication by your doctor, you know, you should be taking that as prescribed until a time in which they take your medication away, not you.
Joshua Roberts 10:54
So yeah, PEMF is really good for a whole range of bone related conditions but as you say, the, when you look at the research, it isn't equally as strong kind of for each different condition. But once again, looking at more a real world scenario, when we're actually looking at now using a PEMF device for one of these conditions or bone health overall, how would we look at actually applying PEMF?
Andy Smith 11:15
Yeah, so for a specific fracture such as a broken arm, an ankle, a localized applicator can be placed directly around that affected area and create an environment in the body to heal in that specific area. So we do recommend putting a s- a, a localized device onto a smaller area. Whereas widespread conditions like osteoporosis, osteopenia, um, bone loss just generally, we, we recommend obviously a full body system for that. But even with the localized applicators and localized issues, I would always say a full body applicator is always preferred and will get you faster results quicker. We've talked about how it helps with vasodilation and how it helps with oxygen delivery across the body. So overall it's gonna give you much more effective treatment consistly- consistently using a full body applicator, and if you've got a localized at- um, issue, then you can wrap a localized applicator around that area. So full body and localized is always the best in my opinion.
Joshua Roberts 12:17
Yeah, exactly. And we always normally kind of say that on these episodes, full body and localized is always kind of the best way to go, no matter really what you're kind of trying to target. Um, but now kind of looking more at the specifications of a device, the first thing people always jump to is intensity, and a lot of people will be thinking considering its bone, obviously bone's quite deep in the body, for example, in your arms kind of at the center. Will you need kind of a super high intensity to actually be able to penetrate all the way through to that bone a- and have an effect on it?
Andy Smith 12:44
Just expanding a little bit on what we just talked about with the application side of things, one thing I would say is that if you have a convenient device, like a device that's battery operated, you can use that just locally and move about the house, if that makes sense. So don't not use a PEMF device 'cause you're thinking you're gonna have to use full body. If you've got a localized battery device, stick that on the area and use that as you go about your day. That's gonna give you consistency. But coming back to your question, no, magnetic fields are not blocked by skin, muscle, or bone in the same way that maybe light or heat can be. A PEMF does not... A PEMF device, sorry, does not need to produce thousands of gauss to simply reach bone tissue, so that is a bit of a myth within the industry. The bone studies as well as many conditions for bone related issues use low to medium intensities, usually between 10 to 100 gauss. The truth comes that, yes, high intensity does give you a much bigger magnetic field. It's not necessarily that it's gonna penetrate deeper into the body though, which is commonly misconce- like a misconception that's used in this industry. So this shows that the effects just between 10 and 100 gauss on bone cells and repair processes have been observed at low to medium intensities, not only with extremely high-powered devices. Intensity is never the full picture anyway. How much field that reaches the target area also depend on the distance from the coil, coil size, and the design, and overall quality of the signal, including the slew rate and waveform. So there's a lot to consider here.
Joshua Roberts 14:16
Yeah, exactly. One specification never really tells you the full picture about a PEMF device. Um, and if you want to learn a little bit more about slew rate, go back to episode 97. I think it's two or three back now. Um, we went into slew rate and waveform completely. And if you want to see one on coil design, do let us know in the comments down below. Um, but now once again another kind of the second biggest, uh, specification when it comes to PEMF is frequency, and probably a lot of people are thinking, "What is the magic frequency when it comes to bone healing for PEMF?"
Andy Smith 14:47
So yeah, we've looked through a lot of the studies and there's no... We couldn't really find one single frequency proven to be the best for every bone related application. All the bone studies used a wide range of frequencies and y- you know, if we compared two devices using the same frequency and intensity, they still could get a very similar outcome. The good thing is that all the studies that we found had a very positive outcome on bone related conditions. But again, you know, it all comes down to different things like waveform, slew rate, coil design. It's all part of the big picture, and really we try and encourage people not to get too lost in frequencies.
Joshua Roberts 15:27
Yeah, exactly. And well, a lot of the studies that I looked at kind of ranged between 10 to 75 hertz, so all kind of falling under 100 hertz, uh, which we normally kind of say is the ideal range for frequency. It's more of a natural kind of range. Um, but now obviously we kind of know some of the key specs and how to apply PEMF, but how long realistically would someone have to apply a PEMF for to actually start seeing results for something like bone health?
Andy Smith 15:53
So the bone related studies that we looked at have very different session lengths, ranging from around 10 minutes to several hours per day. So some clinical bone growth stimulators are designed to be worn around the, around the area for long periods of time on the fracture site. So like I mentioned earlier, if you've got a battery reduced device, you can use that for longer periods of time. There is currently no single session length that can be applied to every device or bone related goal. The research consistently uses repeated exposure over days, weeks, months, rather than relying on just like one session, like one really long session. This means that regular use, more consistent use, is like to be more important than constantly changing set- the settings, uh, or searching for one perfect frequency. So really good example of this is, we mentioned it in one of our other podcasts, is that a, a previous customer of mine, uh, was using PEMF therapy for osteoporosis, and she had a DEXA scan, which was the diagnosis originally of the, of her osteoporosis. And she was using at the time a one gauss system. It was a magnet of our device, a German device that we used to sell many, many years ago. And she was using it for, uh, consistently. She was asking me at the time, you know, "When am I gonna get results with this?" Um, and as we mentioned, PEMF therapy is all about healing the area, so it's gonna take time, especially with bone. Bone forms over a, a number of months, even years. So she was using consistently every single day for 10 to 20 minutes a one gauss full body and localized applicator, and after a year she got a DEXA scan and it was showing that her bone density had got better. So, you know, with this it's more about consistency than looking at super high powers, um, using it as often as you can, once per day, twice a day, and the results will eventually come.
Joshua Roberts 17:44
And one interesting thing that I actually remember from that episode was you said she didn't actually really notice the difference. She wasn't waking up feeling, "Oh, I've got stronger bones now." Um, but as you say on the DEXA scan, it was showing up kinda, yeah, over the years period.
Andy Smith 17:59
Yeah, exactly. And it's a good example because basically with PEMF therapy some people won't actually feel or notice a difference, but it's good to see a tangible result on something you can actually see, like a DEXA scan or looking at blood through a microscope. You know, it's something that you can see and over time they're gonna start feeling the symptoms that come back with those as better.
Joshua Roberts 18:19
Yeah, exactly. Sometimes you might not feel like a massive difference after one session, but what's going on in your body is quite incredible, and as you say, you can see it under a microscope or via scans, um, if you're able to do something like that. But if you want to learn a little bit more about bone health, as you might know from our last episode, we now have launched, uh, the pemfpodcast.com, um, for kind of everything on PEMF from conditions to understanding the specifications, um, to seeing what stacks well with PEMF. There's really so much information over there, um, and s- even product recommendations from a few brands that we do recommend. So if you do want to have a little bit of a deeper dive on bone health and maybe look a little bit deeper at the studies, I'll make sure to link that one underneath this episode. Uh, and while you're there, please do make sure to like, subscribe, leave us a five star, uh, rating on whatever audio platform you're on. It really just helps us keep making more and more of these episodes and bringing you bigger and better guests in the future.
Andy Smith 19:14
Thanks for listening to another episode of the PEMF Podcast, and as Josh said, check out the pemfpodcast.com
