Nitric Oxide (NO) is a signaling molecule produced by body that plays a key role in many physiological processes. NO is essential to the healthy function of the body, and inadequate amounts of NO can result in impaired healing capacity and the development of certain diseases.

One mechanism for the production of NO within the body is by endothelial nitric oxide synthase (eNOS) when it binds with calcium-activated calmodulin.(1) A thoroughly documented effect of PEMF is that it facilitates the influx of calcium ions (Ca2+) into cells and their binding to calmodulin, which results in increase NO production.(2) The increased endogenous production of NO is the basis for a large proportion of the downstream benefits of PEMF therapy, ranging from improved circulation to decreased pain and inflammation to increased energy production.

1.  Pilla (2011) - Electromagnetic fields as first messenger in biological signaling: Application to calmodulin-dependent signaling in tissue repair.
https://doi.org/10.1016/j.bbagen.2011.10.001

2.  Pilla (2012) - Electromagnetic fields instantaneously modulate nitric oxide signaling in challenged biological systems.
https://doi.org/10.1016/j.bbrc.2012.08.078

With an abundance of energy available to the cell, it has the ability to perform all its functions more effectively, making you feel healthier and more energized.

Adenosine triphosphate (ATP) is a compound that provides the energy to drive the vast majority of cellular processes, commonly referred to as the “energy currency” of the cell. The ATP is primarily produced by mitochondria during a process called cellular respiration involving the phosphorylation of adenosine diphosphate. Mitochondria’s ability to produce ATP improves with increased Ca2+ availability.(1) PEMF has been shown to produce an influx of Ca2+ from the extracellular matrix into cells via voltage-gated calcium channels (VGCCs).(2)

1.  Jouaville et al. (1999) - Regulation of mitochondrial ATP synthesis by calcium: Evidence for a long-term metabolic priming
https://doi.org/10.1073/pnas.96.24.13807

2.  Pall (2013) - Electromagnetic fields act via activation of voltage-gated calcium channels to produce beneficial or adverse effects
https://doi.org/10.1111/jcmm.12088

Not only does it enable broken bones to heal more rapidly, but it can also increase bone density and strength, helping to prevent fractures in the first place.

The discovery of PEMF therapy health benefits dates back to the 1970's, with its application in bone repair, drastically improving the successful union rate for fractured bones.(1) Since then, further research has validated its application to bone growth regulation, identifying specific cellular mechanisms of action(2-7) and refining the PEMF signal parameters for clinical application.(8,9) PEMF’s modulation of cellular activity and proliferation can help improve bone density and microstructure to prevent osteoporosis,(2,6,10) decrease disuse-related osteopenia,(11,12) increase the rate of fracture repair,(13-15) and improve implant osseointegration.(16)

1.  Bassett et al. (1977) - A Non-Operative Salvage of Surgically-Resistant Pseudoarthoses and Non-Unions by Pulsing Electromagnetic Fields.
https://pubmed.ncbi.nlm.nih.gov/598067/

2.  Chang et al. (2003) - Pulsed Electromagnetic Fields Prevent Osteoporosis in an Ovariectomized Female Rat Model: A Prostaglandin E2-Associated Process.
https://doi.org/10.1002/bem.10078

3.  Chang et al. (2004) - Effect of Pulse-Burst Electromagnetic Field Stimulation on Osteoblast Cell Activities.
https://doi.org/10.1002/bem.20016

4.  Selvamurugan et al. (2007) - Effects of BMP-2 and Pulsed Electromagnetic Field (PEMF) on Rat Primary Osteoblastic Cell Proliferation and Gene Expression.
https://doi.org/10.1002/jor.20409

5.  Martino et al. (2008) - The Effects of Pulsed Electromagnetic Fields on the Cellular Activity of SaOS-2 Cells
https://doi.org/10.1002/bem.20372

6.  Jing et al. (2013) - Pulsed Electromagnetic Fields Improve Bone Microstructure and Strength in Ovariectomized Rats through a Wnt/Lrp5/b-Catenin Signaling-Associated Mechanism
https://doi.org/10.1371/journal.pone.0079377

7.  He et al. (2018) - Pulsed electromagnetic fields inhibit human osteoclast formation and gene expression via osteoblasts.
https://doi.org/10.1016/j.bone.2017.09.020

8.  Rubin et al. (1993) - Optimization of electric field parameters for the control of bone remodeling: exploitation of an indigenous mechanism for the prevention of osteopenia.
https://doi.org/10.1002/jbmr.5650081327

9.  Chang et al. (2003) - Effects of Different Intensities of Extremely Low Frequency Pulsed Electromagnetic Fields on Formation of Osteoclast-Like Cells.
https://doi.org/10.1002/bem.10118

10.  Li et al. (2018) - Magnetic Resonance Spectroscopy for Evaluating the Effect of Pulsed Electromagnetic Fields on Marrow Adiposity in Postmenopausal Women With Osteopenia.
https://doi.org/10.1097/RCT.0000000000000757

11.  Shen et al. (2010) - Pulsed Electromagnetic Fields Stimulation Affects BMD and Local Factor Production of Rats With Disuse Osteoporosis.
https://doi.org/10.1002/bem.20535

12.  Refai et al. (2014) - Radiodensitometric Assessment of the Effect of Pulsed Electromagnetic Field Stimulation Versus Low Intensity Laser Irradiation on Mandibular Fracture Repair: A Preliminary Clinical Trial.
https://doi.org/10.1007/s12663-013-0551-2

13.  Midura et al. (2005) - Pulsed electromagnetic field treatments enhance the healing of fibular osteotomies.
https://doi.org/10.1016/j.orthres.2005.03.015

14.  Androjna et al. (2014) - Pulsed Electromagnetic Field Treatment Enhances Healing Callus Biomechanical Properties in an Animal Model of Osteoporotic Fracture.
https://doi.org/10.1002/bem.21855

15.  Mohajerani et al. (2019) - Effect of pulsed electromagnetic field on mandibular fracture healing: A randomized control trial, (RCT)
https://doi.org/10.1016/j.jormas.2019.02.022

16.  Jing et al. (2016) - Pulsed electromagnetic fields promote osteogenesis and osseointegration of porous titanium implants in bone defect repair through a Wnt/β-catenin signaling-associated mechanism.
https://doi.org/10.1038/srep32045

PEMF therapy can help with recovery from both acute and chronic injuries, in addition to reducing pain and improving mobility in sore/stiff joints.

PEMF can improve joint health through several different mechanisms of action. In addition to bone (discussed previously), articulating joints typically consist of 3 main biomechanical components: cartilage, ligament, and tendon. PEMF has been shown to benefit all 3 of these types of tissue, with the most attention given to cartilage.(1) PEMF stimulation can increase the proliferation of chondrocytes,(2,3) promote chondrogenic stem cell differentiation,(4,5) and inhibit chondrocyte apoptosis.(6) PEMF also modulates the activity of chondrocytes, simultaneously producing anabolic and anti-catabolic effects, which causes them to increase synthesis of cartilage extracellular matrix components (such as proteoglycans, collagen, glycosaminoglycans)(7,8) and suppress processes that degenerate cartilage.(9) In addition to all these benefits, PEMF also acts as a potent anti-inflammatory stimulus.(10) With all of these factors working together, PEMF can be a powerful tool to protect against natural age-related cartilage degeneration,(11) and enable regeneration of damaged/injured cartilage tissue.(12,13) Use of PEMF in clinical applications have demonstrated significant decreases in pain and improvements in function for patients suffering from osteoarthritis.(14)

Healing of ligaments and tendons, major supporting structures in joints, can also be accelerated using PEMF therapy. Tissue cultures exhibit increased cell proliferation and expression of tissue-specific anabolic genes when exposed to PEMF.(15-18) Improved healing rates and tissue properties were demonstrated for tendon injuries with PEMF application.(19-21)

1. Iwasa et al. (2018) - Pulsed Electromagnetic Fields and Tissue Engineering of the Joints.
   https://doi.org/10.1089/ten.teb.2017.0294
2. Mattei et al. (2001) - Effects of Pulsed Electromagnetic Fields on Human Articular Chondrocyte Proliferation.
   https://doi.org/10.3109/03008200109016841
3. Fitzsimmons et al. (2008) - A Pulsing Electric Field (PEF) Increases Human Chondrocyte Proliferation through a Transduction Pathway Involving Nitric Oxide Signaling.
   https://doi.org/10.1002/jor.20590
4. Esposito et al. (2013) - Differentiation of Human Umbilical Cord-derived Mesenchymal Stem Cells, WJ-MSCs, into Chondrogenic Cells in the Presence of Pulsed Electromagnetic Fields.
   https://iv.iiarjournals.org/content/27/4/495
5. Parate et al. (2017) - Enhancement of mesenchymal stem cell chondrogenesis with short-term low intensity pulsed electromagnetic fields.
   https://doi.org/10.1038/s41598-017-09892-w
6. Li et al. (2011) - Effects of pulsed electromagnetic fields on cartilage apoptosis signalling pathways in ovariectomised rats.
   https://doi.org/10.1007/s00264-011-1245-3
7. Mattei et al. (2007) - Proteoglycan synthesis in bovine articular cartilage explants exposed to different low-frequency low-energy pulsed electromagnetic fields.
   https://doi.org/10.1016/j.joca.2006.06.019
8. Parate et al. (2020) - Pulsed electromagnetic fields potentiate the paracrine function of mesenchymal stem cells for cartilage regeneration.
   https://doi.org/10.1186/s13287-020-1566-5
9. Zhou et al. (2016) - Pulsed electromagnetic field ameliorates cartilage degeneration by inhibiting mitogen-activated protein kinases in a rat model of osteoarthritis.
   https://doi.org/10.1016/j.ptsp.2016.10.003
10. Varani et al. (2008) - Characterization of adenosine receptors in bovine chondrocytes and fibroblast-like synoviocytes exposed to low frequency low energy pulsed electromagnetic fields.
    https://doi.org/10.1016/j.joca.2007.07.004
11. Fini et al. (2008) - Effect of pulsed electromagnetic field stimulation on knee cartilage, subchondral and epyphiseal trabecular bone of aged Dunkin Hartley guinea pigs.
    https://doi.org/10.1016/j.biopha.2007.03.001
12. Veronesi et al. (2015) - Pulsed electromagnetic fields combined with a collagenous scaffold and bone marrow concentrate enhance osteochondral regeneration: an in vivo study.
    https://doi.org/10.1186/s12891-015-0683-2
13. Boopalan et al. (2011) - Pulsed electromagnetic field therapy results in healing of full thickness articular cartilage defect.
    https://doi.org/10.1007/s00264-010-0994-8
14. Wu et al. (2018) - Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis.
    https://doi.org/10.1136/bmjopen-2018-022879
15. Girolamo et al. (2013) - Low frequency pulsed electromagnetic field affects proliferation, tissue-specific gene expression, and cytokines release of human tendon cells.
    https://doi.org/10.1007/s12013-013-9514-y
16. Girolamo et al. (2015) - In vitro functional response of human tendon cells to different dosages of low-frequency pulsed electromagnetic field.
    https://doi.org/10.1007/s00167-014-3143-x
17. Liu et al. (2016) - Role of pulsed electromagnetic fields (PEMF) on tenocytes and myoblasts-potential application for treating rotator cuff tears.
    https://doi.org/10.1002/jor.23278
18. Colombini et al. (2020) - A2A adenosine receptors are involved in the reparative response of tendon cells to pulsed electromagnetic fields.
    https://doi.org/10.1371/journal.pone.0239807
19. Strauch et al. (2006) - Pulsed magnetic field therapy increases tensile strength in a rat Achilles’ tendon repair model.
    https://doi.org/10.1016/j.jhsa.2006.03.024
20. Huegel et al. (2018) - Effects of pulsed electromagnetic field therapy at different frequencies and durations on rotator cuff tendon-to-bone healing in a rat model.
    https://doi.org/10.1016/j.jse.2017.09.024
21. Huegel et al. (2020) - Effects of Pulsed Electromagnetic Field Therapy on Rat Achilles Tendon Healing.
    https://doi.org/10.1002/jor.24487

Muscle recovery and growth can be enhanced with the application of PEMF following a training session or injury. Athletic performance can also be improved by increasing circulating Nitric Oxide with PEMF. 

One of the most well-documented physiological effects of PEMF is an increase in endogenous nitric oxide production. Not only does nitric oxide increase oxygen/nutrient supply to muscles through a vasodilatory mechanism to provide an array of benefits, but it also acts directly on muscles to improve performance(1) and training adaptations.(2) PEMF can be used prior to and/or during workouts to increase Nitric Oxide levels. PEMF has also been shown to increase myogenesis by modulating mitochondrial activity via an increase in TRPC1 signaling(3) in addition to activation of the MAPK/ERK pathway.(4)

1. Jones et al. (2018) - Dietary Nitrate and Physical Performance.
   https://doi.org/10.1146/annurev-nutr-082117-051622
2. Filippin et al. (2009) - Nitric oxide and repair of skeletal muscle injury.
   https://doi.org/10.1016/j.niox.2009.08.002
3. Yap et al. (2019) - Ambient and supplemental magnetic fields promote myogenesis via a TRPC1-mitochondrial axis: evidence of a magnetic mitohormetic mechanism.
   https://doi.org/10.1096/fj.201900057R
4. Xu et al. (2016) - Low frequency pulsed electromagnetic field promotes C2C12 myoblasts proliferation via activation of MAPK/ERK pathway.
   https://doi.org/10.1016/j.bbrc.2016.09.044

PEMF therapy can support heart health by improving blood and nutrient flow to the heart in addition to making it easier for the heart to pump blood throughout the body. PEMF has also been shown to reduce blood pressure and improve recovery from heart attacks.

PEMF can increase circulating nitric oxide (NO) levels throughout the body, and by doing so it can dilate blood vessels and facilitate greater blood flow at decreased pressures. By decreasing the systemic blood pressure required to deliver a given blood volume, it decreases the strain on the pump that is producing the pressure, i.e. the heart. This blood pressure lowering effect by PEMF therapy is most pronounced during exercise and in people with hypertension, but it has only mild effects in healthy individuals at rest and will not produce a hypotensive state.(1,2) A common and effective treatment for patients with hypertension are pharmaceuticals that invoke a NO producing effect within the body.(3) One of the leading causes of death in humans globally is heart failure by means of myocardial infarction (MI), also known as heart attack, which is the damage or death of heart tissue due to lack of sufficient blood supply. PEMF can stimulate the release of vascular endothelial growth factor (VEGF), which is a signalling protein that promotes angiogenesis - the creation of new blood vessels. Vasodilating coronary arteries with NO and stimulating angiogenesis around the heart by VEGF is a potent combination that will improve the heart’s blood supply and protect against MI. Even following MI, PEMF can be used to improve cardiac function and help repair the incurred damage.(4,5)

1. Kim et al. (2020) - The impact of pulsed electromagnetic field therapy on blood pressure and circulating nitric oxide levels: a double blind, randomized study in subjects with metabolic syndrome.
   https://doi.org/10.1080/08037051.2019.1649591
2. Nishimura et al. (2011) - A 1uT extremely low-frequency electromagnetic field vs. sham control for mild-to-moderate hypertension: a double-blind, randomized study.
   https://doi.org/10.1038/hr.2010.246
3. Pinheiro et al. (2017) - The potential of stimulating nitric oxide formation in the treatment of hypertension.
   https://doi.org/10.1080/14728222.2017.1310840
4. Peng et al. (2020) - Pulsed Electromagnetic Fields Increase Angiogenesis and Improve Cardiac Function After Myocardial Ischemia in Mice.
   https://doi.org/10.1253/circj.CJ-19-0758
5. Hao et al. (2014) - Pulsed electromagnetic field improves cardiac function in response to myocardial infraction.
   https://www.ncbi.nlm.nih.gov/pubmed/24936220

PEMF can cause blood vessel expansion to increase blood flow and improve nutrient exchange within tissues. PEMF can promote the formation of new blood vessels where they’re needed.

PEMF can significantly improve the circulation of blood throughout your entire body. As previously described, nitric oxide (NO) is produced by the blood vessels via endothelial nitric oxide synthase (eNOS) in response to PEMF application. While an instantaneous elevation in NO levels occurs locally (where the PEMF was applied),(1) it produces systemic effects as the NO circulates throughout the body.(2) Blood vessels dilate (expand) in response to the NO and cGMP signalling, which facilitates a greater volumetric flow rate of blood through the body. Increased blood flow improves the delivery rate of essential nutrients (oxygen, glucose, amino acids, etc.) and the removal rate of waste products (CO2, urea, etc.) from all tissues. Vasodilation of the microvasculature also improves blood perfusion and enhances nutrient exchange.(3,4)

Another mechanism by which PEMF improves circulation is by stimulating angiogenesis through FGF-2 and VEGF signalling.(5-7) Angiogenesis is the process of creating new blood vessels, which is essential for healing damaged tissue and maintaining optimal blood supply.

1. Pilla (2012) - Electromagnetic fields instantaneously modulate nitric oxide signaling in challenged biological systems.
   https://doi.org/10.1016/j.bbrc.2012.08.078
2. Cichoń et al. (2017) - Benign Effect of Extremely Low-Frequency Electromagnetic Field on Brain Plasticity Assessed by Nitric Oxide Metabolism during Poststroke Rehabilitation.
   https://doi.org/10.1155/2017/2181942
3. Smith et al. (2004) - Microcirculatory effects of pulsed electromagnetic fields.
   https://doi.org/10.1016/S0736-0266(03)00157-8
4. Bragin et al. (2015) - Increases in microvascular perfusion and tissue oxygenation via pulsed electromagnetic fields in the healthy rat brain.
   https://doi.org/10.3171/2014.8.JNS132083
5. Tepper et al. (2004) - Electromagnetic fields increase in vitro and in vivo angiogenesis through endothelial release of FGF-2.
   https://doi.org/10.1096/fj.03-0847fje
6. Li et al. (2014) - Pulsed electromagnetic field improves postnatal neovascularization in response to hindlimb ischemia.
   https://pubmed.ncbi.nlm.nih.gov/26045885/
7. Peng et al. (2020) - Pulsed Electromagnetic Fields Increase Angiogenesis and Improve Cardiac Function After Myocardial Ischemia in Mice.
   https://doi.org/10.1253/circj.CJ-19-0758
   

Certain PEMF signals can be used to alter states of consciousness, helping to relax and sleep or to become focused and alert. Other PEMF applications can nourish brain tissue with improved blood and nutrient delivery, resulting in improved cognitive performance and memory.

The brain is an organ that is especially sensitive to electromagnetic signals.(1) All our thoughts and brain activity is generated by the billions of brain cells (neurons) sending electrical signals back and forth within a vastly complex neuronal network. Time-varying magnetic fields (such as PEMF) induce electrical currents and can influence the signals transmitted within the body and between cells even at very low magnitudes that are insufficient to surpass the action potential of nerves. It has been shown that PEMF signals applied to the brain caused the brainwave pattern to shift and synchronize with the PEMF frequency.(2,3) By applying a particular frequency (or frequency sweep) with PEMF, one can shift their state of consciousness to achieve a desired result (alertness, relaxation, flow, etc.).

Nitric oxide (NO) plays a large role in brain function and can be augmented through PEMF. NO is a neurotransmitter that regulates cerebral blood flow, neurogenesis, and synaptic plasticity. As with any other organ or tissue within the body, the brain can also benefit greatly from increased circulation and improved nutrient supply. Dilation of the brain’s microvasculature using PEMF has been shown to improve oxygenation and blood perfusion.(4) Synaptic plasticity, affecting one’s learning, memory, and ability to recover from brain trauma.(5,6) PEMF has also been demonstrated to produce functional changes in the brain, increasing intracortical facilitation.(7)

1. Carrubba et al. (2009) - The Effects of Low-Frequency Environmental-Strength Electromagnetic Fields on Brain Electrical Activity: A Critical Review of the Literature.
   https://doi.org/10.1080/15368370802088758
2. Zmeykina et al. (2020) - Weak rTMS‑induced electric fields produce neural entrainment in humans.
   https://doi.org/10.1038/s41598-020-68687-8
3. Thut et al. (2011) - Rhythmic TMS Causes Local Entrainment of Natural Oscillatory Signatures.
   https://doi.org/10.1016/j.cub.2011.05.049
4. Bragin et al. (2015) - Increases in microvascular perfusion and tissue oxygenation via pulsed electromagnetic fields in the healthy rat brain.
   https://doi.org/10.3171/2014.8.JNS132083
5. Cichoń et al. (2017) - Benign Effect of Extremely Low-Frequency Electromagnetic Field on Brain Plasticity Assessed by Nitric Oxide Metabolism during Poststroke Rehabilitation.
   https://doi.org/10.1155/2017/2181942
6. Cichoń et al. (2018) - Increase in Blood Levels of Growth Factors Involved in the Neuroplasticity Process by Using an Extremely Low Frequency Electromagnetic Field in Post-stroke Patients.
   https://doi.org/10.3389/fnagi.2018.00294
7. Capone et al. (2009) - Does exposure to extremely low frequency magnetic fields produce functional changes in human brain?
   https://doi.org/10.1007/s00702-009-0184-2

PEMF therapy can aid in the repair of damaged nerves as well as reducing symptoms associated with improper nerve function.

PEMF has remarkable benefits for the peripheral nervous system. It has been demonstrated to promote and guide nerve growth,(1) allowing for improved repair and regeneration of damaged nerves.(2-6) PEMF can also aid in the treatment of peripheral neuropathy, improving nerve conduction and motor neuron function,(7) aiding in pain management,(8-10) and protecting against nerve degeneration.(11)

1. Macias et al. (2000) - Directed and Enhanced Neurite Growth With Pulsed Magnetic Field Stimulation
   https://pubmed.ncbi.nlm.nih.gov/10797456/
2. Mohammadi et al. (2014) - Pulsed electromagnetic fields accelerate functional recovery of transected sciatic nerve bridged by chitosan conduit: An animal model study
   https://doi.org/10.1016/j.ijsu.2014.11.004
3. Kim et al. (2015) - Co-treatment effect of pulsed electromagnetic field (PEMF) with human dental pulp stromal cells and FK506 on the regeneration of crush injured rat sciatic nerve
   https://doi.org/10.3109/00207454.2014.971121
4. Seo et al. (2018) - Low-frequency pulsed electromagnetic field pretreated bone marrow-derived mesenchymal stem cells promote the regeneration of crush-injured rat mental nerve
   https://doi.org/10.4103/1673-5374.224383
5. Hei et al. (2016) - Effects of electromagnetic field (PEMF) exposure at different frequency and duration on the peripheral nerve regeneration: in vitro and in vivo study
   https://doi.org/10.3109/00207454.2015.1054032
6. Hei et al. (2016) - Schwann-Like Cells Differentiated from Human Dental Pulp Stem Cells Combined With a Pulsed Electromagnetic Field Can Improve Peripheral Nerve Regeneration
   https://doi.org/10.1002/bem.21966
7. Musaev et al. (2003) - The Use of Pulsed Electromagnetic Fields with Complex Modulation in the Treatment of Patients with Diabetic Polyneuropathy
   https://doi.org/10.1023/a:1025184912494
8. Weintraub et al. (2004) - Pulsed Magnetic Field Therapy in Refractory Neuropathic Pain Secondary to Peripheral Neuropathy: Electrodiagnostic Parameters—Pilot Study
   https://doi.org/10.1177/0888439003261024
9. Kortekaas et al. (2014) - A Novel Magnetic Stimulator Increases Experimental Pain Tolerance in Healthy Volunteers A Double-Blind Sham-Controlled Crossover Study
   https://doi.org/10.1371/journal.pone.0061926
10. Liu et al. (2017) - The change of HCN1/HCN2 mRNA expression in peripheral nerve after chronic constriction injury induced neuropathy followed by pulsed electromagnetic field therapy
    https://doi.org/10.18632/oncotarget.13584
11. Lei et al. (2013) - Therapeutic Effects of 15 Hz Pulsed Electromagnetic Field on Diabetic Peripheral Neuropathy in Streptozotocin-Treated Rats
    https://doi.org/10.1371/journal.pone.0061414

Excessive inflammation, due to an injury or otherwise, can result in swelling, pain, and a reduced ability to heal. PEMF therapy is highly effective in reducing inflammation and facilitating the healing process in all tissues of the body.

The anti-inflammatory effects of PEMF therapy are well-established and have far-reaching consequences for the health of multiple systems in the body. A primary mechanism of action for PEMF in the inflammatory process is via adenosine receptors (especially A2A and A3 subtypes), suppressing proinflammatory cytokines such as tumor necrosis factor alpha (TNF-α), interleukin beta (IL-β), and prostaglandin E2 (PGE2).(1)

Another method of action is through the production of NO, which in turn inhibits caspase-1 from releasing active IL-1β.(2) Although inflammatory processes are necessary for the healthy functioning of the body, excessive inflammation is detrimental to the healing process. By downregulating the expression of proinflammatory cytokines, the cells’ environment becomes much more conducive to repair and regeneration.

There are applications for this in numerous disease conditions that are driven by inflammation in addition to natural healing processes in all tissues to recover from strenuous activity,(3) injuries,(4,5) and more serious trauma.(6-8)

1. Varani et al. (2017) - Adenosine Receptors as a Biological Pathway for the Anti-Inflammatory and Beneficial Effects of Low Frequency Low Energy Pulsed Electromagnetic Fields
   https://doi.org/10.1155/2017/2740963
2. Rohde et al. (2009) - Effects of Pulsed Electromagnetic Fields on Interleukin-1 and Postoperative Pain: A Double-Blind, Placebo-Controlled, Pilot Study in Breast Reduction Patients
   https://doi.org/10.1097/PRS.0b013e3181c9f6d3
3. Liu et al. (2016) - Role of pulsed electromagnetic fields (PEMF) on tenocytes and myoblasts-potential application for treating rotator cuff tears
   https://doi.org/10.1002/jor.23278
4. Chan et al. (2019) - Pulsed electromagnetic fields reduce acute inflammation in the injured rat-tail intervertebral disc
   https://doi.org/10.1002/jsp2.1069
5. Colombini et al. (2020) - A2A adenosine receptors are involved in the reparative response of tendon cells to pulsed electromagnetic fields
   https://doi.org/10.1371/journal.pone.0239807
6. Rasouli et al. (2012) - Attenuation of interleukin-1beta by pulsed electromagnetic fields after traumatic brain injury
   https://doi.org/10.1016/j.neulet.2012.03.089
7. Strauch et al. (2009) - Evidence-Based Use of Pulsed Electromagnetic Field Therapy in Clinical Plastic Surgery
   https://doi.org/10.1016/j.asj.2009.02.001
8. Stocchero et al. (2015) - Pulsed electromagnetic fields for postoperative pain: a randomized controlled clinical trial in patients undergoing mandibular third molar extraction
   https://doi.org/10.1016/j.oooo.2014.11.017
   

PEMF therapy has been shown to enhance skin appearance and elasticity in addition to greatly accelerating wound healing.

PEMF therapy can improve skin health by stimulating collagen production(1,2) and improving cutaneous blood circulation.(3) It is well documented as a highly efficacious therapy for cutaneous wound healing, improving the wound closure rate and the biomechanical properties of the new tissue during the healing process. This effect has been demonstrated in healthy(4-6) as well as diabetic subjects,(7-11) who typically experience greater difficulty in wound healing. The applications to recovery from surgical interventions is quite clear, especially in the field of plastic surgery.(12) Additionally, the application of PEMF therapy to rejuvenate skin health and appearance has demonstrated effectiveness.(13,14)

1. De Loecker et al. (1989) - Effects of pulsed electromagnetic fields on rat skin metabolism
   https://doi.org/10.1016/0005-2736(89)90167-3
2. Ahmadian et al. (2006) - Effects of extremely-low-frequency pulsed electromagnetic fields on collagen synthesis in rat skin
   https://doi.org/10.1042/BA20050086
3. Sun et al. (2016) - Effects of pulsed electromagnetic fields on peripheral blood circulation in people with diabetes: A randomized controlled trial
   https://doi.org/10.1002/bem.21983
4. Patruno et al. (2009) - Extremely low frequency electromagnetic fields modulate expression of inducible nitric oxide synthase, endothelial nitric oxide synthase and cyclooxygenase-2 in the human keratinocyte cell line HaCat: potential therapeutic effects in wound healing
   https://doi.org/10.1111/j.1365-2133.2009.09527.x
5. Athanasiou et al. (2007) - The effect of pulsed electromagnetic fields on secondary skin wound healing: an experimental study
   https://doi.org/10.1002/bem.20303
6. Jiao et al. (2016) - Effects of low‐frequency pulsed electromagnetic fields on plateau frostbite healing in rats
   https://doi.org/10.1111/wrr.12487
7. Callaghan et al. (2008) - Pulsed electromagnetic fields accelerate normal and diabetic wound healing by increasing endogenous FGF-2 release
   https://doi.org/10.1097/01.prs.0000293761.27219.84
8. Goudarzi et al. (2010) - Pulsed electromagnetic fields accelerate wound healing in the skin of diabetic rats
   https://doi.org/10.1002/bem.20567
9. Cheing et al. (2014) - Pulsed electromagnetic fields (PEMF) promote early wound healing and myofibroblast proliferation in diabetic rats
   https://doi.org/10.1002/bem.21832
10. Choi et al. (2016) - Pulsed electromagnetic field (PEMF) promotes collagen fibre deposition associated with increased myofibroblast population in the early healing phase of diabetic wound
    https://doi.org/10.1007/s00403-015-1604-9
11. Choi et al. (2018) - Effects of pulsed electromagnetic field (PEMF) on the tensile biomechanical properties of diabetic wounds at different phases of healing
    https://doi.org/10.1371/journal.pone.0191074
12. Strauch et al. (2009) - Evidence-Based Use of Pulsed Electromagnetic Field Therapy in Clinical Plastic Surgery
    https://doi.org/10.1016/j.asj.2009.02.001
13. Lee et al. (2014) - Effects of multi-polar radiofrequency and pulsed electromagnetic field treatment in Koreans: case series and survey study
    https://doi.org/10.3109/09546634.2012.714454
14. Oliveira et al. (2017) - Effects of Multipolar Radiofrequency and Pulsed Electromagnetic Field Treatment for Face and Neck Rejuvenation
    https://doi.org/10.1155/2017/4146391
    

Long-term, chronic exposure to low-strength EMF hinders the adaptive immune system, but short-term exposure to higher-strength PEMF can improve the function of certain immune cells. It is clear that EMFs affect the immune system, but more research is required on how to utilize PEMF to improve immune function.

The immune system is a multi-faceted collaboration of different subsystems to respond to both external and internal health threats. In this context it is important to distinguish between the innate immune system, which provides nonspecific defenses against pathogens and in response to damaged cells, and the adaptive immune system, which provides a stronger defense and long-lasting immunity to specific pathogens via antigen recognition. PEMF has demonstrated effects on the function of numerous components of the immune system,(1-5) but due to the complex nature of immune system function, it is presently unclear what end-result these changes will produce.

While more research is still necessary to fully understand the mechanisms and downstream implications of all the presently identified effects, certain theories have been postulated. Long-term exposure to low-intensity, low-frequency magnetic fields appears to reduce the adaptive immune response(6,7) whereas short-term exposure to higher-intensity magnetic fields may improve the innate immune response.(8) In particular, there is evidence of benefit to the response of the innate immune system by enhancing the efficacy of neutrophils(9) and in modulating macrophage activity.(10)

1. Cossarizza et al. (1989) - Extremely low frequency pulsed electromagnetic fields increase interleukin-2 (IL-2) utilization and IL-2 receptor expression in mitogen-stimulated human lymphocytes from old subjects
   https://doi.org/10.1016/0014-5793(89)80449-1
2. Cossarizza et al. (1989) - Extremely low frequency pulsed electromagnetic fields increase cell proliferation in lymphocytes from young and aged subjects
   https://doi.org/10.1016/0006-291x(89)92488-1
3. Cadossi et al. (1992) - Lymphocytes and low-frequency electromagnetic fields
   https://doi.org/10.1096/fasebj.6.9.1612290
4. Varani et al. (2002) - Effect of low frequency electromagnetic fields on A2A adenosine receptors in human neutrophils
   https://doi.org/10.1038/sj.bjp.0704695
5. Varani et al. (2003) - Alteration of A3 adenosine receptors in human neutrophils and low frequency electromagnetic fields
   https://doi.org/10.1016/S0006-2952(03)00454-4
6. Li et al. (2015) - Effect of long-term pulsed electromagnetic field exposure on hepatic and immunologic functions of rats
   https://doi.org/10.1007/s00508-015-0732-8
7. Doyon et al. (2017) - Electromagnetic fields may act via calcineurin inhibition to suppress immunity, thereby increasing risk for opportunistic infection: Conceivable mechanisms of action
   https://doi.org/10.1016/j.mehy.2017.06.028
8. Mahaki et al. (2018) - A review on the effects of extremely low frequency electromagnetic field (ELF-EMF) on cytokines of innate and adaptive immunity
   https://doi.org/10.1080/15368378.2018.1545668
9. Goldbach et al. (2015) - Low-Frequency Electromagnetic Field Exposure Enhances Extracellular Trap Formation by Human Neutrophils through the NADPH Pathway
   https://doi.org/10.1159/000380764
10. Rosado et al. (2018) - Immune-Modulating Perspectives for Low Frequency Electromagnetic Fields in Innate Immunity
    https://doi.org/10.3389/fpubh.2018.00085
    

The ability of PEMFs to ameliorate symptoms associated with many autoimmune diseases is promising for future therapeutic treatments. However, the mechanism of action is not yet fully understood, and further research would greatly benefit treatment protocols.

Autoimmune disease can be expressed in numerous forms (over 100 different types), but it is universally characterized by a dysfunction of the immune system that results in healthy cells and tissues native to the body being identified as threats and subsequently attacked by the body’s immune cells. Autoimmune diseases can have debilitating consequences for the lives of people suffering from them, but fortunately PEMF has proven efficacy in treating the symptoms, and even the causes in some cases, for several types of these diseases, with promising applications in others yet to be confirmed.(1) Several autoimmune diseases in which PEMF shows promise are rheumatoid arthritis,(2,3) multiple sclerosis,(4,5) Diabetes (type 1),(6-9) Parkinson’s disease,(10-12) Crohn’s disease,(13) and Alzheimer’s disease.(14)

1. Guerriero et al. (2016) - Extremely low frequency electromagnetic fields stimulation modulates autoimmunity and immune responses: a possible immunomodulatory therapeutic effect in neurodegenerative diseaseshttps://doi.org/10.4103/1673-5374.195277
2. Ross et al. (2019) - Targeting Mesenchymal Stromal Cells/Pericytes (MSCs) With Pulsed Electromagnetic Field (PEMF) Has the Potential to Treat Rheumatoid Arthritis
   https://doi.org/10.3389/fimmu.2019.00266
3. Selvam et al. (2007) - Low frequency and low intensity pulsed electromagnetic field exerts its antiinflammatory effect through restoration of plasma membrane calcium ATPase activity
   https://doi.org/10.1016/j.lfs.2007.03.019
4. Sandyk et al. (1993) - Resolution of longstanding symptoms of multiple sclerosis by application of picoTesla range magnetic fields
   https://doi.org/10.3109/00207459309000580
5. Sandyk et al. (1997) - Therapeutic effects of alternating current pulsed electromagnetic fields in multiple sclerosis
   https://doi.org/10.1089/acm.1997.3.365
6. Musaev et al. (2003) - The Use of Pulsed Electromagnetic Fields with Complex Modulation in the Treatment of Patients with Diabetic Polyneuropathy
   https://doi.org/10.1023/a:1025184912494
7. Kavak et al. (2009) - Repetitive 50 Hz pulsed electromagnetic field ameliorates the diabetes-induced impairments in the relaxation response of rat thoracic aorta rings
   https://doi.org/10.1080/09553000903009522
8. Weintraub et al. (2009) - Pulsed Electromagnetic Fields to Reduce Diabetic Neuropathic Pain and Stimulate Neuronal Repair: A Randomized Controlled Trial
   https://doi.org/10.1016/j.apmr.2009.01.019
9. Cheing et al. (2014) - Pulsed electromagnetic fields (PEMF) promote early wound healing and myofibroblast proliferation in diabetic rats
   https://doi.org/10.1002/bem.21832
10. Jensen et al. (2018) - Effects of Long-Term Treatment with T-PEMF on Forearm Muscle Activation and Motor Function in Parkinson’s Disease
    https://doi.org/10.1159/000492486
11. Malling et al. (2018) - Effect of transcranial pulsed electromagnetic fields (T-PEMF) on functional rate of force development and movement speed in persons with Parkinson's disease: A randomized clinical trial
    https://doi.org/10.1371/journal.pone.0204478
12. Malling et al. (2019) - The effect of 8 weeks of treatment with transcranial pulsed electromagnetic fields on hand tremor and inter-hand coherence in persons with Parkinson’s disease
    https://doi.org/10.1186/s12984-019-0491-2
13. Kaszuba-Zwoiñska et al. (2008) - Magnetic Field Anti-inflammatory Effects In Crohn's Disease Depends Upon Viability And Cytokine Profile Of The Immune Competent Cells
    https://pubmed.ncbi.nlm.nih.gov/18441397/
14. Capelli et al. (2017) - Low-Frequency Pulsed Electromagnetic Field Is Able to Modulate miRNAs in an Experimental Cell Model of Alzheimer’s Disease
    https://doi.org/10.1155/2017/2530270