Pulsed Electromagnetic Fields (PEMF) therapy accelerates fracture healing by inducing a low-level electrical field at the
injury site, which mimics the body's natural bioelectricity and stimulates cellular and molecular processes essential for
bone regeneration.
Mechanism of Action
The process involves several overlapping stages at the molecular, cellular, and tissue levels.
Mimicking Natural Processes:
When a bone is stressed or broken, it naturally generates a low-level negative electrical
charge (a piezoelectric effect) at the injury site, which promotes new tissue deposition. PEMF devices induce a similar
negative charge to enhance this natural healing mechanism.
Activating Signaling Pathways:
On a molecular level, PEMF exposure generates an electric field gradient across cell
membranes, which activates crucial intracellular signaling pathways within minutes. Key pathways involved include:
Wnt/ - catenin:
This pathway plays a vital role in bone formation, and PEMF stimulation helps activate it, promoting bone
anabolic processes.
BMPs and TGF- :
PEMF increases the expression of Bone Morphogenetic Proteins (BMPs) and Transforming Growth
Factor-beta (TGF- ) , which are essential growth factors for bone and cartilage repair.
MAPK/ERK and PI3K/Akt/mTOR:
These pathways are stimulated to enhance cell survival, proliferation, and differentiation
of osteoblasts (bone-forming cells).
Enhancing Cellular Activity:
At the cellular level, PEMF stimulation enhances the proliferation, differentiation, and
mineralization of osteoblasts and mesenchymal stem cells (MSCs) into bone tissue.
Improving Angiogenesis and Circulation:
PEMF promotes the formation of new blood vessels (angiogenesis) by
stimulating growth factors like VEGF (Vascular Endothelial Growth Factor) and FGF-2. This increased blood flow delivers
more oxygen and nutrients to the injury site, which is vital for tissue repair and also helps reduce in flammation and swelling.
Balancing Bone Remodeling:
PEMF helps regulate the balance between osteoblasts (bone formation) and osteoclasts
(bone resorption) to ensure the formation of strong, high-density bone tissue during the remodeling phase.
Clinical Application
PEMF therapy is an FDA-approved, non-invasive, and safe adjunct treatment, primarily for non-union fractures (fractures that
fail to heal on their own) and as an aid following spinal fusion surgery. The effectiveness can vary depending on the speci fic
parameters (frequency, intensity, and duration) used, and consistent patient use is a critical factor for successful outcomes.