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Short and Long Term Exposure to Unique, Time-Varying Pulsed Electro-Magnetic Fields in Refractory Carpal Tunnel Syndrome

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00277563
Recruitment Status : Completed
First Posted : January 16, 2006
Last Update Posted : September 21, 2007
Dr. Steven P. Cole, PhD. Statistician
Information provided by:
Weintraub, Michael I., MD, FACP, FAAN

Brief Summary:
Pulsed electromagnetic fields (PEMF) have been approved by FDA and are utilized currently in treating non-union fractures, neurogenic bladder and musculoskeletal pains. Based on 2 prior pilot studies (open label) demonstrating reduction in neuropathic pain from carpal tunnel syndrome we decided to perform a placebo-controlled trial, randomized for 2 months utilizing a wrist PEMF device attached by Velcro for 4 hours/day.

Condition or disease Intervention/treatment Phase
Refractory Carpal Tunnel Syndrome Neurpathic Pain Neuromodulaton Device: reduction of pain scores by magnetic energy Phase 4

Detailed Description:


Entrapment of the median nerve at the wrist is the most common cause of sensory and motor disturbance in the hands and can be progressively disabling.1,2 Complex mechanisms of compression and ischemia exist that adversely influence the large A myelinated fibers and small unmyelinated nociceptive C fibers. From a pathophysiological standpoint, neuropathic pain (numbness, tingling and burning, NP) is believed secondary to ectopic firing of nociceptive afferent unmyelinated C-fiber axons that are undergoing degeneration.3 Microneurography has confirmed that dysregulated expression of sodium and calcium channels, which accumulate at site of injury, are responsible for ectopic depolarization.3,4,53,54 When conventional therapy of splinting and pharmacotherapy fail, surgical decompression has been offered for moderate-severe cases. While usually successful, it is associated with significant complications, limitations and costs.5,6,7 Thus, the search for reliable and new therapeutic strategies is appealing.

Substantial evidence exists that time-varying magnetic fields produce biological effects by safely inducing extremely low-frequency (ELF) small electrical eddy currents within the tissues that can depolarize, repolarize and hyperpolarize neurons.8,9,10,11,12

Prior pilot data using static13 and pulsed magnetic fields (PEMF)14,15 directed to the carpal tunnel region significantly reduced NP. Since a new, novel device became commercially available that produced a combination of static and time-varying magnetic fields simultaneously, it was hypothesized that this energy could be directed into the wrists and potentially influence not only NP scores, but also modulate neuronal distal latencies (neurotransmission).


DESCRIPTION: (FIGURE 1) This patented device (Biaxial Super Mini [Mx2R] by Nikken, Inc.) measures 2" in diameter and 1" in height and is worn with a Velcro strap similar to a wristwatch. It is noiseless and nonthermal. Its main component is a spherical permanent magnet, 1150G, 3/8" in diameter that rotates in two perpendicular directions simultaneously producing biaxial magnetic rotation (MX2R) and oscillating polarities up to 1,200 rpm-20 times per second. It is driven by a 2 V DC micro-motor which is shielded one inch away and produces a negligible back EMF. The device is powered by three ¼ AAA rechargeable NiMH (Nickel Metal Hydride) batteries

Randomized double blind placebo-controlled device with primary parameters of pain and sleep interupption scores, NPS scale and secondary parameters of neurological exam changes, nerve conduction latencies of median nerve, dynamometry, finger gauge pressures, CPT and PGIC were compared at baseline and end of two months. Patients were given a free "active" device gratis at end of study.

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Study Type : Interventional  (Clinical Trial)
Enrollment : 50 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: Short and Long Term Exposure to Unique, Time-Varying Pulsed Electro-Magnetic Fields in Refractory Carpal Tunnel Syndrome (Cts): A Randomized, Placebo-Controlled Trial With Secondary Bayesian Modification
Study Start Date : June 2004
Study Completion Date : July 2005

Primary Outcome Measures :
  1. VAS Pain scores 0-10 (leikert scale)
  2. VAS Sleep interrupption 0-10
  3. Neuropathic Pain scale (NPS)

Secondary Outcome Measures :
  1. Neurological Exam
  2. Median nerve distal latencies (CMAP/SNAP)
  3. Hand help Dynamometry and Finger gauge pressures
  4. CPT (Neurometer)
  5. PGIC

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Intractable neuropathic pain in median nerve innervated hand for at least 3 months;
  • Abnormal neurological examination compatible with diagnosis of CTS

Exclusion Criteria:

  • Post-surgical failures,
  • Pregnancy,
  • Pts with pacemaker

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00277563

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United States, New York
Michael I. Weintraub MD, PC
Briarcliff, New York, United States, 10510
Sponsors and Collaborators
Weintraub, Michael I., MD, FACP, FAAN
Dr. Steven P. Cole, PhD. Statistician
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Study Chair: Steven P. Cole, PhD Statistician
Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information Identifier: NCT00277563    
Other Study ID Numbers: 1-Weintraub
First Posted: January 16, 2006    Key Record Dates
Last Update Posted: September 21, 2007
Last Verified: September 2007
Keywords provided by Weintraub, Michael I., MD, FACP, FAAN:
Carpal Tunnel Syndrome
Neuropathic Pain
Magnetic Field Therapy
Additional relevant MeSH terms:
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Carpal Tunnel Syndrome
Pathologic Processes
Median Neuropathy
Peripheral Nervous System Diseases
Neuromuscular Diseases
Nervous System Diseases
Nerve Compression Syndromes
Cumulative Trauma Disorders
Sprains and Strains
Wounds and Injuries