CodeBlueBlog: Magnets, Arthritis, And A Spot of Tea

April 2005

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British Study Supports Treating Arthritis With Magnets
Will the British next turn their attention to tickle therapy?

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CodeBlueBlog STAT Summary Box
If you don't want to read the whole post

1. As reported this month in The British Medical Journal, magnetic bracelets were effective in reducing patient discomfort in osteoarthritis.

2. No one should mistake osteoarthritis for rheumatoid arthritis or any other inflammatory arthritis. Make sure you know the difference.

3. Can magnets on the wrist actually be doing something medically here to reduce pain in osteoarthritis of the hip and knee? My answer: ABSOLUTELY NOT (did anyone think they could...really?). This study has an enormous error that everyone missed which completely invalidates the hypothesis. So don't go spending any money on magnets for pain.

4. Just remember, if magnets can have effects AWAY from where they are worn, then who's to say magnets cannot, in 20 years cause leukemia or lymphoma?

5. The patients in this study were experiencing the placebo effect.

6. Why does The British Medical Journal that touts itself as one of "the world's top four general medical journals" proffer this watery porridge while the prestigious American journals are serving steak and lobster?

7. As I pointed out last week in this post, degradation of the quality of research and fewer important medical breakthroughs are among the long term consequences of nationalizing health care.

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The Long Story: A Magnet a Day...

Last week in its special "double" Christmas edition, The British Medical Journal (BMJ) published this study as one of its headliners:

"Randomized controlled trial of magnetic bracelets for relieving pain in osteoarthritis of the hip and knee."

The press scooped it up (I should say out). This study was quickly trumpeted, especially in the British press, as showing -- finally -- that the promulgators of therapeutic magnetic jewelry have been right all along...just as everyone suspected. The Mirror said:

Doctors have long derided the benefits of the bracelets, which many patients insist give some relief, calling it a figment of the imagination.

The press went along with the study because of the BMJ's publishing pedigree, and even Medscape posted up the study without critique, claiming:

Magnetic bracelets may reduce the pain associated with osteoarthritis of the hip and knee, suggest the results of a multicenter, randomized, placebo-controlled study published in the December issue of the British Medical Journal.

For this study, researchers from The Peninsular Medical School located patients with documented osteoarthritis of the hip or knee. Patients then got one of three bracelets to wear: a strong magnet, a weak magnet, or a dummy magnet. After wearing the bracelets, researchers had the patients fill out standard questionnaires concerning pain perception in the hip and knee. The results indicated that patients wearing the strong magnets had relief of pain that is attributable to the magnet itself.

The researchers don't discuss how it might be that magnets achieve this astounding effect.

Osteoarthritis is NOT Rheumatoid Arthritis

Of first importance for all non medical people reading this, is to distinguish osteoarthritis from other arthritis diseases.

Osteoarthritis is a wear-and-tear disease involving the gradual erosion of cartilage and underlying bone in work-performing joints. This type of arthritis is associated with aging and/or overuse and trauma.
Rheumatoid arthritis is an autoimmune (body "attacking" itself) disease where the cartilage and bone of joints is destroyed prematurely by inflammation in the joint.

So no matter what you believe or take home from this or any other article, you should never confuse these types of arthritis. Rheumatoid arthritis, and other types of inflammatory arthritis -- must be treated by a physician and must never be treated by magnets or any other bogus (homeopathic, manipulative, etc) therapy. You will lose the function of your joints completely if inflammatory arthritis is treated inadequately.

Unfortunately, I saw no media report that made this important point to its readers.

FANTASTIC VOYAGE

Most of the work I could find concerning magnets and treatment of...anything...dealt with the local effects of the magnet. In other words, the magnets are supposed to help the area they cover, physically. Because tyhe boys from Peninsular Medical School didn't tell us how this magnet might effect changes in the underlying flesh and blood, I tried to research the proposed mechanisms of local magnetism (electromagnetic effects not included), and here's what I came up with:

1. Magnets affect the flow of blood because blood contains iron

2. Magnets affect temperature locally (secondary to #1)

3. Magnets affect ion flow

All of these effects are local, i.e. directly underneath or near the bracelet.

What is a bracelet?

Bracelet

Noun

1. An ornamental band or chain encircling the wrist

So these magnetic bracelets encircle the wrist. And the proposed effects of static magnets are local (i.e. in the general body area of the magnet). How then are these wrist magnets affecting the hip or knee? The British magnet researchers don't even tell us in the study if patients wore the bracelets on the same side as their osteoarthritic joints! So could a bracelet on the right wrist improve osteoarthritis pain in the left knee?

Here's the Fantastic Voyage a red blood cell (or ion) has to travel to get from the wrist to the knee:

...from the wrist the cell travels to the fingers, crosses to the veins, goes up the arm, into the chest, into the right heart, out to the lungs, back to the left heart, out to the chest, down through the belly, out through the groin, down the thigh, HOME (to the knee).

In anatomic mileage, the distance from the right wrist to the left knee is like driving from Bangor Maine to Amarillo, Texas. Could this tired, road-beaten red cell then have any effect on that distant anatomic colossus, the knee? No way.

Even if the researchers could propose some mechanism for this effect then I would counter propose that any such highly-potent, long-lasting effect on cells, cell metabolism, or function, needs to be studied. Because who is to say that such a potent influence -- when applied over years -- would not give these patients cancer down the line. Especially blood cancers like lymphoma and leukemia. Bracelet emptor.

Placebo Effect

Definition: The beneficial effect in a patient following a particular treatment that arises from the patient's expectations concerning the treatment rather than from the treatment itself.

The British researchers tried to weakly refute the placebo effect with a few twists in their study. I found these to be dodges. I won't go into their methodology here, but even they thought it was unconvincing, saying, finally, in their conclusion to the study

It is uncertain whether thisresponse is due to specific or non-specific (placebo) effects

Think of it this way. The magnet used in this study was TWENTY times stronger than an average bar magnet (see photo, top of post); or 170 to 200 mT (bracelet) versus 10 mT (bar magnet). Ever see what a bar magnet does when you pass it through your junk drawer at home? It picks up all the little metal objects it approaches. Now make that magnet twenty times stronger. What do you think was happening?

These patients were probably stuck to their refrigerators and car doors for hours until help arrived. They were probably local sources for paper clips and penny nails. The patients had to believe that there was a mighty potent magic going on there. This in contradistinction to the patients with weakly magnetic and dummy bracelets -- they were likely unimpressed.

The Quality of Their Research

As discussed in CodeBlueBlog last week, nationalized health care systems tend to produce inferior research and fewer significant medical breakthroughs.

One window for viewing such degradation, real-time, is a system's major medical periodicals -- where fundamental research and ground-breaking studies are first published.

The British Medical Journal is a window into research and innovation in health care in Great Britain. And this highly touted article from the special Christmas edition -- which cites as its most relevant sources several papers from a journal called Alternative & Complementary Therapies -- is a good example of the type and kind of research we would hate to see in The New England Journal of Medicine. It's inexpensive. It's shoddy. It makes conclusions that don't cost the system money, and it eventually hurts patients.

We don't want that here. Let them keep their magnetic bracelets over there, where they can't hurt us.

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CodeBlueBlog

health care also health·care (hlthkâr) n. :efforts made to maintain or restore health especially by trained and licensed professionals -- usually hyphenated when used attributively

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April 2005

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