Richard MARKOLL, Dulce M. DA SILVA FERREIRA and Theresa K. TOOHIL

Abstract

Pulsed Signal Therapy® (PST®) is a unique form of therapy that entails directing a specific physiological signal carried on a series of magnetic field pulses to the treatment site. These uniquely specific energy parameters are transmitted through the injured tissue to target the affected area via direct induction. The corrective PST® signal, carried on the magnetic wave-pulse, induces a tiny electrical signal that mimics the physiological signaling normally occurring in healthy living organisms. In this way, it exerts its therapeutic effects by stimulating cellular repair. Double-blind clinical trials and other open label randomized studies conducted in over 100,000 patients have consistently confirmed the long term efficacy and safety of PST® in patients suffering from osteoarthritis of the knee, cervical and lumbar spine. Data was collected over a 10 year period in the USA, Canada, France, Italy and Germany, by qualified specialists at major medical centers, or their affiliated teaching hospitals and other facilities.* Extensive studies in patients with temporomandibular joint disorder (TMJ) and tinnitus, not responsive to other therapies, have shown significant improvement, following PST®. Ergo PST has been successfully used in the treatment of chronic pain associated with connective tissue (cartilage, tendon, ligaments and bone) injury, osteoarthritis (OA or arthrosis) and also in the treatment of joint-associated soft tissue injury (traumatic, including soft tissue injury). In effect, PST® has been shown to exert positive effects on both cartilage and dense connective tissue, and in stimulating the repair of bone-tissue.

INTRODUCTION

Astounding as it may sound, statistics have shown that lower back pain and osteoarthritis, are among the most common of public health disorders.^1,2 In fact, at some point in one's life, there is bound to be a need for medical assistance due to disorders of the musculoskeletal system. These disorders are associated with considerable pain, often hinder mobility, and so too, very often interfere with the normal activities of daily living. Numerous medical solutions are currently available to treat joint and spinal complaints, but these are most often associated with undesirable side-effects, high costs, and short duration of results. A detailed overview of most of the conventional treatments available for osteoarthritis, is provided in Table 1. In light of this, decades of intense research have instigated an awakening, perhaps a revolution of conventional treatment modalities. A signalling device capable of restoring the natural physiologic stimulus, crucial for cartilage production and bone-formation, and for successful treatment of connective tissue lesions, was developed over 20 years. This treatment modality, known as Pulsed Signal Therapy ® (PST®), has been commercially available since 1994 and has shown not only to be safe and effective, but is conveniently painless, non-invasive, and nonpharmacological. Furthermore, it has added benefits that include a long-term follow-up, sustained efficacy and an absence of adverse effects.³

ELECTROPHYSIOLOGY OF THE JOINT

Perhaps, prior to seeking an understanding of the underlying principle of PST®, it is best to begin with an understanding of the electrophysiology of the joint. It has been well established, that under physiological conditions, the healthy joint-cartilage retains virtually wear-free functionality. In retrospect, under nonphysiological loads, including incorrect positioning, inactivity and changes in the synovia caused by infection, progressive wearing of the joint surface occurs, causing attrition and destruction of the cartilage. Cartilage is a structural tissue, with an extracellular matrix composed of 60-80% water and an intercellular matrix composed of basic substances manufactured by the chondrocytes (cartilage cells), namely proteoglycans, glucoproteins and collagen (filaments).⁴ The proteoglycans are macromolecules, to which several glycosaminoglycan (GAG) chains are bound, possessing negatively charged sulphate (SO 2- 4) and carboxyl (COO-) groups. When a joint is subjected to a load or mild stress, as for example, on walking, it is massaged; or biophysically, the hydrogen protons (of water) are forced through the extracellular matrix causing a small pulsed energy signal to occur. In part, the underlying science is explained by the Donnan effect, which states that the fixed negative ion concentration (imposed by the sulphate and carboxyl groups), determines the effect of the counter-ion, which in this case is sodium (Na+). The resulting piezoelectric signal generates a so-called 'streaming potential' in the extracellular matrix, which is responsible for stimulating the growth and repair, as well as the healing of cartilage defects.⁵

THE BIRTH OF PULSED SIGNAL THERAPY

The eventual bridging of the vast interdisciplinary gap between biophysics and medicine was already evident in the work championed by Bassett, Becker, Liboff, and other pioneers many decades ago. Bassett clearly predicted this in saying:

Before the next century is out of its infancy, physics will be as important in the treatment of disease as pharmacology and biotechnology are today ... The future holds exciting and rewarding prospects for those ... who use their diverse knowledge and skills as teams to forge the principles for a new era of medical therapeutics. Without interdisciplinary effort, however, success will be elusive ... Herein lies our challenge. C. Andrew L. Bassett, Applications of electromagnetic fields in Medicine.
Bioelectromagnetic Society Newsletter 1993; 110:1, 4.

Pulsed electromagnetic fields (PEMF) have been used in the treatment of non-union and related problems in bone healing and pain relief, due to osteoarthritis and traumatic joint damage, since the 1970s with a relatively consistent success rate of 70-80% in several countries.4,6 Since most of these claims were based on anecdotal observations, and different PEMF devices had varied characteristics, an effort was made to determine whether a pulsed electromagnetic field with specific parameters might provide superior and more consistent results.⁵ In the mid-1970s, Dr Markoll (PST® patent holder) and colleagues completed a 4 year pilot study of 1000 patients with various types of musculoskeletal disorders characterized by persistent pain. Each patient was treated for half an hour, over 18 days, with a specific energy signal formulated from basic science research.7 Since then, the protocol has been optimized, and today provides safe and effective pain relief in about 80% of patients.⁷

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REFERENCES

¹ Lidgren L (2001) The global economic and healthcare burden of musculoskeletal disease. An executive summary from the Bone and Joint Decade Organisation. 29 October 2001. Published online at: http://www.boneandjointdecade.org/news/whobjd.executive.summary.pdf
² Elders MJ (2000) The increasing impact of arthritis on public health. J Rheumatol 27, 6-8.
³ Faensen M, Breul R (2001) Multi-center-studie zum wirksamkeitsnachweis der PST Pulsierende Signal Therapie bei der behandlung von gonarthrosen [Multi-Center Study of the Effectiveness of PST (Pulsed Signal Therapy) in the Treatment of Osteoarthritis of the Knee]. Orthopädische Praxis. 1(XI).
⁴ Brighton CT, Pollack SR (1985) Treatment of recalcitrant non-union with a capacitively coupled electrical field. A preliminary report. J Bone Joint Surg 67A, 577-85.
⁵ Markoll R (2001) Pulsed Signal Therapy: a practical guide for clinicians. In: Weiner RS, ed. Pain Management: A Practical Guide for Clinicians. Boca Raton, FL: CRC Press, 715-28.
⁶ Bassett CAL, Pilla AA, Pawluk RJ (1977) A non-operative salvage of surgically resistant pseudoarthrosis and nonunions by pulsing electromagnetic fields. A preliminary report. Clin Orthop 124, 128-43.
⁷ Kornhauser SH (1999) Pulsed Signal Therapy: Powerful pain relief and promising potential. Interview with Dr. Richard Markoll. Med Electronics 30, 44-9.