Efficacy and safety of low- and high-intensity magnetic field therapies for orthopedic pain: a systematic review

Introduction: Orthopedic and musculoskeletal pain is a leading cause of disability worldwide, and many patients continue to experience suboptimal relief despite advances in pharmacological and physical therapies. Magnetic field–based interventions, including pulsed electromagnetic field therapy (PEMF) and repetitive peripheral magnetic stimulation (rPMS), have emerged as non-invasive approaches for pain modulation and functional improvement. This systematic review aimed to evaluate the efficacy and safety of low-intensity (PEMF) and high-intensity (rPMS) magnetic field therapies in adults with musculoskeletal conditions. Methods Randomized controlled trials published between 2015 and 2025 were identified through searches in PubMed, Embase, Scopus, and Web of Science. Eligible studies compared PEMF or rPMS with sham, placebo, or standard care and reported outcomes related to pain intensity, functional performance, and safety. Results Eight RCTs met the inclusion criteria. Most included studies reported reductions in pain and improvements in functional outcomes, including the Oswestry Disability Index and WOMAC. No serious adverse events were reported. PEMF was primarily linked to sustained analgesic and anti-inflammatory effects, whereas rPMS showed faster pain reduction, likely related to neuromuscular activation and modulation of descending inhibitory pathways. Some studies reported greater benefits using higher stimulation intensities or combining therapy with exercise. Discussion Magnetic field therapies appear to be safe and well tolerated, with potential benefits for pain and function for the management of musculoskeletal pain. Their complementary mechanisms suggest potential clinical synergy; however, larger and more standardized trials are needed to establish optimal protocols and long-term effectiveness. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251170876 , PROSPERO CRD420251170876.