Exploring the Role of Magnetotherapy, Laser Therapy, Electrotherapy, and Cryotherapy in Rheumatoid Arthritis Treatment: A Review
DOI:
https://doi.org/10.12775/QS.2025.42.60485Keywords
rheumatoid arthritis, cryotherapy, magnetotherapy, PEMF, electrotherapy, TENS, laser therapy, photobiomodulation, whole body cryotherapyAbstract
Rheumatoid arthritis (RA) is a chronic systemic autoimmune connective tissue disorder that leads to disability, impairment and premature mortality. As non-pharmacological approaches that do not interfere with existing treatments, magnetotherapy, laser therapy, electrotherapy and cryotherapy present promising supplemental options. Although they are employed in the treatment of RA patients,their mechanisms of action and advantages are not fully understood and remain an area of ongoing research.
Aim of the Study: This review explores the mechanisms of magnetotherapy, laser therapy, electrotherapy andcryotherapy and evaluates their effects on inflammation, oxidative stress, pain, and functional outcomes in RA, providing insights into their potential as a complementary treatment and identifying potential risks.
Materials and Methods: A review of research literature was conducted through databases such as PubMed, Google Scholar, ResearchGate, and the Cochrane Library
Results: The studied methods effectively reduced pain and disease activity in RA patients.
Conclusions: These methods can complement conventional treatments, but further research is needed to standardize protocols and assess risks.
References
1. Almutairi K, Nossent J, Preen D, Keen H, Inderjeeth C. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol Int. 2021;41(5):863-877.
https://doi.org/10.1007/s00296-020-04731-0
2. Scherer HU, Häupl T, Burmester GR. The etiology of rheumatoid arthritis. J Autoimmun. 2020;110:102400.
https://doi.org/10.1016/j.jaut.2019.102400
3. Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res. 2002;4 Suppl 3(Suppl 3):S265-S272.
4. Goeldner I, Skare TL, de Messias Reason IT, Nisihara RM, Silva MB, Utiyama SR. Anti-cyclic citrullinated peptide antibodies and rheumatoid factor in rheumatoid arthritis patients and relatives from Brazil. Rheumatology (Oxford). 2010;49(8):1590-1593
https://doi.org/10.1093/rheumatology/keq134
5. Shams S, Martinez JM, Dawson JRD, et al. The Therapeutic Landscape of Rheumatoid Arthritis: Current State and Future Directions. Front Pharmacol. 2021;12:680043.
https://doi.org/10.3389/fphar.2021.680043
6. Mitrović J, Hrkač S, Tečer J, et al. Pathogenesis of Extraarticular Manifestations in Rheumatoid Arthritis-A Comprehensive Review. Biomedicines. 2023;11(5):1262
https://doi.org/10.3390/biomedicines11051262
7. Firestein GS. Evolving concepts of rheumatoid arthritis. Nature. 2003;423(6937):356-361.
https://doi.org/10.1038/nature01661
8. O'Neil LJ, Alpízar-Rodríguez D, Deane KD. Rheumatoid Arthritis: The Continuum of Disease and Strategies for Prediction, Early Intervention, and Prevention. J Rheumatol. 2024;51(4):337-349.
https://doi.org/10.3899/jrheum.2023-0334
9. Mariani FM, Martelli I, Pistone F, Chericoni E, Puxeddu I, Alunno A. Pathogenesis of rheumatoid arthritis: one year in review 2023. Clin Exp Rheumatol. 2023;41(9):1725-1734.
https://doi.org/10.55563/clinexprheumatol/sgjk6e
10. van Riel PL, Renskers L. The Disease Activity Score (DAS) and the Disease Activity Score using 28 joint counts (DAS28) in the management of rheumatoid arthritis. Clin Exp Rheumatol. 2016;34(5 Suppl 101):S40-S44.
11. Bruce B, Fries JF. The Stanford Health Assessment Questionnaire: dimensions and practical applications. Health Qual Life Outcomes. 2003;1:20.
https://doi.org/10.1186/1477-7525-1-20
12. Whittle SL, Colebatch AN, Buchbinder R, et al. Multinational evidence-based recommendations for pain management by pharmacotherapy in inflammatory arthritis: integrating systematic literature research and expert opinion of a broad panel of rheumatologists in the 3e Initiative. Rheumatology (Oxford). 2012;51(8):1416-1425.
https://doi.org/10.1093/rheumatology/kes032
13. Del Grossi Moura M, Cruz Lopes L, Silva MT, Barberato-Filho S, Motta RHL, Bergamaschi CC. Use of steroid and nonsteroidal anti-inflammatories in the treatment of rheumatoid arthritis: Systematic review protocol. Medicine (Baltimore). 2018;97(41):e12658.
https://doi.org/10.1097/MD.0000000000012658
14. Zwolińska J, Gąsior M, Śnieżek E, Kwolek A. The use of magnetic fields in treatment of patients with rheumatoid arthritis. Review of the literature. Reumatologia. 2016;54(4):201-206.`
https://doi.org/10.5114/reum.2016.62475
15. Brosseau LU, Pelland LU, Casimiro LY, Robinson VI, Tugwell PE, Wells GE. Electrical stimulation for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2002;2002(2):CD003687.
https://doi.org/10.1002/14651858.CD003687
16. Księżopolska-Orłowska K, Pacholec A, Jędryka-Góral A, et al. Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?. Disabil Rehabil. 2016;38(11):1034-1040.
https://doi.org/10.3109/09638288.2015.1060265
17. Kerschan-Schindl K, MacHold K. Rehabilitation of patients with rheumatoid arthritis. Physikalische Medizin Rehabilitationsmedizin Kurortmedizin. 2011;21(6):297–310.
https://doi.org/10.1055/s-0031-1276996
18. England BR, Smith BJ, Baker NA, et al. 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis Rheumatol. 2023;75(8):1299-1311.
https://doi.org/10.1002/art.42507
19. Brosseau L, Judd MG, Marchand S, et al. Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Cochrane Database Syst Rev. 2003;2003(3):CD004377.
https://doi.org/10.1002/14651858.CD004377
20. Negrei C, Bojinca V, Balanescu A, et al. Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches. Exp Ther Med. 2016;11(4):1177-1183.
https://doi.org/10.3892/etm.2016.3045
21. Mocanu-Dobranici AE, Costache M, Dinescu S. Insights into the Molecular Mechanisms Regulating Cell Behavior in Response to Magnetic Materials and Magnetic Stimulation in Stem Cell (Neurogenic) Differentiation. Int J Mol Sci. 2023;24(3):2028.
https://doi.org/10.3390/ijms24032028
22. Markov M. XXIst century magnetotherapy. Electromagn Biol Med. 2015;34(3):190-196.
23. Ganesan K, Gengadharan AC, Balachandran C, Manohar BM, Puvanakrishnan R. Low frequency pulsed electromagnetic field--a viable alternative therapy for arthritis. Indian J Exp Biol. 2009;47(12):939-948.
24. Ross CL, Zhou Y, McCall CE, Soker S, Criswell TL. The Use of Pulsed Electromagnetic Field to Modulate Inflammation and Improve Tissue Regeneration: A Review. Bioelectricity. 2019;1(4):247-259.
https://doi.org/10.1089/bioe.2019.0026
25. Eccles NK. A critical review of randomized controlled trials of static magnets for pain relief. J Altern Complement Med. 2005;11(3):495-509.
https://doi.org/10.1089/acm.2005.11.495
26. Fan Y, Ji X, Zhang L, Zhang X. The Analgesic Effects of Static Magnetic Fields. Bioelectromagnetics. 2021;42(2):115-127.
https://doi.org/10.1002/bem.22323
27. Yamaguchi-Sekino S, Sekino M, Ueno S. Biological effects of electromagnetic fields and recently updated safety guidelines for strong static magnetic fields. Magn Reson Med Sci. 2011;10(1):1-10.
https://doi.org/10.2463/mrms.10.1
28. Krylov VV, Osipova EA. Molecular Biological Effects of Weak Low-Frequency Magnetic Fields: Frequency-Amplitude Efficiency Windows and Possible Mechanisms. Int J Mol Sci. 2023;24(13):10989.
https://doi.org/10.3390/ijms241310989
29. Pophof B, Brix G. Magnetic resonance imaging : Recent studies on biological effects of static magnetic and high‑frequency electromagnetic fields. Radiologe. 2017;57(7):563-568.
https://doi.org/10.1007/s00117-017-0260-9
30. Hong JE, Lee CG, Hwang S, et al. Pulsed Electromagnetic Field (PEMF) Treatment Ameliorates Murine Model of Collagen-Induced Arthritis. Int J Mol Sci. 2023;24(2):1137.
https://doi.org/10.3390/ijms24021137
31. Zwolińska J, Kasprzak M, Kielar A, Prokop M. Positive and Negative Effects of Administering a Magnetic Field to Patients with Rheumatoid Arthritis (RA). J Clin Med. 2024;13(6):1619.
https://doi.org/10.3390/jcm13061619
32. Eldoushy EE. Efficacy of Applying Mild-Magnetic Compression versus Massage Therapy on Hand-Joints’ Functional Disability Symptoms among Patients with Rheumatoid Arthritis. Egyptian Journal of Health Care.2022. 13(3):1268-1289
https://doi.org/10.21608/ejhc.2022.259469
33. Glass GE. Photobiomodulation: The clinical applications of low-level light therapy. Aesthet Surg J. 2021;41(6):723–38.
https://doi.org/10.1093/asj/sjab025
34. Rola P, Włodarczak S, Lesiak M, Doroszko A, Włodarczak A. Changes in Cell Biology under the Influence of Low-Level Laser Therapy. Photonics. 2022; 9(7):502.
https://doi.org/10.3390/photonics9070502
35. Wickenheisser VA, Zywot EM, Rabjohns EM, Lee HH, Lawrence DS, Tarrant TK. Laser Light Therapy in Inflammatory, Musculoskeletal, and Autoimmune Disease. Curr Allergy Asthma Rep. 2019;19(8):37.
https://doi.org/10.1007/s11882-019-0869-z
36. Kohale BR, Agrawal AA, Sope AB, Pardeshi K V, Raut CP. Low-level Laser Therapy: A Literature Review. International Journal of Laser Dentistry. 2015.1–5.
https://doi.org/10.5005/jp-journals-10022-1064
37. Zhuravleva N, Karzakova L, Kudryashov S, Petrova E. Evaluation of the effectiveness of laser therapy in the treatment of rheumatoid arthritis. Annals of the Rheumatic Diseases 2021;80:1388
https://doi.org/10.1136/annrheumdis-2021-eular.238
38. Yamaura M, Yao M, Yaroslavsky I, Cohen R, Smotrich M, Kochevar IE. Low level light effects on inflammatory cytokine production by rheumatoid arthritis synoviocytes. Lasers Surg Med. 2009;41(4):282-290.
https://doi.org/10.1002/lsm.20766
39. Kostro A, Dakowicz, A, Moskal-Jasińska D, Kuryliszyn-Moskal A. The Influence of Laser Therapy and Magnetotherapy on the Function and Quality of Life Patients with Rheumatoid Artritis of Hand Joints.Acta Balneologica. 2020; 149-153.
https://doi.org/10.36740/ABAL202003103
40. Thajeel R A, Hasan, J A, Tahseen D, Al-Aridhi N.Design and Enhancement Low-Level Laser Therapy System for Rheumatoid Arthritis. Pakistan Journal of Life and Social Sciences.2024;22(1). 3639-3652.
https://doi.org/10.57239/pjlss-2024-22.1.00265
41. Ailioaie LM, Litscher G. Molecular and Cellular Mechanisms of Arthritis in Children and Adults: New Perspectives on Applied Photobiomodulation. Int J Mol Sci. 2020;21(18):6565.
https://doi.org/10.3390/ijms21186565
42. Zhang R, Qu J. The Mechanisms and Efficacy of Photobiomodulation Therapy for Arthritis: A Comprehensive Review. Int J Mol Sci. 2023;24(18):14293.
https://doi.org/10.3390/ijms241814293
43. Tai G, Tai M, Zhao M. Electrically stimulated cell migration and its contribution to wound healing. Burns Trauma. 2018;6:20.
https://doi.org/10.1186/s41038-018-0123-2
44. Brosseau L, Judd MG, Marchand S, et al. Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Cochrane Database Syst Rev. 2003;2003(3):CD004377.
https://doi.org/10.1002/14651858.CD004377
45. Johnson MI, Paley CA, Jones G, Mulvey MR, Wittkopf PG. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study). BMJ Open. 2022;12(2):e051073.
https://doi.org/10.1136/bmjopen-2021-051073
46. Vance CG, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag. 2014;4(3):197-209.
https://doi.org/10.2217/pmt.14.13
47. Brosseau L, Judd MG, Marchand S, et al. Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Cochrane Database Syst Rev. 2003;2003(3):CD004377.
https://doi.org/10.1002/14651858.CD004377
48. Abelson K, Langley GB, Sheppeard H, Vlieg M, Wigley RD. Transcutaneous electrical nerve stimulation in rheumatoid arthritis. N Z Med J. 1983;96(727):156-158.
49. Wu Y, Zhu F, Chen W, Zhang M. Effects of transcutaneous electrical nerve stimulation (TENS) in people with knee osteoarthritis: A systematic review and meta-analysis. Clin Rehabil. 2022;36(4):472-485.
https://doi.org/10.1177/02692155211065636
50. Zhang Z, Shao Z, Xu Z, Wang J. Similarities and differences between osteoarthritis and rheumatoid arthritis: insights from Mendelian randomization and transcriptome analysis. J Transl Med. 2024;22:851
https://doi.org/10.1186/s12967-024-05643-4
51. Drewes AM, Brock C, Rasmussen SE, Møller HJ, Brock B, Deleuran BW, et al. Short-term transcutaneous non-invasive vagus nerve stimulation may reduce disease activity and pro-inflammatory cytokines in rheumatoid arthritis: results of a pilot study. Scand J Rheumatol. 2021;50(1):20–27.
https://doi.org/10.1080/03009742.2020.1764617
52. Koopman FA, Chavan SS, Miljko S, Grazio S, Sokolovic S, Schuurman PR, et al. Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in Rheumatoid arthritis. Proc Natl Acad Sci U S A. 2016;113(29):8284–8289.
https://doi.org/10.1073/pnas.1605635113
53. Johnson MI, Paley CA, Jones G, Mulvey MR, Wittkopf PG. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study). BMJ Open. 2022;12(2):e051073.
https://doi.org/10.1136/bmjopen-2021-051073
54. Genovese MC, Gaylis NB, Sikes D, et al. Safety and efficacy of neurostimulation with a miniaturised vagus nerve stimulation device in patients with multidrug-refractory rheumatoid arthritis: a two-stage multicentre, randomised pilot study. Lancet Rheumatol. 2020;2(9):e527-e538.
https://doi.org/10.1016/S2665-9913(20)30172-7
55. Stålman A, Berglund L, Dungnerc E, Arner P, Felländer-Tsai L. Temperature-sensitive release of prostaglandin E₂ and diminished energy requirements in synovial tissue with postoperative cryotherapy: a prospective randomized study after knee arthroscopy. J Bone Joint Surg Am. 2011;93(21):1961-1968.
https://doi.org/10.2106/JBJS.J.01790
56. Peyronnel C, Petitcolin V, Totoson P, Martin H, Verhoeven F, Demougeot C. Structural effects of local cryotherapy in rheumatoid arthritis: a study in adjuvant-induced arthritis. Ann Rheum Dis. 2020;79(Suppl 1):940-941.
https://doi.org/10.1136/annrheumdis-2020-eular.4118
57. England BR, Thiele GM, Anderson DR, Mikuls TR. Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications. BMJ. 2018;361:k1036.
https://doi.org/10.1136/bmj.k1036
58. Wojtecka-Lukasik E, Ksiezopolska-Orlowska K, Gaszewska E, et al. Cryotherapy decreases histamine levels in the blood of patients with rheumatoid arthritis. Inflamm Res. 2010;59 Suppl 2:S253-S255.
https://doi.org/10.1007/s00011-009-0144-1
59. Laktašić Žerjavić N, Hrkić E, Žagar I, et al. Local Cryotherapy, Comparison of Cold Air and Ice Massage on Pain and Handgrip Strength in Patients with Rheumatoid Arthritis. Psychiatr Danub. 2021;33(Suppl 4):757-761.
60. Klemm P, Hoffmann J, Asendorf T, et al. Whole-body cryotherapy for the treatment of rheumatoid arthritis: a monocentric, single-blinded, randomised controlled trial. Clin Exp Rheumatol. 2022;40(11):2133-2140.
61. Gizińska M, Rutkowski R, Romanowski W, Lewandowski J, Straburzyńska-Lupa A. Effects of Whole-Body Cryotherapy in Comparison with Other Physical Modalities Used with Kinesitherapy in Rheumatoid Arthritis. Biomed Res Int. 2015;409174.
https://doi.org/10.1155/2015/409174
62. Istrati J,Gluszko P, Suszko R, Iwaniec T. Whole-body cryotherapy decreases fibrinolytic activity in blood of patients with rheumatoid arthritis and patients with osteoarthritis. Reumatologia.2010;48(3):171-176.
63. Hirvonen HE, Mikkelsson MK, Kautiainen H, Pohjolainen TH, Leirisalo-Repo M. Effectiveness of different cryotherapies on pain and disease activity in active rheumatoid arthritis. A randomised single blinded controlled trial. Clin Exp Rheumatol. 2006;24(3):295-301.
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