Magnetic Resonance Therapy is a treatment method based on the physical principle of magnetic resonance. It is aimed to activate reparative processes in specific cells and tissues. So far, there is not any major clinical trial supporting the effectiveness of the method.[1][2][3][4][5] The therapy is used predominantly by practitioners for the complementary treatment of painful degenerate or pathological modifications to the musculoskeletal system. Magnetic Resonance therapy is carried out internationally in clinical practices and rehabilitation facilities. It is also supported by research establishments, e.g. the Ludwig-Boltzmann Institute in Saalfelden, Austria. The therapy can be considered under the alternative medicine as it is not approved by conventional medicine. The field generated is approximately 10,000 weaker than a diagnostic MRI.,[6]standard modern MRI machines being around 1.5 Tesla.

Functional Principle
Exposing nuclei to a magnetic field causes them to arrange themselves in relation to the field. They spin around their own axis (precession) and the speed is given by the Larmor frequence \omega. After the nuclei have been aligned along the field they are be exposed to a radio magnetic pulse. If the precession frequence is the same as the frequence of the applied radio wave, the nuclei will absorb energy from the radio waves. Hence, nuclear magnetic resonance is the selective absorption of specific frequences of radio waves by atomic nuclei in a magnetic field. The spin vectors will then start to move in phase and fall back in equilibrium as soon as the radio wave is switched off. The absorbed energy will be transmitted as radiation. This process gives information about the molecular structure of the material and is applied in medicine to obtain images by observing the magnetic moments of hydrogen nuclei in the body (magnetic resonance imaging).[7]

Given that hydrogen nuclei respond differently in various biological tissue structures, it is aimed by practitioners of the method to take advantage of this process in magnetic resonance therapy.[8]The technical specific feature of the method is that the physical technique of ‘adiabatic fast passage’ is used to generate the magnetic resonant spin activation.[9][10]

The condition of ‘adiabatic fast passage’ is given by:

$( \frac{dB_0}{dt} \cdot \frac{1}{B_1} \ge \gamma B_0 ) \wedge ( \frac{dB_0}{dt} \cdot \frac{1}{B_1} \gg \frac{1}{T_1} )$

Whereby B_1 is the magnetic excitation within the high frequency range and dB_0/dt is the rate of change of the magnetic excitation of the main field caused by the sweep field; \gamma is the gyromagnetic constant.

This condition assures that magnetic resonance is created despite small-or inhomogeneous magnetic fields. The principle is patent-registered (e.g. U.S. Patent 7,524,276; EU-Patent EP 1 089 792 B1) and approved for medical devices in agreement with 93/42/EWG.

Evidence
Several in vivo, in vitro and animal model studies were performed.[8] Observed data were presented at medical congresses and represented in publications. Based on first qualitative evidence that magnetic resonance might regenerate cartilage tissue,[11] a number of further studies were conducted.

Studies have shown that NMR may have therapeutic effects on osteoarthritis. The treatment of patients with osteoarthritis of the hand or finger joints resulted in an improvement in the physical function of the hand.[2] There is also evidence that functionality and rehabilitation success is improved for patients with chronic lower back pain.[1] Further evidence for the effectiveness of magnetic resonance therapy was given by in vitro studies on chondrocytes, osteoblasts, fibroblasts, and the extracellular matrix. It was demonstrated, that the method caused a proliferation of the chondrocytes as well as of the osteoblasts.[3] Further, experiments using the technology with fibroblast cultures revealed a significant change in protein synthesis.[12] In addition, crosslinking of collagen and the extracellular matrix was affected.

Application
Supporters of the therapy claim a broad indication spectrum in nonconservative orthopedics. It is intended as a complementary therapeutic method to support the range of service of orthopedics and accident surgery. The therapy is used for the treatment of osteoarthritis, in particular osteoarthritis of joints and for the treatment of sprained ligaments, tendon extension and sports injuries. Moreover, the therapy is applied for the prevention and treatment of osteoporosis as well as disorder of metabolisms in the area of bones.

References

1. W. Kullich, H. Schwann, J. Walcher, K. Machreich (2006). The effect of MBST with complex 3-dimensional electromagnetic nuclear resonance fields on patients with low back pain. Journal of Back and Musculoskeletal Rehabilitation, 19:79-87 abstract
2. W. Kullich, M. Außerwinkler (2008). Functional improvement in finger joint osteoarthritis with therapeutic use of nuclear magnetic resonance. Orthopedic Practice. S. 287-290 poster
3. Temiz-Artmann A, Linder P, Kayser, Digel I, Artmann GM, Lücker P (2005). NMR in vitro effects on proliferation, apoptosis, and viability of human chondrocytes and osteoblasts. Methods Find Exp Clin Pharmacol 27:391-4 PMID 16179956
4. Jump up^ A. Levers, M. Staat, W. van Laack (2011). Analysis of the Long-term Effect of the Nuclear Magnetic Resonance Therapy on Gonarthrosis, Special edition from Orthopedic Practice 11 abstract
5. Jump up^ Jansen H, Frey SP, Paletta J, Meffert RH. (2011). Effects of low-energy NMR on posttraumatic osteoarthritis: observations in a rabbit model Arch Orthop Trauma Surg.(6):863-8. PMID 21063883
6. Jump up^ http://www.mbst.de/en/faq/
7. Jump up^ Loeffler W, Oppelt A (1981). Eur J Radiol. Nov;1(4):338-44. Physical principles of NMR tomography PMID 7346283
8. D. Krpan (2011) Nuclear Magnetic Resonance Therapy. The new possible of osteoarthritis and osteoporosis treatment. Balneoclimatologia . Volume 35 Broj 3
9. Jump up^ E. Kupce (2001) Applications of adiabatic pulses in biomolecular nuclear magnetic resonance. Methods Enzymol. 338:82-111 PMID 11460562
10. Jump up^ A. Abragam (1961). The Principles of Nuclear Magnetism. International series of monographs on physics 32. Oxford University Press.
11. Jump up^ Froböse I, Eckey U, Reiser M, Glaser C, Englmeier F, Assheuer J, Breitgraf G (2000) Evaluation of the effectiveness of three-dimensional pulsating electromagnetic fields in respect to the regeneration of cartilage structures. Orthopedic Practice 36: 510-15.
12. Jump up^ I. Digel , E. Kuruglan, Pt. Linder, P. Kayser, D. Porst, G. J. Braem, K. Zerlin, G. M. Artmann, A. Temiz Artmann (2007). Decrease in extracellular collagen crosslinking after NMR magnetic field application in skin fibroblasts. Med Biol Eng Comput. Jan;45(1):91-7 PMID 7203317