{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:08:32Z","timestamp":1779170912866,"version":"3.51.4"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Low back pain (LBP) is a leading cause of disability worldwide, with intervertebral disc degeneration (IDD) as a major contributor. IDD is strongly associated with aging and is characterized by cellular senescence, extracellular matrix degradation, and chronic low-grade inflammation, all of which impair disc homeostasis. Current treatments often provide limited or transient relief, prompting interest in non-invasive, biologically active approaches such as pulsed electromagnetic fields (PEMFs). This systematic review evaluates the evidence on PEMF therapy for IDD, including\n                      <jats:italic>in vitro<\/jats:italic>\n                      ,\n                      <jats:italic>in vivo<\/jats:italic>\n                      , and clinical studies, and summarizes mechanisms of action, efficacy, and limitations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Scopus, and Web of Science (2000\u20132025) was conducted following PRISMA guidelines. Eligible studies included cell, animal, or clinical models of IDD treated with PEMFs versus controls, reporting significant outcomes. Risk of bias was assessed using QUIN, SYRCLE, and RoB 2.0 tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixteen studies were included: 7 in vitro, 4 in vivo, 4 clinical RCTs, and 1 combined study.\n                      <jats:italic>In vitro<\/jats:italic>\n                      , PEMFs reduced pro-inflammatory cytokines, MMPs, and apoptosis, while promoting ECM synthesis, BMP signaling, and autophagy\/SIRT1 pathways, mechanisms implicated in age-related degeneration.\n                      <jats:italic>In vivo<\/jats:italic>\n                      , PEMFs improved disc structure, reduced inflammation, and enhanced functional recovery, with timing influencing outcomes. Clinically, PEMFs were safe and showed potential benefits in pain, function, and mobility, especially alongside physiotherapy, although results were inconsistent and influenced by age-related variability. Methodological limitations were common.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>PEMF therapy appears safe and biologically active, with potential to modulate key processes of IDD and aging, including inflammation, senescence, and impaired autophagy. However, current evidence remains insufficient for clinical recommendations. Standardized protocols, mechanistic studies, and long-term trials stratified by age are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251247528<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fragi.2026.1840672","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:39:58Z","timestamp":1779169198000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of pulsed electromagnetic fields on intervertebral disc degeneration: a systematic review of preclinical and clinical evidence"],"prefix":"10.3389","volume":"7","author":[{"given":"Francesca","family":"Veronesi","sequence":"first","affiliation":[{"name":"Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli","place":["Bologna, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Salamanna","sequence":"additional","affiliation":[{"name":"Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli","place":["Bologna, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Martini","sequence":"additional","affiliation":[{"name":"Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli","place":["Bologna, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deyanira","family":"Contartese","sequence":"additional","affiliation":[{"name":"Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli","place":["Bologna, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Ghermandi","sequence":"additional","affiliation":[{"name":"Spine Surgery Unit, IRCCS Istituto Ortopedico Rizzoli","place":["Bologna, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Marchese","sequence":"additional","affiliation":[{"name":"Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli","place":["Bologna, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Gasbarrini","sequence":"additional","affiliation":[{"name":"Spine Surgery Unit, IRCCS Istituto Ortopedico Rizzoli","place":["Bologna, Italy"]},{"name":"Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna","place":["Bologna, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Giavaresi","sequence":"additional","affiliation":[{"name":"Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli","place":["Bologna, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"14298","DOI":"10.3390\/ijms232214298","article-title":"The role of PEMFs on bone healing: an in vitro study","volume":"23","author":"Caliogna","year":"2022","journal-title":"Int. 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