Ionised wrist bracelets for musculoskeletal pain

Clinical bottom line

There were no differences in pain intensity between patients treated with an 'ionized' bracelet and those treated with a placebo bracelet. A significant decrease in pain intensity from baseline (unrelated to ‘ionization’) was found for both groups.

Reference

Bratton et al. Effect of 'ionized' wrist bracelets on musculoskeletal pain: a randomised, double-blind, placebo-controlled trial. Mayo Clin Proc. 2002; 77: 1164-1168

Study

Patients with established musculoskeletal pain in various locations took part in a randomised, double blind, placebo controlled study. 610 participants were randomly divided into two groups. One group was given an 'ionised' bracelet (n=305) and the other an identically appearing placebo bracelet of (n=305) to wear continuously for four weeks.

For each painful location patients rated their pain intensity on a 10 point scale (1= very little pain, 10= pain as bad as it could be) at the beginning of the trial, at 1, 3, 7, 14, 21 and 28 days. Primary endpoints defined were the change in pain score at the location with the highest baseline value and the change in the sum of scores across all locations at four weeks.

Results

Patient baseline demographics between groups were similar for age, sex (though women accounted for 75% of participants), ethnicity, previous experience and expectations with the bracelets.

Baseline pain intensity scores for all 12 reported locations were not significantly different (except for feet (p=0.4)). The most frequently reported locations for musculoskeletal pain were shoulders, neck, lower back and knees.

There were no statistically significant differences in pain intensity between those treated with the ionised bracelet and those treated with placebo for either primary endpoints (Table 1). A statistically significant decrease in pain intensity from baseline was observed within both groups across all time points.

Table 1 Mean change in pain score after 4 weeks for the four most frequently reported locations of musculoskeletal pain

	Ionized			Placebo
Location of pain	Mean baseline pain score (SD)	Mean change score (SD) after 4 weeks	N	Mean baseline pain score (SD)	Mean change score (SD) after 4 weeks	N
Lower back	5.8 (2.3)	-2.3 (2.7)	186	5.5 (2.2)	-2.1 (2.6)	191
Shoulders	5.1 (2.4)	-2.0 (2.6)	177	5.0 (2.2)	-1.5 (2.6)	182
Neck	4.7 (2.3)	-1.7 (2.4)	166	4.9 (2.2)	-1.4 (2.5)	174
Knees	5.1 (2.6)	-1.9 (2.6)	158	5.4 (2.4)	-2.1 (2.4)	157

Comment

Many of us have seen 'ionized' bracelets on sale in shops, often presented with an endorsement from someone or other. This trial was the first, so far as we know, that evaluated the use of such bracelets in a non-biased sensible fashion. Apart from somewhat curious differences in patient numbers at baseline and four week assessment, the trial was of high quality and design, of good size and used sensible outcomes.

The fact that no differences were found between the 'ionized' bracelet and the placebo bracelet suggests that any benefits are not due to special features of the bracelets.

It is unfortunate that the high standards imposed on mainstream medicine are suspended when it comes to potential alternatives. There is no evidence that money spent on an 'ionized' bracelet which bring anymore benefit than any other.