Repetitive peripheral magnetic stimulation for pain, disability, and kinesiophobia in patients with chronic musculoskeletal pain: a systematic review and meta-analysis.

The authors rated the certainty of the evidence very low for all three outcomes, because of risk of bias, small samples and wide confidence intervals, so these results are not settled. Every included trial was judged to have 'some concerns' for risk of bias, and the review rests on only eight trials and roughly 180 participants. The trials differed widely in stimulation settings (frequency, intensity, coil type, number of sessions, total pulses) and in the populations treated, so no single protocol can be recommended and the authors say results should be adjusted to the individual clinical condition. In several trials the stimulation was given alongside exercise or usual treatment, so its own contribution cannot be separated from the rest of the care. No long-term follow-up data were available, so nothing is known about whether any benefit lasts. Only English-language trials published up to May 2023 were included. The participant numbers reported in different parts of the paper do not match: 186 participants included in the review, 177 recruited in the eight trials, and 91 in the experimental groups against 88 in the control groups.

The authors declare no conflict of interest with any financial organisation regarding the material in the manuscript. The work was funded by the Natural Science Foundation of Shandong Province (ZR2024MH143), a Co-construction of Traditional Chinese Medicine Technology Project of the National Administration of Traditional Chinese Medicine and provincial government (GZY-KJS-SD-2023-081) and the Scientific Research Innovation Plan Project of Shandong Second Medical University (2023BKQ001). The paper does not say whether the funders had any role in the study.

Do not conclude from this review that repetitive peripheral magnetic stimulation works for chronic musculoskeletal pain. The authors themselves rated the certainty of the evidence very low for pain, disability and fear of movement, every included trial was judged to have 'some concerns' for risk of bias, and in several trials the stimulation was added to exercise or to usual treatment, so the improvement cannot be credited to the stimulation alone.