October 24, 2006
Static Magnetic Field Therapy for Pain in the Abdomen and Genitals
Robert R. Holcomb, MD, PhD, W. Bradley Worthington, MD, Barbara A. McCullough, RN, and Michael J. McLean, MD, PhD
Introduction
How often neurologic etiologies are overlooked as possible explanations for abdominal and genital pain in adolescent patients is unknown. We present the cases of two adolescents with such pain that illustrate both the diagnostic dilemma and the issues related to the cost of diagnosis and treatment.
Both individuals went to multiple physicians before a definitive diagnosis. The neurologic examination was able to localize the abnormality to the spinal canal and nerve roots in both cases, and noninvasive, cost-effective treatment with investigational magnetic devices was instituted. The magnetic devices consisted of four permanent magnets of alternating polarity housed in a hypoallergenic plastic case (Magna Bloc), which were taped to the skin over areas involved with the pain.
Case Reports Patient 1
A 17-year-old white female was admitted to the Vanderbilt University Medical Center for further evaluation of chronic pain of 3 years’ duration that had begun suddenly in the low back and radiated around the right flank. She could not attend school and relied on homebound teaching while she lay in bed. Over the years, her many physicians uniformly described her complaint of constant right lower quadrant abdominal pain of variable intensity with intermittent radiation into the vulva.
Community-based physicians, including pediatricians, emergency service personnel, an anesthesiologist, an obstetric-gynecologic specialist, a cardiologist, and a neurologist, had assessed her. Laparoscopic examination and appendectomy had been performed in the course of the evaluations. Pediatric specialty consultations in neurology, general surgery, infectious diseases, rheumatology, and gastroenterology at a university center led to a diagnosis of gastrointestinal migraine.
The patient’s pain continued without amelioration despite multiple medications, including narcotics. The patient was referred to the pediatric general surgery service at the Vanderbilt University Medical. She was bedridden and unable to walk because of severe opiate-resistant pain. The laboratory and radiologic tests, including liver and pancreatic enzymes and abdominal radiographs were normal. Symptomatic treatment with saline enemas, intravenous fluids, and intramuscular and intravenous medications failed to relieve the pain.
A pediatric gastroenterologist found no etiology for the patient’s pain. A psychiatric consultant identified no underlying psychopathology and recommended relaxation and stress reduction training. The neurologic consultant obtained a history of intermittent lancinating pain of burning quality that radiated from the right posterior lumbar region into the right lower quadrant of the abdomen ventrally.
This pain was superimposed on a constant aching pain. Burning lancinating pain also occurred from the right posterior lumbar region into the right hip, buttocks, leg, and heel. Intense burning pain of the vulva was also present intermittently. Percussion over the L5-S1 lumbar spinous processes reproduced many of the components of the patient’s pain, including intense lumbosacral muscle spasm and burning lancinating pain around the right flank into the lower abdomen and vulva. These complaints suggested S1 radiculopathy or lumbosacral plexopathy (or both).