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. 2025 Oct 29;15(12):1007–1014. doi: 10.1080/17581869.2025.2578549

Millimeter wave neuromodulation for the management of osteoarthritis pain: a real word evidence study

Emilie Chipon a, Erwan Treillet b,c, Julie Bros a,✉, Paolo Zanini a, David Crouzier a
PMCID: PMC12674372  PMID: 41159242

ABSTRACT

Introduction

Managing osteoarthritis aims to relieve pain, improve joint function and quality of life. Current guidelines recommend combining non-drug and pharmacological approaches. A non-medication solution integrating an endorphin-stimulating millimeter wave device, mobile application, and coaching program was evaluated.

Methods

This combined approach is evaluated in a real-world evidence study over three months in patients with osteoarthritis-related pain. The primary endpoint was patient-perceived change at three months using the Patient Global Impression of Change (PGIC). Secondary outcomes, assessed at baseline and three months, included pain intensity (mean and maximum), frequency of pain crises, quality of life, sleep, mental health, and medication use.

Results

Among 156 participants completing follow-up, 80.1% reported improvement (PGIC > 4). Quality of life improved by 29.8%, while sleep and mental health improved by 13.1% and 13.5%, respectively. Mean and maximum pain intensity decreased by 33.9% and 33.1%. Pain crises became less frequent, and patients reported reduced medication use.

Conclusion

These results align with recent randomized controlled trial findings, supporting millimeter wave neuromodulation as an innovative, non-drug strategy targeting both nociceptive and nociplastic pain mechanisms to improve quality of life in osteoarthritis patients.

KEYWORDS: Osteoarthritis, neuromodulation, millimeter wave, quality of life, pain

Plain Language Summary

Osteoarthritis causes joint pain and limits daily activities. Its treatment focuses on reducing pain, improving movement, and enhancing quality of life. Current recommendations suggest combining lifestyle changes with medication. This study evaluated a millimeter wave device that stimulates natural endorphins, a mobile app, and a coaching program, used for three months by people with osteoarthritis pain. After three months, 80% of participants reported feeling better. Pain levels decreased by about one-third, and quality of life improved by nearly 30%. Sleep, mood, and daily comfort also improved, and many participants reported using less medication. These findings suggest that millimeter wave therapy is a promising, non-drug approach that may help people with osteoarthritis manage pain and improve their well-being.

1. Introduction

Osteoarthritis (OA) is a chronic, progressive disease characterized by degeneration of articular cartilage, joint pain, stiffness and loss of function, particularly in weight-bearing joints such as the knees, hips and spine [1–4]. The disease usually progresses slowly but can eventually lead to joint failure with pain and disability [1]. OA is a highly prevalent disease with an estimated 600 million sufferers worldwide [5]. There has been a significant increase in prevalence due to an aging population and rising obesity rates [6]. OA can occur in any joint, but most commonly affects the hands, knees, hips, shoulders and spine, and can also affect multiple joints [1,7,8]. The disease has a significant impact on individuals’ quality of life (QoL), mobility and mental health, and places a considerable burden on healthcare systems [5,6,9]. Pain is the most common symptom associated with OA. Pain in OA is complex, associated with a wide range of origins, intensities and responses to treatment [10], and its mechanism is considered to be a mixture of different pain components, nociceptive, neuropathic and nociplastic, in any combination, acting simultaneously and/or concurrently [11]. The variability of these three components depends on a complex interaction between biological, psychological, social and environmental factors [12]. Each patient has a unique combination of these factors that influence not only the intensity and type of pain they experience, but also the way they respond to and cope with it [13]. Patients with mixed pain have higher pain intensity scores and significantly lower quality of life [11].

European and international guidelines recommend a multidisciplinary approach to pain management, including education, exercise and pharmacological treatments [14–16]. Pharmacological treatments for OA include analgesics (such as paracetamol, oral and topical non-steroidal anti-inflammatory drugs (NSAIDs), duloxetine, and opioids including tramadol) and intra-articular therapies (corticosteroids and viscosupplements such as hyaluronic acid), but they may be ineffective or inappropriate for some patients [17]. In particular, they are less effective if the patient has nociplastic pain rather than nociceptive pain, and the use of opioid analgesics is strongly discouraged [18]. Patients with nociplastic pain are likely to respond better to centrally rather than peripherally targeted therapies [19].

Millimeter waves (MMW) correspond to electromagnetic radiation with frequencies between 30 and 300 GHz, which does not penetrate the skin more than a fraction of a millimeter (0.3 to 0.5 mm) [20,21]. Applying these waves to a highly innervated area increases peripheral nerve stimulation (Figures 1 and 2), leading to a central response by increasing the production of endorphins and other neurotransmitters, and activating the parasympathetic system [22–25]. Two recent randomized controlled trials (RCT), one in Fibromyalgia in 170 patients (clinicaltrials.gov id: NCT05058092), the other in pain associated with OA in 60 patients (clinicaltrials.gov id: NCT04590079), have demonstrated the benefit of MMW on these pathologies and particularly on the nociplastic dimension of pain, these results have been recently published [26–30]. The same technology is offered as part of a monthly subscription to a solution designed to improve QoL, patients pay for 50€ monthly fees. When subscribing to this offer, patients report that they are mainly looking for a non-drug solution to reduce chronic pain due to OA, fibromyalgia, or inflammatory rheumatism, improve sleep quality and reduce stress/anxiety.

Figure 1.

Figure 1.

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Millimeter waves stimulation. Skin exposed to waves with frequencies (a) below 30GHz, (b) 61 GHz, (c) above 300 GHz. The purple arrows represent the absorption of energy by the skin.

Figure 2.

Figure 2.

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Remedee device.

While RCTs remain the gold standard for medical evidence of the efficacy of a drug or medical device, the fact remains that there may be a discrepancy between these results and day-to-day observations [31]. Real-world data (RWD), collected from larger numbers of patients, and not restricted to the rigorous selection criteria of RCTs, provide additional information on the use of these treatments and their impact on disease symptoms [31,32]. The aim of the present study is to observe the evolution of symptoms in OA patients using the solution through RWD and to contrast these results with those of the RCT.

2. Methods

2.1. MMW neuromodulation solution

The solution evaluated in this Real-World Evidence (RWE) study combines an MMW-emitting wristband paired with a mobile application and a coaching program. The wristband contains two microelectronic components that generate and amplify a 61.25 GHz electromagnetic field at a power density of approximately 10 mW/cm2 over 2 cm2. The MMW energy is deposited on the inside of the wrist, approximately 2 cm below of the hand. By targeting this area, MMW stimulation reaches peripheral nerves that communicate directly with central pain-modulating pathways, while also engaging the autonomic nervous system. The effect of this stimulation has been clearly demonstrated in animal model, with increase of endorphin secretion [33], and an hypoalgesic effect reported in human volunteers, notably with an increased pain perception threshold [34–36]. The patient performs neuromodulation sessions autonomously, using the wristband for a minimum of 3 sessions per day (up to 6 sessions/day if required), each session lasting 30 minutes. The device is connected via a mobile app that gives the patient access to their session history, as well as training content on MMW, endorphins and their expected benefits, and recommendations on how to use the wristband. The coaching aims to improve patient adherence to the technology, thereby optimizing treatment compliance and efficacy. As part of the program, patients are invited to complete generic and symptom-specific questionnaires before starting to use the wristband (D0), and frequently to monitor the evolution of their symptoms. Patients received a report summarizing their responses and the level of their symptoms every 3 months.

2.2. Selection criteria

Real-world data were collected from adults (≥18 years old), men and women with osteoarthritis, who subscribed to the offer between 1 December 2022 and 31 January 2024, who did not object to the use of their data for this research project, and who completed the questionnaires after 3 months.

2.3. Ethics and regulatory

This study was a non-interventional, retrospective research based on existing data collected by the manufacturer of the MMW wristband (Remedee Well, Remedee Labs, Montbonnot-Saint-Martin, FRANCE). It complies with French regulations on studies not involving the human subjects and follows a simplified procedure, including: i) compliance with the “Reference Methodology for the processing of personal data in the context of research not involving the human person, studies and evaluations in the field of health (MR004)” and ii) registration on the Health Data Hub under reference number F20231103190631 (https://www.health-data-hub.fr/projets). As part of this simplified procedure, approval from the Scientific and Ethical Committee for Health Research, Studies and Assessments (CESRESS – Comité Ethique et Scientifique pour les Recherches, les Etudes et les Evaluations dans le domaine de la Santé) was not required. In accordance with MR004, patients were individually informed about the study and their right to object, if applicable, before data extraction.

2.4. Objectives and data collection

The main objective of this study was to characterize the patients’ impression of change at 3 months in terms of health status using the Patient Global Impression of Change questionnaire (PGIC [37]). The PGIC is a 7-point Likert scale ranging from “very much worse” to “very much better.” Results are reported by calculating the percentage of patients in each of the seven categories.

Secondary objectives assess changes after three months on:

  • average pain intensity on a VAS (Visual Analogue Scale) from 0 (no pain) to 100 (maximum pain)

  • maximum pain intensity on a VAS from 0 (not important) to 100 (very important)

  • frequency of pain crises on a 5-point Likert scale from 1 (never) to 5 (all the time)

  • general quality of life on a visual analogic scale (VAS) from 0 (very bad) to 100 (very good)

  • sleep quality reported on an in-house scale from 0 (very bad) to 100 (very good)

  • impact of symptoms on mental health (stress/anxiety) on an in-house scale from 0 (bad) to 100 (very good)

  • drug treatments consumption habits (paracetamol alone and in combination with a level 2 analgesic, NSAIDs, opioids): no use, as needed in the event of a crisis, systematic use.

Patient adherence to the use of wristband during the three-month period was also assessed as a secondary objective. The number of sessions by day was collected from the wristband’s internal memory,

2.5. Statistical analysis

A descriptive analysis was performed for the demographic parameters at D0 and for outcomes at D0 and M3. Results are presented using means and standard deviations, medians and quartiles or proportions when appropriate. Several Paired t-tests (or Wilcoxon signed-rank tests) to compare values at D0 and M3 for pain intensity (average and maximum), general quality of life, sleep quality and mental health were performed, and a significance level of 0.05 was fixed. The assumption of normality of the distributions was checked with a Shapiro-Wilk test. Normality of the distributions was confirmed for average pain, general quality of life and mental health, in which case a paired t-test was used. Normality was rejected for maximum pain and sleep quality; in which case a Wilcoxon signed-rank test was used. In accordance with MR004, the analyses were performed on a pseudo-anonymized database.

3. Results

Among the 318 osteoarthritis patients who subscribed to the MMW neuromodulation offer, 221 (69.5%) are still on the program after 3 months. Among the 97 unsubscribes the main reason to discontinue the program reported is lack of benefits (59.8%), insufficient/partial benefits (27.8%) and cost (16.5%). On average, these patients unsubscribed after 58 ± 19 days of subscription. Among the 221 patients, at three months, 156 (70.6%) completed the PGIC, general quality of life and mental health questionnaires, 155 (70.1%) completed the pain questionnaires, 160 (72.4%) completed the sleep quality questionnaire and 116 (52.5%) completed the habit of drugs consumption questionnaire.

The demographics parameters of the population are shown in Table 1. The sample was predominantly female (80.1%) with a mean age of 63.6 ± 12.1 years. The mean duration of OA symptoms was 12.7 ± 11.1 years. Most patients reported having at least one comorbidity in addition to osteoarthritis, the most common being low back pain, tendonitis and sciatica.

Table 1.

Baseline characteristics for the sample.

  Global sample (n = 156)
Age (mean±SD) 63.6 ± 12.1
Sex (% of female) 80.1
Professional activity 49.4% of retired
Other concomitant comorbidities 84% with one comorbidity at least
46.2% with lower back pain
39.7% with tendonitis
35.3% with sciatica
24.4% with migraine
17.9% with inflammatory rheumatic
7.1% with pelvic pain
Number of years with OA symptoms (mean±SD) 12.7 ± 11.1
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The proportion of patients reporting an improvement in their health status on the PGIC was 80.1%, including 27.5% in the “much better” and “very much better” categories. The mean value of PGIC was: 5.02 ± 0.90. The distribution of the 156 patients at 3 months in each PGIC category is show in the Figure 3.

Figure 3.

Figure 3.

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Distribution of patients (n = 156) at M3 in the 7 PGIC categories: 1-very much worse; 2- much worse; 3-Worse; 4-Unchanged; 5-little better; 6-much better; 7-very much better.

The mean pain intensity decreased significantly by 33.9% from D0 (mean = 63.9 ± 17.1) to M3 (mean = 40.3 ± 21.4) (n = 155, p < 0.001). A similar range of improvement was observed for the maximum pain intensity, with a mean decrease of 33.1% from D0 (mean = 78.6 ± 16.3) to M3 (mean = 51.8 ± 23.7), (n = 155, p < 0.001). The distribution of the mean and maximum pain intensity at D0 and at M3 is display in Figures 4 and 5 respectively.

Figure 4.

Figure 4.

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Box plot of the mean pain intensity at D0 and M3 (n = 155).

Figure 5.

Figure 5.

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Box plot of the max pain intensity at D0 and M3 (n = 155).

The distribution of pain crises in each of the 5 categories of the Likert scale at D0 and at M3 is show in Figure 6. There was a clear reduction in the frequency of pain crises at M3. At D0, 38.1% of patients reported having crises “most of the time” and 38.7% “always.” By M3, these percentages had fallen to 16.1% and 7.7% respectively.

Figure 6.

Figure 6.

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Distribution of the frequency of pain crises at D0 and M3 (n = 155).

A statistically significant improvement of the general QoL was seen at 3 months, with a mean improvement of 29.8%, from 57.4 ± 21.2 at D0 to 61.8 ± 21.3 at M3 (n = 156, p = 0.007). Sleep quality improved significantly by an average of 13.1%, from 50.9 ± 21.1 at D0 to 60.0 ± 20.2 at M3 (n = 160, p < 0.001). For the mental health score (stress/anxiety), a significant improvement of 13.5% was reported, from 43.2 ± 10.5 at D0 to 47.0 ± 9.8 at M3 (n = 156, p < 0.001). In average on the three-month period, the patients performed 3.2 ± 1.0 neuromodulation sessions per day.

The evolution of the habits of drug use from D0 to M3 for the 116 patients who completed this questionnaire at D0 and M3 is presented in Figure 7. In terms of paracetamol use, the number of patients who used paracetamol on demand (in case of a crisis) decreased by 34% from D0 to M3, from 47 to 31 subjects respectively, while the number of subjects who said they did not use paracetamol increased by 30.5% from D0 to M3, from 59 to 77 subjects respectively. The number of combined paracetamol users (paracetamol combined with a level 2 analgesic) was low and remained stable between D0 and M3: 20 patients (17.2%) used it as needed or systematically at D0 and 16 (13.8%) at M3. Regarding the use of NSAIDs consumption, the number of patients taking NSAIDs on demand decreased by 36.6% from D0 to M3, from 22 to 15 subjects respectively. This reduction argues in favor of discontinuing NSAIDs in these patients. The number of patients taking NSAIDs daily was 4 (3.4%) at D0 and 3 (2.6%) at M3. Regarding opioid use, 13 (11.2%) patients reported taking opioids as needed (n = 7) or routinely (n = 6) at D0. At M3, only 6 (5.2%) were using opioids: 2 as needed and 4 routinely.

Figure 7.

Figure 7.

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Evolution of drug consumption habits from D0 (left side of each figure) to M3 (right side) for the 116 subjects who completed this questionnaire at D0 and M3. Figure 7(A) shows paracetamol use; 7(B) combined paracetamol use; 7(C) NSAIDs use and 7(D) opioids use.

4. Discussion

Remedee Labs has launched a Real-World Evidence study among osteoarthritis patients who subscribed to the offer offering an MMW-emitting wristband paired with a mobile application and a coaching program. In this offer, which aims to improve pain, quality of sleep and stress/anxiety, patients are free to stop using the solution at any time. This study is the first to report RWD on the effects of MMW neuromodulation on the evolution of OA-related symptoms, adding further evidence to the results obtained in an RCT in 60 patients with peripheral OA [27].

Of the 318 subjects who started using the neuromodulation wristband during the inclusion period, 221 (69.5%) were still subscribing to the program after 3 months, and 156 (49%) had completed the 3-month symptom follow-up questionnaires. Among these 156 patients, 80.1% reported an improvement in their health status after three months of wristband use, with an average improvement of 29.8% on the general QoL questionnaire compared to D0. This perceived improvement goes hand by hand with the very good adherence to the use of the wristband, which is 3.2 ± 1.0 sessions/day. This number of sessions, collected by the mobile application through wristband log data, is fully consistent with the recommended minimum of 3 sessions per day. Patients also reported a 33.9% reduction in mean pain intensity, which corresponds to a moderately clinically important improvement (i.e., MCID ≥30%) [38]. Maximum pain intensity showed a similar trend, with an average reduction of 33.1%. As for pain crises, patients reported a significant decrease in their frequency: 76.8% reported having pain crises “always” or “most time” at D0 compared to 23.8% at M3. In addition to pain relief, these results are reinforced by the results for sleep quality and mental health, which improved by 13.1% and 13.5% respectively compared to D0. The combined improvement in background pain, sleep quality and mental health appears to confirm the effect on the nociplastic component of pain, previously observed in the RCT.

The RCT was conducted in 60 patients with peripheral OA and similar gender and age characteristics (80.1% versus 90% female and 63.6 ± 12.1 versus 61.7 ± 14.3 years old for RWE study and RCT, respectively). After 3 months of wristband use, the mean amplitude of pain reduction was 19.4 in the RCT (61.7 ± 14.3 at D0 to 42.3 ± 22.9 at M3) versus 26.8 in the RWE study (78.6 ± 16.3 at D0 to 51.8 ± 23.7 at M3). It should be noted that, on average, patients in the present study were more painful at inclusion than patients in the RCT (17 points over 100). In terms of QoL scores, the RCT mean scores on the VAS scale of the EQ-5D-5 L questionnaire at D0 and M3 are fully consistent with the RWD: 57.2 ± 19.4 at D0 and 61.8 ± 19.5 at M3 for the RCT versus 57.4 ± 21.2 at D0 and 61.8 ± 21.3 at M3 for the RWD. The largest amplitude of pain reduction observed in the present study, could be explained by the fact that the data relates to patients who pay to use the solution, unlike the RCT, and if they are still subscribing after 3 months, it means they are benefiting from MMW neuromodulation. Another explanation could be the frequency of use of the wristband, 3.2 ± 1.0 sessions per day on average in the present study versus 1.7 ± 0.7 sessions in the RCT. This increase in frequency of use can be explained by the evolution of the recommendations given to patients, based on the manufacturer’s experience: in the RCT 1 to 3 sessions per day were recommended, whereas in the offer, a minimum of 3 sessions per day and up to 6 if necessary were recommended. This good adherence may be enhanced by the compliance monitoring displayed to the patient in the mobile application which didn’t exist in the RCT [39]. Another explanation for this difference in pain results could be explained by the study bias.

The limitations identified, which are inherent to this type of study, related to methodological bias, in particular confounding bias due to the lack of a control group [40]. There was also a selection bias, because only data from subjects who were still subscribing to the solution after 3 months and who completed follow-up surveys were used. A follow-up bias also exists because the patients’ concomitant treatments were not controlled and not accurately recorded. Perceived benefits could be related to the introduction of new treatments. However, the data collected on drug-taking habits show that after 3 months, patients have reduced their consumption of paracetamol (alone or in combination with a level 2 analgesic), NSAIDs and opioids. In addition, of the 221 subjects who were still registered on the program after 3 months, 29% did not respond to the follow-up questionnaires despite two reminders, making it difficult to generalize the results of the study to all patients. The last limitation is the length of follow-up, which was limited to 3 months for this study. It will be interesting to analyze follow-up data on QoL over a longer period of use of MMW neuromodulation.

5. Conclusion

This RWE study confirms the RCT results on the efficacy of the MMW neuromodulation for the management of pain associated with OA and provides additional data on these benefits in terms of impression of change, maximum pain, frequency of pain crises and the proportion of patients responding to this connected technology.

The synergy between drug treatments for nociceptive pain and MMW neuromodulation, which specifically targets nociplastic pain through its central action, offers new perspectives in the management of osteoarthritis pain. This non-pharmacological method of pain management is therefore fully in line with the recommendations for the management of OA-related pain.

Further studies would allow to follow the evolution of OA-related symptoms over a longer period of use of MMW neuromodulation, and also to better identify responders based on intrinsic factors (disease duration, comorbidities, pain hypersensitivity), and on specific questionnaires assessing different OA pain dimensions such as the OA Symptom Inventory Scale (OASIS) [41].

Funding Statement

The authors declare that no financial support was received for the research, authorship, and/or publication of this article.

Article highlights

  • This real-world evidence (RWE) study confirms previous RCT findings on the efficacy of millimeter waves (MMW) neuromodulation for managing osteoarthritis (OA)-related pain, more specifically on the nociplastic component of chronic pain.

  • MMW neuromodulation acts synergistically with drug treatments (used for nociceptive pain management) by specifically increasing endorphin level leading to an increase of pain threshold and then targeting nociplastic pain dimension through central mechanisms.

Author contributions

David Crouzier: Conceptualization, Supervision, Validation, Writing – review & editing. Emilie Chipon: Conceptualization, Project administration, Writing – original draft, Writing – review & editing. Erwan Treillet: Writing – review & editing. Julie Bros: Investigation, Resources, Validation, Writing – review & editing. Paolo Zanini: Data curation, Formal analysis, Writing – review & editing.

Disclosure statement

DC, EC, JB and PZ are employed by Remedee Labs, the manufacturer of the solution evaluated in this study, they have no other conflicts of interest.

ET has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Reviewer Disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethical declaration

This study was a non-interventional, retrospective research based on existing data collected by the manufacturer of the MMW wristband (Remedee Well, Remedee Labs, Montbonnot-Saint-Martin, FRANCE). It complies with French regulations on studies not involving the human subjects and follows a simplified procedure, including: i) compliance with the “Reference Methodology for the processing of personal data in the context of research not involving the human person, studies and evaluations in the field of health (MR004)” and ii) registration on the Health Data Hub under reference number F20231103190631 (https://www.health-data-hub.fr/projets).

Data availability statement

The raw data supporting the conclusions of this article are not available because subjects are not informed about the availability of their data outside the company.

References

Papers of special note have been highlighted as either of interest (•) or of considerable interest (••) to readers.

  • 1.Litwic A, Edwards MH, Dennison EM, et al. Epidemiology and burden of osteoarthritis. Br Med Bull. 2013;105(1):185–199. doi: 10.1093/BMB/LDS038 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Tuncay Duruöz M, Öz N, Gürsoy DE, et al. Clinical aspects and outcomes in osteoarthritis. Best Pract Res Clin Rheumatol. 2023;37(2):101855. doi: 10.1016/j.berh.2023.101855 [DOI] [PubMed] [Google Scholar]
  • 3.Barnett R. Osteoarthritis. Lancet. 2018;391(10134):1985. doi: 10.1016/S0140-6736(18)31064-X [DOI] [PubMed] [Google Scholar]
  • 4.Martel-Pelletier J, Barr AJ, Cicuttini FM, et al. Osteoarthritis. Nat Rev Dis Primers. 2016;2. doi: 10.1038/NRDP.2016.72 [DOI] [PubMed] [Google Scholar]
  • 5.Chen Y, Nelson AM, Cohen SP. Chronic pain for rheumatological disorders: pathophysiology, therapeutics and evidence. Joint Bone Spine. 2024;91(6). doi: 10.1016/j.jbspin.2024.105750 [DOI] [PubMed] [Google Scholar]
  • 6.Hawker GA. Osteoarthritis is a serious disease. Clin Exp Rheumatol. 2019;37 Suppl 120(5):3–6. [PubMed] [Google Scholar]
  • 7.Nelson AE, Renner JB, Schwartz TA, et al. Differences in Multijoint radiographic osteoarthritis phenotypes among African Americans and caucasians: the Johnston county osteoarthritis project. Arthritis Rheum. 2011;63(12):3843–3852. doi: 10.1002/ART.30610 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Gullo TR, Golightly YM, Cleveland RJ, et al. Defining multiple joint osteoarthritis, its frequency and impact in a community-based cohort. Semin Arthritis Rheum. 2019;48(6):950–957. doi: 10.1016/j.semarthrit.2018.10.001 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Bijlsma JWJ, Berenbaum F, Lafeber FPJG. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377(9783):2115–2126. doi: 10.1016/S0140-6736(11)60243-2 [DOI] [PubMed] [Google Scholar]
  • 10.Saxer F, Hollinger A, Bjurström MF, et al. Pain-phenotyping in osteoarthritis: current concepts, evidence, and considerations towards a comprehensive framework for assessment and treatment. Osteoarthr Cartil Open. 2024;6(1):100433. doi: 10.1016/j.ocarto.2023.100433 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Trouvin AP, Perrot S. New concepts of pain. Best Pract Res Clin Rheumatol. 2019;33(3):101415. doi: 10.1016/j.berh.2019.04.007 [DOI] [PubMed] [Google Scholar]; •• This article demonstrates that chronic pain associated with osteoarthritis is complex and involves multiple dimensions of pain, including mechanical/nociceptive, neuropathic, and nociplastic pain.
  • 12.Dimitroulas T, Duarte RV, Behura A, et al. Neuropathic pain in osteoarthritis: a review of pathophysiological mechanisms and implications for treatment. Semin Arthritis Rheum. 2014;44(2):145–154. doi: 10.1016/J.SEMARTHRIT.2014.05.011 [DOI] [PubMed] [Google Scholar]
  • 13.Hochberg MC. Osteoarthritis Year 2012 in review: clinical. Osteoarthr Cartil. 2012;20(12):1465–1469. doi: 10.1016/j.joca.2012.07.022 [DOI] [PubMed] [Google Scholar]
  • 14.Geenen R, Overman CL, Christensen R, et al. EULAR recommendations for the health Professional’s approach to pain management in inflammatory Arthritis and osteoarthritis. Ann Rheum Dis. 2018;77(6):797–807. doi: 10.1136/annrheumdis-2017-212662 [DOI] [PubMed] [Google Scholar]
  • 15.Bannuru RR, Osani MC, Vaysbrot EE, et al. Oarsi guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthr Cartil. 2019;27(11):1578–1589. doi: 10.1016/j.joca.2019.06.011 [DOI] [PubMed] [Google Scholar]
  • 16.Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American college of Rheumatology/Arthritis foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2020;72(2):149–162. doi: 10.1002/ACR.24131 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Robinson RL, Schnitzer TJ, Barlow S, et al. Satisfaction with medications prescribed for osteoarthritis: a cross-sectional survey of patients and their physicians in the United States. Pain Ther. 2022;11(1):191–208. doi: 10.1007/S40122-021-00350-0 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Fitzcharles MA, Cohen SP, Clauw DJ, et al. Nociplastic pain: towards an understanding of prevalent pain conditions. Lancet. 2021;397(10289):2098–2110. doi: 10.1016/S0140-6736(21)00392-5 [DOI] [PubMed] [Google Scholar]
  • 19.Kosek E, Clauw D, Nijs J, et al. Chronic nociplastic pain affecting the musculoskeletal System: clinical criteria and grading System. Pain. 2021;162(11):2629–2634. doi: 10.1097/J.PAIN.0000000000002324 [DOI] [PubMed] [Google Scholar]
  • 20.Alekseev SI, Radzievsky AA, Logani MK, et al. Millimeter wave dosimetry of human skin. Bioelectromagnetics. 2008;29(1):65–70. doi: 10.1002/BEM.20363 [DOI] [PubMed] [Google Scholar]
  • 21.Zhadobov M, Chahat N, Sauleau R, et al. Millimeter-wave interactions with the human body: state of knowledge and recent advances. Int J Microw Wirel Technol. 2011;3(2):237–247. doi: 10.1017/S1759078711000122 [DOI] [Google Scholar]
  • 22.Radzievsky AA, Rojavin MA, Cowan A, et al. Peripheral neural System involvement in hypoalgesic effect of electromagnetic millimeter waves. Life Sci. 2001;68(10):1143–1151. doi: 10.1016/S0024-3205(00)01016-X [DOI] [PubMed] [Google Scholar]; •• This article demonstrates, in an animal model, the mechanisms of action of millimeter waves on pain.
  • 23.Wong TM, Shan J. Modulation of sympathetic actions on the heart by opioid receptor stimulation. J Biomed Sci. 2001;8(4):299–306. doi: 10.1007/BF02258370 [DOI] [PubMed] [Google Scholar]
  • 24.Holaday JW. Cardiovascular effects of endogenous opiate systems. Annu Rev Pharmacol Toxicol. 1983;23(1):541–541. doi: 10.1146/ANNUREV.PA.23.040183.002545 [DOI] [PubMed] [Google Scholar]
  • 25.Pilozzi A, Carro C, Huang X. Roles of β-endorphin in stress, behavior, neuroinflammation, and brain energy metabolism. Int J Mol Sci. 2020;22(1):1–25. doi: 10.3390/IJMS22010338 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Maindet C, Giai J, Leroy C, et al. Efficacy and safety of a millimetre wave medical device for pain neuromodulation in peripheral oa: a crossover randomized trial. Rheumatology. 2025. doi: 10.1093/RHEUMATOLOGY/KEAF486 [DOI] [PubMed] [Google Scholar]; •• This article presents the positive results of a clinical trial investigating the effects of millimeter waves on pain associated with osteoarthritis.
  • 27.Maindet C, Giai J, Dumolard A, et al. POS1372 innovative pain management device using millimetre band radiation: electronic-pain killer, assessment in patients with peripheral osteoarthistis. Monocentic, prospective, randomised in cross-over design and controled trial. Ann Rheum Dis. 2023;82:1039. doi: 10.1136/annrheumdis-2023-eular.4891 [DOI] [Google Scholar]; • This article explains why millimeter waves could be of great interest in chronic pain management, particularly with regard to their effect on nociplastic pain.
  • 28.Maindet C, Minier L, Chipon E, et al. Millimetre wave-based neuromodulation combined with coaching improves quality of life in fibromyalgia patients: a 9-month prospective, multicenter, Open, randomized, controlled trial. Med (Baltim). 2025;104(10):e41706. doi: 10.1097/MD.0000000000041706 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Maindet C, Debouzy JC, Barmaki M, et al. Effet Antalgique Potentiel Des Ondes Électromagnétiques Millimétriques : Une Possible Application Au Traitement Des Douleurs Nociplastiques. Douleurs : ÉValuat - Diagnostic - Traitement. 2023;24(2):72–78. doi: 10.1016/J.DOULER.2022.11.007 [DOI] [Google Scholar]; •• Given the inclusion of the above article, this reference can be removed.
  • 30.Therapy combining millimeter wave-based neuromodulation with coaching for the improvement in quality of life of patients with fibromyalgia: a prospective, multicenter, randomized, controlled trial -. Acr meeting abstracts. [cited 2025 Oct 16]. Available from: https://acrabstracts.org/abstract/therapy-combining-millimeter-wave-based-neuromodulation-with-coaching-for-the-improvement-in-quality-of-life-of-patients-with-fibromyalgia-a-prospective-multicenter-randomized-controlled-trial/
  • 31.Dang A. Real-world evidence: a primer. Pharmaceut Med. 2023;37(1):25–36. doi: 10.1007/S40290-022-00456-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32.Tashkin DP, Amin AN, Kerwin EM. Comparing randomized controlled trials and Real-world studies in chronic obstructive pulmonary disease pharmacotherapy. Int J Chron Obstruct Pulmon Dis. 2020;15:1225–1243. doi: 10.2147/COPD.S244942 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.Rojavin MA, Radzievsky AA, Cowan A, et al. Pain relief caused by millimeter waves in mice: results of cold water tail flick tests. Int J Radiat Biol. 2000;76(4):575–579. doi: 10.1080/095530000138592 [DOI] [PubMed] [Google Scholar]
  • 34.Minier L, Debouzy JC, Foerster M, et al. Hypoalgesia and parasympathetic effects of millimeter waves on experimentally induced pain in healthy volunteers. Electromagn Biol Med. 2023;42(1):3–11. doi: 10.1080/15368378.2022.2162919 [DOI] [PubMed] [Google Scholar]; •• This article demonstrates that the use of millimeter waves increases the pain threshold in healthy volunteers, as shown in a double-blind clinical trial.
  • 35.Radzievsky AA, Gordiienko OV, Alekseev S, et al. Electromagnetic millimeter wave induced hypoalgesia: frequency dependence and involvement of endogenous opioids. Bioelectromagnetics. 2008;29(4):284–295. doi: 10.1002/BEM.20389 [DOI] [PubMed] [Google Scholar]
  • 36.Partyla T, Hacker H, Edinger H, et al. Remote effects of electromagnetic millimeter waves on experimentally induced cold pain: a Double-blinded crossover investigation in healthy volunteers. Anesth Analg. 2017;124(3):980–985. doi: 10.1213/ANE.0000000000001657 [DOI] [PubMed] [Google Scholar]
  • 37.Rampakakis E, Ste-Marie PA, Sampalis JS, et al. Real-life assessment of the validity of patient Global impression of change in fibromyalgia. RMD Open. 2015;1(1). doi: 10.1136/RMDOPEN-2015-000146 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. The J Pain. 2008;9(2):105–121. doi: 10.1016/j.jpain.2007.09.005 [DOI] [PubMed] [Google Scholar]
  • 39.Seewoodharry MD, Maconachie GDE, Gillies CL, et al. The effects of feedback on adherence to treatment: a systematic review and meta-analysis of RCTs. Am J Prev Med. 2017;53(2):232–240. doi: 10.1016/j.amepre.2017.03.005 [DOI] [PubMed] [Google Scholar]
  • 40.Sterrantino AF. Observational studies: practical tips for avoiding common statistical pitfalls. Lancet Reg Health - Southeast Asia. 2024;25. doi: 10.1016/j.lansea.2024.100415 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41.Perrot S, Trouvin AP, Bouhassira D. Three dimensions of pain in osteoarthritis: development and Validation of the osteoarthritis symptom inventory scale. Pain. 2023;164(7):1566–1577. doi: 10.1097/J.PAIN.0000000000002856 [DOI] [PMC free article] [PubMed] [Google Scholar]

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