Anyone who has lived with a painful knee, hip or shoulder for more than a year has been handed a lot of advice. Some of it from clinicians, some from the internet, some from a well-meaning neighbour. Very little of it arrives with any sense of proportion — of which options carry real weight behind them, which are worth a try, and which are mostly hope with a price tag.
So rather than write another page telling you why one treatment is the answer, here’s the landscape. All of it, in rough order of how much evidence sits behind each option, with MBST placed honestly within it.
First, the thing with the most evidence behind it
If you have osteoarthritis, the single most strongly supported treatment is not a machine, an injection or an operation. It’s therapeutic exercise.
NICE guideline NG226, which governs osteoarthritis care in England and Wales, positions therapeutic exercise as core treatment — offered to everyone, regardless of severity, and continued long-term. Weight management is recommended alongside it where relevant. Manual therapy may be considered, but as an addition to exercise rather than a replacement for it.
This is genuinely unglamorous advice, and it’s routinely underestimated for exactly that reason. A machine feels like it’s doing something to you. Exercise feels like work you’re doing yourself, and it takes weeks before anything changes.
But the difference in evidence quality between the two is not subtle, and any clinic that sells you a device without also getting you stronger is selling you half a solution at best. If you take one thing from this article, take that.
Where medication fits
NICE frames drug treatment as an adjunct to exercise, not an alternative. For knee osteoarthritis, a topical anti-inflammatory is the recommended first option, with oral anti-inflammatories considered if topical treatment isn’t suitable or effective — at the lowest dose, for the shortest time, and with proper attention to your other health conditions.
This is your GP’s territory, not ours, and it’s worth having that conversation properly rather than working through the pharmacy shelf on your own.
Where injections fit
Corticosteroid injections can be considered for short-term symptom relief. The key phrase is short-term — they’re a way of buying a window, and the sensible use of that window is to do the strengthening work that’s otherwise too painful to start.
Injections used repeatedly as a standalone strategy, with nothing else changing, tend to deliver diminishing returns.
Where surgery fits
Joint replacement is a genuinely transformative operation for the right person at the right time. NICE’s position is that referral should be considered when symptoms are substantially affecting quality of life and non-surgical management has been ineffective or is unsuitable — and that the decision should rest on clinical assessment rather than a scoring system.
The relevant point for anyone reading this: “my X-ray looks bad” is not, on its own, a reason for surgery. How much the joint is affecting your life is what counts.
Where electrotherapy sits — and this is the awkward bit
Here’s a section most clinics offering device-based therapies would rather not write.
NICE NG226 recommends against a number of named electrotherapy treatments for osteoarthritis — including TENS, therapeutic ultrasound and laser therapy — on the grounds of insufficient evidence of benefit. That’s a specific and fairly blunt recommendation.
Two things are worth understanding about it.
First, MBST is not among the modalities NICE named or assessed. The guideline looked at a defined set of treatments, and magnetic resonance therapy wasn’t part of that review. So it would be wrong to say NICE has ruled against MBST — it hasn’t examined it.
Second, it would be equally wrong to treat that silence as endorsement. The absence of an assessment is not a favourable assessment.
We’d rather tell you this than let you find it later and wonder why nobody mentioned it.
So where does MBST actually sit?
Fairly, here’s the position.
What it is: a non-invasive, contact-free therapy developed by the German manufacturer MedTec, using the physical principle of magnetic resonance at field strengths thousands of times weaker than an MRI scanner. Courses run as daily hour-long sessions, typically across five to ten consecutive days.
What the manufacturer proposes: that energy transfer involving hydrogen protons in the tissue stimulates cellular activity in the treated area.
What the research shows: mixed. A 2021 scoping review in Radiography found generally positive results across the available studies, but was explicit that those studies mostly lacked control groups, involved small numbers, and didn’t control for confounders such as medication — and called for more robust research. The one randomised, double-blind, placebo-controlled trial, published in 2016 in 97 patients with mild-to-moderate knee osteoarthritis, found that the treatment and placebo groups improved by similar amounts at both two and twelve weeks, with no significant difference on blinded imaging. Its authors concluded the therapy was safe but not superior to placebo in that group.
What the regulator says: the Advertising Standards Authority has stated it has not yet seen convincing evidence for the efficacy of MBST, and requires clinics advertising it to hold robust evidence for any claims they make. That’s why this page describes what MBST is and what the research found, rather than telling you what it will do for you.
What we can say about safety: no adverse events were recorded in the placebo-controlled trial, and large observational datasets have not raised significant safety concerns.
That is the honest sum of it. MBST is an option some people choose to try, generally after the well-supported measures are already in place and haven’t got them where they want to be. It is not a substitute for exercise therapy, for medication your GP has recommended, or for a surgical opinion when one is warranted.
A note on osteoporosis specifically
MBST is often discussed in connection with osteoporosis as well as joint pain, so it’s worth addressing directly.
Osteoporosis is a condition where the consequences of getting management wrong are serious and sometimes irreversible — a fracture, particularly of the hip or spine, is a life-altering event. It is firmly a condition for medical supervision, and the established management pathway involves bone density assessment, fracture risk calculation, and medication where indicated, overseen by your GP or a specialist.
There is also strong evidence for the role of exercise in bone health: progressive resistance training and weight-bearing impact activity, prescribed appropriately for your fracture risk, along with attention to falls prevention, balance, vitamin D and calcium intake.
If you have osteoporosis or osteopenia, nothing on this page should be read as a reason to defer, decline or discontinue any of that. Anything else you choose to explore sits alongside it.
Four questions worth asking any clinic
Whatever you’re considering, and wherever you’re considering it, these four questions will tell you a lot.
“What does the evidence for this actually show?” A clinic that answers with nuance is more trustworthy than one that answers with certainty. Anyone promising a specific outcome for a specific person is overreaching.
“What am I doing alongside this?” If the answer is “nothing”, walk away. Any passive treatment should sit on top of an active plan, not replace it.
“How will we know whether it’s worked?” Agree measures beforehand — walking distance, stairs, sleep, how long you can stand, what you’ve stopped doing that you’d like to resume. Deciding afterwards whether you feel better is unreliable, particularly when you’ve paid for something.
“What happens if it doesn’t help?” A clinic with a good answer to that question has thought about your situation rather than their diary.
What we’d say if you rang us tomorrow
Probably not what you’d expect from a page about MBST.
We’d want to know what’s actually going on with the joint, what you’ve already tried and how thoroughly, what your GP or consultant has said, and what you’re no longer able to do that matters to you. We’d want to make sure the foundations — strength, load, activity, weight where relevant — are genuinely in place, because they’re where the best-supported gains are and they’re frequently skipped.
And then, if MBST is something you want to explore, we’d go through it properly: what’s involved, what the evidence does and doesn’t show, the screening questions, the time commitment, and the cost, so that whatever you decide is a decision rather than a hope.
Sometimes we’ll tell people it isn’t the right next step for them. We’d rather do that than take a booking we don’t believe in.
Book a free discovery visit
MBST Blackpool, delivered by JAM Physio, offers a free discovery visit — no cost, no obligation, and no obligation to book treatment afterwards.
It’s a conversation and an assessment: where you are, what’s realistic, and what’s genuinely worth your time and money. Including, when that’s the honest answer, the option we don’t charge for.