Background Foot and ankle diseases are highly prevalent in both the general and athletic populations, frequently resulting in pain, impaired physical function, and a decreased quality of life. Pulsed Electromagnetic Field (PEMF) therapy has shown beneficial effects on pain by reducing inflammation and improving circulation, yet its efficacy in treating foot and ankle soft-tissue pathologies remains unclear. This systematic review aimed to evaluate the impact of PEMF therapy on pain and physical function among individuals with foot and ankle soft-tissue pathologies. Methods A systematic literature search was conducted across Medline, Embase, Emcare (Ovid Nursing Allied Health), Allied and Complementary Medicine Database (AMED), and Web of Science from database inception to May 15, 2025. Additional searches were performed using Google Scholar and clinical trial registries. Two reviewers independently screened studies and extracted data on pain and physical function outcomes. Results Four randomised controlled trials (RCTs), comprising a total of 243 participants with a mean age of 48.79 years, were included in the review. In three of the four trials, PEMF therapy was administered alongside another conservative intervention, such as shockwave therapy, heel pads, or eccentric exercise, and compared to the conservative treatment alone. Only one study investigated the isolated effects of PEMF therapy vs. sham stimulation. Among the included studies, three reported statistically significant reductions in pain in the intervention groups compared to controls ( p 0.05 ). However, only one of three studies demonstrated a significant improvement in physical function following PEMF therapy (p 0.05 ). Large heterogeneity in terms of treatment protocols and intervention parameters was observed across the studies which may limit the comparability of outcomes. No serious adverse events were reported; only minor skin redness was documented as a side effect. Conclusion PEMF therapy appears safe and effective for reducing pain in individuals with various foot and ankle soft-tissue pathologies. However, the findings on the PEMF therapy in improving physical function remain inconclusive. Future research should focus on a large-scale, standardised setting, including the PEMF therapy protocol, to evaluate the efficacy of PEMF therapy on both pain and functional outcomes in this specific population. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251076499 , PROSPERO CRD420251076499.
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