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Metal Implants & Safety

A practical guide for anyone with metal or a device inside them — joint replacements, plates and screws, dental work, stents, pacemakers or shrapnel: MRI safety labels, magnets and phones, airport screening, metal allergy, and the warning signs of infection or a failing implant.

Get help quickly if you have an implant or device and notice any of these:

Who this guide is for

Many people live with metal inside them: artificial hips and knees, plates, screws and rods, dental fillings and bridges, surgical clips, stents, pacemakers, drug pumps and other devices — and sometimes bullets, shrapnel or other fragments left behind after an injury (FDA, NHS, MedlinePlus). Usually it causes no trouble. This guide covers the moments when it matters: scans, magnets, airports, allergies, follow-up and warning signs. (This entry once sat on an older list of magnet products; our Magnet Therapy guide covers that topic.)

MRI scans: the most important safety check

MRI uses a powerful magnet and radio waves (MedlinePlus). Near an implant, the scanner can pull on magnetic metal, heat the device and nearby tissue (which could cause burns), make electronic devices malfunction, and blur the pictures. Problems are very rare — around 300 reports a year, mostly burns, among millions of U.S. scans (FDA) — and careful screening keeps it that way.

The three safety labels

  • MR Safe — nonmagnetic, contains no metal, doesn’t conduct electricity, and poses no known hazard in any MRI setting.
  • MR Conditional — safe only in an MRI setting that matches the device’s specific conditions for safe use.
  • MR Unsafe — should not go into the MRI environment. Any device whose MRI safety is unknown should be treated as MR Unsafe (FDA, FDA).

The FDA says people with implanted devices should not have an MRI unless the device has been positively identified as MR Safe or MR Conditional (FDA). Even many defibrillators can be scanned with the right precautions (NHLBI); your radiologist and device team decide.

Before any MRI

Magnets, phones and electronics near a device

Strong magnets in some phones and smart watches can switch a pacemaker or defibrillator into “magnet mode”; a defibrillator might then miss a dangerous fast rhythm. The FDA believes the risk is low, but it recommends keeping phones, smart watches and similar electronics at least six inches (15 cm) from an implanted device and out of pockets over it (FDA). Hold your phone to the ear on the opposite side and keep headphones away from the device. Household appliances in good working order are usually safe, but welding equipment, electric pet fences and some medical treatments, including TENS units, can interfere (NHLBI). Some magnet therapy products may also interfere with pacemakers and insulin pumps (NCCIH).

Airport security

  • Tell the TSA officer about metal implants, a pacemaker, defibrillator or other internal device — out loud, with a TSA Notification Card, or with medical documentation (TSA).
  • Pacemakers and similar devices: TSA says you should not be screened by the walk-through metal detector, and to talk to your doctor before flying (TSA). Body scanners appear to be safe for pacemakers, and you can show your ID card and ask for separate screening (NHLBI); a handheld metal detector shouldn’t be held over a pacemaker (NHS). If you set off an alarm or skip the scanner, expect a pat-down (TSA).
  • Need help? Contact TSA Cares at least 72 hours before you fly, at (855) 787-2227 or by online form, to request a trained Passenger Support Specialist. It doesn’t skip screening (TSA).

Metal allergy and implants

Skin allergy to metal is common — estimated at 10–15% of the general population — and nickel is the metal people react to most. Yet a true allergic reaction to a metal implant is rare, estimated at under 1% (review, JAAOS Global Research & Reviews, 2021). Common orthopaedic alloys, including stainless steel and cobalt-chromium, contain some nickel for strength (review, 2021).

  • Before surgery: tell your surgeon about any metal sensitivity — for example, rashes from jewelry or a belt buckle (FDA). Allergy testing is generally reserved for people with a notable history of metal allergy (review, 2021).
  • After surgery: reactions most often show up as pain and swelling, and sometimes a rash, within the first months to two years. Because infection, loosening and instability can look the same, metal allergy is diagnosed only after those are ruled out, and no test is a gold standard (review, 2021).

Metal-on-metal hip implants

In these hips both the ball and the socket are metal. As they rub, tiny particles and metal ions such as cobalt and chromium are released, and some enter the bloodstream. In some people this damages the bone and tissue around the joint, which can lead to pain, loosening and another operation (revision) (FDA). None are currently marketed in the U.S. as total hip replacements, but people who had surgery before May 2016 may have one (FDA); if you aren’t sure, ask your surgeon (FDA).

  • Follow-up: with no symptoms and a hip that is working well, the FDA advises a check with your orthopaedic surgeon every 1 to 2 years, with an exam and X-rays; extra tests aren’t needed (FDA).
  • Call your surgeon about new or worse hip or groin pain, swelling, numbness, weakness, grinding or squeaking, or a change in how you walk. Case reports also describe problems in the skin, heart, nerves, kidneys and thyroid, so tell any doctor you see about your hip (FDA).
  • Blood tests: surgeons may check cobalt and chromium when there are symptoms, but not in people who feel fine, and a level on its own doesn’t predict problems (FDA).

Women, people with both hips replaced, and people with kidney problems or a suspected metal sensitivity may need closer follow-up (FDA). See also our Hips guide.

Breast implants and BIA-ALCL

Breast implants hold saline or silicone, not metal, but they are long-term implants too. BIA-ALCL is an immune-system cancer (not breast cancer) that usually develops in the scar tissue and fluid around an implant, often years later. The risk is low but higher with textured implants. See your provider for persistent swelling, a lump or pain near an implant; removal is not recommended for people without symptoms (FDA).

Dental amalgam (“silver”) fillings

Amalgam is about half mercury, bound with silver, tin and copper, and it releases low levels of mercury vapor. Most evidence shows this does not harm the general population (FDA). In September 2020 the FDA recommended that people at higher risk avoid new amalgam fillings whenever possible and appropriate, choosing alternatives such as composite resin or glass ionomer. The higher-risk groups are pregnant women and their developing babies, women planning a pregnancy, nursing women and their infants, children (especially under six), people with neurological disease such as multiple sclerosis, Alzheimer’s or Parkinson’s, people with impaired kidney function, and people allergic to mercury or other amalgam ingredients (FDA).

Don’t rush to have fillings drilled out. The FDA does not recommend removing amalgam fillings that are in good condition unless it is medically necessary, because removal briefly increases mercury vapor exposure and sacrifices healthy tooth (FDA, FDA).

Retained shrapnel and fragments in veterans

Embedded fragments — shrapnel from bombs, mines, shells or IEDs — can inflame the tissue around them, and material can leach into the bloodstream (VA). Some contain depleted uranium; so far there is no evidence of long-term health effects from embedded depleted uranium fragments (VA). VA’s surveillance program for post-9/11 veterans offers special metal testing (VA), and if a fragment is going to be removed, ask your VA provider to send it for analysis (VA). See our Gulf War Illness guide.

Signs of infection or a loosening implant

An infected joint replacement is serious and hard to treat, and it can appear months or even years after surgery (AAOS OrthoInfo). Watch for:

  • redness and swelling at the incision, or wound drainage;
  • pain that doesn’t change with activity, or new pain and stiffness in a joint that was working well; and
  • tiredness (AAOS OrthoInfo), or a high temperature, chills or feeling hot and shivery (NHS).

For pacemakers, watch for fever, chills, and pain or redness at the device site — sometimes six months or more after surgery (NHLBI). Modern hip replacements are designed to last at least 15 years but can wear, loosen or dislocate (NHS, FDA). Heart devices, including stents and pacemakers, are covered in our Heart guide, and dedicated Stents and Pacemakers guides are coming soon.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Regular follow-up with the surgeon or device clinic; X-rays, and MRI only when the device is confirmed MR Safe or MR Conditional; metal-ion tests and soft-tissue imaging for symptomatic metal-on-metal hips; revision surgery when an implant fails; antibiotics before dental work only if your surgeon advises. Without insurance, an X-ray often runs about $50–$500 or more; a routine single-body-part MRI about $250–$1,000 at discounted outpatient centers. Revision surgery: cost estimate being researched. Most implants work well for many years. Keeping follow-up appointments and reporting new pain, swelling or noises early gives the best chance of catching problems while they are easier to treat.
Chiropractic Can be used for back or neck pain in people with past spine surgery, but only after a full history of any hardware, fusion and implants. About $55–$100 per self-pay follow-up visit; a first visit about $90–$200. Evidence is limited and chiropractors disagree about thrust manipulation after a fusion. One chart review found no serious short-term harms, but ask your surgeon first.
Acupuncture Standard needling may be used for pain; electroacupuncture needs extra caution with pacemakers, defibrillators and other electronic implants. About $125–$230 for a first visit and $90–$185 for follow-ups (cash price). Generally few complications with sterile, single-use needles. Electrical stimulation has been linked in case reports to defibrillator shocks and burns.
Herbal medicine No role in removing metal. The main step is safety: avoid over-the-counter “chelation” or “detox” products and tell your doctors about every supplement. No cost — the key step is an honest list of what you take. The FDA has never approved any over-the-counter chelation product; real chelation is prescription-only and can cause serious side effects.
Massage therapy Gentle massage for pain and stiffness during recovery, avoiding fresh incisions, firm pressure over a device, and electrical massage gadgets near heart devices. At one national chain, about $125–$160 for a 60-minute massage for non-members. Trials after knee replacement suggest less pain and better movement in the first weeks, but the studies vary a lot. Massage supports rehab; it doesn’t replace it.
MBHA Wellness Coach Practical habits: carrying your implant card, telling every provider, preparing for MRIs and flights, keeping follow-ups, and building recovery routines. Cost estimate being researched. Supports — never replaces — your surgeon and device team, and helps you avoid the common slip-ups (forgotten cards, missed checks, phones in shirt pockets).

Approach 1 of 6

Conventional medicine (AMA)

Follow-up schedules

  • Pacemakers: in the NHS, a check about 6 weeks after the procedure, again at 3 to 6 months, then at least every 12 months; the battery usually lasts 6 to 7 years (NHS). Your doctor may also check the battery and wires remotely and offer software updates (NHLBI).
  • Defibrillators (ICDs): ICDs last about 5 or 6 years, and you should ask at visits whether the maker has announced any problems or recalls (NHLBI).
  • Metal-on-metal hips: every 1 to 2 years with an exam and X-rays if all is well, and sooner if symptoms appear (FDA).
  • Knee replacements: artificial knees are made of metal and plastic, and success depends a lot on the exercises you keep up at home (MedlinePlus). See our Knees guide.

Imaging choices

Metal can distort pictures. For metal-on-metal hips, the FDA describes the trade-offs: MRI with special metal-reducing settings shows soft tissue best, but most of these hips haven’t been tested for MRI safety; CT shows implant position and bone best but uses radiation; ultrasound avoids metal distortion but depends on the operator’s skill (FDA). Your surgeon and radiologist weigh these together (FDA).

Antibiotics before dental work

This is a common question, and the answer is “only if your surgeon or dentist advises it.” An American Dental Association panel concluded in 2015 that the evidence did not show dental procedures cause joint replacement infections, and that, in general, antibiotics before dental work are not recommended for people with prosthetic joints; dentist and patient should still consider individual medical risks (ADA guideline, JADA, 2015). The American Academy of Orthopaedic Surgeons, working with the ADA, later published appropriate-use criteria that rate many specific patient situations (AAOS appropriate use criteria, 2017), and AAOS notes that your surgeon may prescribe antibiotics before dental work (AAOS OrthoInfo). So ask: your own surgeon’s advice, based on your health, comes first. If you also have a heart device or heart valve, ask your cardiologist too.

What it costs

  • X-rays: a basic X-ray at a cash-pay imaging center, doctor’s office or urgent care can run from $50 to $500 or more without insurance (cost guide, updated 2026: The Pricer).
  • MRI: a self-pay scan of one body part often costs about $250–$1,000 at discounted outpatient imaging centers; hospital prices can be far higher (cost guide, updated 2026: The Pricer). These are examples, not a quote.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Many people with past spine surgery see a chiropractor — about one in nine patients receiving chiropractic manipulation in one large U.S. records study had at least one earlier spine surgery (cohort study, Cureus, 2023). If you have spinal rods, screws, a fusion, or a disc replacement, that history should shape your care.

Tell your chiropractor everything

Share your full health history, medicines and supplements (NCCIH), and bring your operation notes. The type of surgery, the time since it, any implants, and how many spinal levels are involved may all influence whether and how manual therapy is used (case report, 2023). In one published case, a chiropractor chose CT instead of MRI because it wasn’t clear what metal had been used in an old neck fusion (case report, 2023).

Manipulation near a fusion

There is no agreement in the profession. In one survey of Asia-Pacific chiropractors, about half said they would not use thrust manipulation on the neck of a patient with a single-level neck fusion, and more (63%) would avoid it after a multilevel fusion (case report, 2023). A chart review of 418 adults with prior spine surgery found no serious short-term harms, such as fractures or hardware failure, after manipulation (chart review, J Man Manip Ther, 2025), and a review found the overall evidence after lumbar surgery limited, with moderate support for nerve mobilization and myofascial release after lumbar fusion (systematic review, 2021).

Our suggestion: ask your spine surgeon before anyone uses thrust manipulation on or next to fused or instrumented segments, and ask your chiropractor to favor gentler techniques there. Mild-to-moderate soreness, stiffness or headache often follows manipulation and usually goes away within 24 hours; serious side effects are very rare (NCCIH).

Cost

About $55–$100 per self-pay follow-up visit and about $90–$200 for a first appointment (cost guide, updated 2026: The Pricer).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture uses fine needles, sometimes stimulated with small electrical currents (electroacupuncture) (NCCIH). For people with implants, the key question is whether electricity will be used.

Electroacupuncture and implanted electronics

  • A review of case reports listed defibrillator shocks, heart emergencies and electrical burns among the possible harms specific to electroacupuncture, and urged caution (systematic review, Acupuncture in Medicine, 2020).
  • Published reports have suggested avoiding electroacupuncture in people with pacemakers because of a theoretical risk of malfunction. One case report described a woman with a pacemaker treated safely for two years, but the authors stressed that every patient must be considered individually (case report, 2011).
  • NHLBI lists TENS (transcutaneous electrical nerve stimulation) for pain among the treatments that can affect pacemakers (NHLBI).

Practical steps: tell your acupuncturist about any pacemaker, defibrillator, nerve or spinal-cord stimulator, pump or other electronic implant; ask for manual needling only unless your cardiologist or device team approves electrical stimulation; and keep needles away from fresh incisions. Make sure needles are sterile and single-use, as the FDA requires (NCCIH).

Cost

About $125–$230 for a first private visit and $90–$185 for follow-ups, cash price (cost guide, updated 2026: The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement removes metal from your body, dissolves an implant, or protects a joint replacement. The main role here is safety.

Beware of “chelation” and “detox” products

  • Chelation uses chemicals to remove heavy metals from the body. FDA-approved chelation products all need a prescription and medical supervision; the FDA has never approved an over-the-counter one for any condition (FDA).
  • The FDA has warned about home chelation products sold as supplements, nasal sprays, suppositories, drops and clay baths, and about unapproved home urine tests used to sell them. Chelation can cause dehydration, kidney failure and death, and there is no proof that “detox” with these products prevents or treats anything (FDA, NCCIH).
  • If you think you’ve been exposed to too much lead, NCCIH advises seeing your health care provider for evaluation (NCCIH).

Tell your doctors what you take

Dietary supplements are one of the things that can raise blood metal results in people with metal-on-metal hips, so list them before any metal-ion test (FDA). More generally, talk with your health care providers about any complementary approaches you use (NCCIH), and bring a list of every supplement, as well as your medicines, to surgery and dental visits.

Approach 5 of 6

Massage therapy

What the research says

A 2024 review of 11 trials with 940 people found that massage after knee replacement eased pain in the first three weeks and improved knee movement in the first two, with fewer adverse events; the studies varied a lot, and the authors saw massage as an add-on to rehab (meta-analysis, J Orthop Surg Res, 2024).

Staying safe

  • Recent surgery: keep away from fresh incisions and follow your surgeon’s timeline. After a pacemaker, for example, the NHS advises no heavy lifting or raising the elbow above shoulder height for 4 to 6 weeks (NHS) — so ask before any arm or shoulder work.
  • Over a device: we suggest no firm pressure directly over a pacemaker, defibrillator, pump or other implanted device. Electrical massage gadgets are a particular concern: in one lab test, a shoulder massage machine interfered with a pacemaker from up to 28 cm away, and in a test setup with a defibrillator it induced a dangerous heart rhythm (ventricular fibrillation) (lab study, J Artif Organs, 2014). TENS units can also affect pacemakers (NHLBI).
  • A painful, swollen leg is not for massage. After a joint replacement it can be a sign of a blood clot and needs a doctor (NHS). Rare serious side effects of massage include blood clots, nerve injury and fractures, often with vigorous deep-tissue work or in frail people (NCCIH).

Cost

At one national chain, published non-member prices for a 60-minute massage ran about $125–$160 at three locations (cost guide, updated 2026: The Pricer).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

A wellness coach can help you turn all of this into simple habits, so the right information is always where it is needed.

Your implant card and records

  • Carry your card. It should show your device type, leads, implant date and your doctor’s contact details; show it to airport security and new doctors (NHLBI). If you move or change your phone number, ask the manufacturer for a new card (NHLBI).
  • No card? Ask your surgeon, or request your operative notes from the facility, for the maker and model of your implant (FDA).
  • Keep a one-page list of every implant, fragment and dental restoration you have, with dates. A phone photo of your card is a handy backup.

Tell every provider

Doctors, dentists, physical therapists, chiropractors, acupuncturists and massage therapists all need to know. Some procedures — electrocautery, diathermy, lithotripsy, TENS and MRI — can affect heart devices (NHLBI, NHLBI), and with a metal-on-metal hip, new symptoms anywhere in the body are worth mentioning (FDA).

Travel and everyday habits

Recovering after surgery

  • Keep up the exercises your physical therapist gives you — after knee replacement, success depends a lot on what you do at home (MedlinePlus).
  • Follow wound-care, driving and lifting instructions — after a pacemaker, no driving for at least the first week (NHS).
  • Before joint surgery, check your skin for cuts, scrapes, rashes or bites and report them, and don’t shave the surgical area yourself (AAOS OrthoInfo).

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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