Acupuncture for Knee Arthritis?

Summarized by Robert W. Griffith, MD
February 11, 2005

Introduction

Gradual acceptance of acupuncture as a useful therapeutic measure has come slowly to Western medicine. New impetus, however, is given by two reports of its effectiveness in osteoarthritis (OA) of the knees. OA is a very common and disabling disorder that affects over 20 million Americans, and it's been estimated that 80% of them have some form of limitation of movements.

Acupuncture has been accepted as a useful treatment for other types of pain, e.g. migraine, tennis elbow, and trigeminal neuralgia. Recent concerns about the safety of painkilling medications have led to renewed interest in non-drug treatment for OA - exercise, heat/cold therapy, yoga, and herbal supplements. So these reports of acupuncture's effectiveness in knee OA are quite timely.

A US study

One of the difficulties of proving the effectiveness of acupuncture is creating a control group for comparison with the test subjects. In this case, 570 patients were divided into three groups - one received true acupuncture, one had a sham procedure (simulated needle insertion or insertion into a non-therapeutic area), and the third had six 2-hour group education classes with follow-up mailings. The study lasted 26 weeks; acupuncture sessions were twice a week initially, then gradually reduced to once a month.

The average age of the patients was 66. There was a large drop-out rate - by 6 months, 43% of the education group and 25% of the true and sham acupuncture groups failed to attend for examination.

After 8 weeks, the patients in the true acupuncture group had a significantly greater improvement in function of their knees, compared with those in the sham-treated group. However, pain scores and overall assessment were similar in the two groups. After 26 weeks, those in the true acupuncture group were significantly greater improved with regard to function, pain, and overall assessment, compared with the sham-acupuncture group. There were no side effects associated with acupuncture.

A Spanish study

This was a smaller study. Acupuncture - true or sham - was administered to 97 patients for 12 weeks. All the participants took the nonsteroidal anti-inflammatory drug diclofenac (Voltaren^®), but were told to reduce the dose if their symptoms improved.

A total of 88 patients completed the study. There was a significantly greater reduction in pain, loss of function, stiffness, and 'psychological functioning' in the true acupuncture group, compared with the sham-treated group. Moreover, the consumption of diclofenac was significantly reduced in the acupuncture patients. Three patients reported bruising associated with the procedure.

What these studies reveal

These studies show that acupuncture can help patients with knee OA. The number of acupuncture specialists in the USA and other Western countries is growing, so that it should not be difficult for patients to find one. The best approach for OA patients anxious to reduce their dependency on pain-killers is to consult their physician about the best alternative therapies, including the possibility of acupuncture.

Sources

• Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee. BM. Berman, L. Lao, P. Langenberg,  et al., Arch Intern Med, 2004, vol. 141, pp. 901--910



• Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial. JV. Vas, C. Mendez,  Perea-Milla,  et al., BMJ, 2004, vol. 329, pp. 1216--1219

Related Links
Steroid Injections for Arthritic Knees?
Knee Osteoarthritis? Call in the Leeches!

Please take a moment to give us your comments. For questions about Health matters you may check our "Questions & Answers" Portal and Service.