Acupuncture As Treatment for Osteoarthritis of the Knee
]]>Osteoarthritis]]> is a degenerative disease caused by inflammation and eventual loss of cartilage in the joints. It is the most common form of joint disease and occurs most often in the knees. Osteoarthritis is characterized by pain, stiffness, and decreased function, and affects 17 million Americans over age 65.
Typically, the pain and stiffness associated with osteoarthritis are treated with anti-inflammatory medicines. However, there is growing evidence that a combination of conventional and unconventional treatments may be effective. Acupuncture, an ancient Chinese medical practice, has become popular and widely practiced in the US, especially for chronic conditions like arthritis.
There are few credible studies demonstrating the efficacy of acupuncture. Fortunately, as interest in the treatment grows, so does the number of studies. A recent study, published in the November 20, 2004, edition of the British Medical Journal (BMJ), compared the effect of acupuncture to placebo acupuncture in groups with osteoarthritis of the knee. The objective of the study was to observe changes in pain, stiffness, physical functioning, quality of life, and the use of pain relievers.
About the Study
This study took place during 2001 and 2002 at the pain management unit of a primary care center in southern Spain. There were 89 participants, all of whom were age 45 or older, had knee pain, and had x-rays showing evidence of osteoarthritis. Investigators divided the participants into a control group and an intervention group, and followed them for 12 weeks. Both groups were prescribed the drug diclofenac, a standard anti-inflammatory painkiller, which could be taken up to three times daily. The intervention group received real acupuncture, and the control group received placebo acupuncture using retractable needles that didn’t penetrate the skin.
Before and after the study, patients rated their condition using a standardized osteoarthritis index to measure pain, stiffness, and function; a visual pain indicator scale; and a quality-of-life profile. They also kept track of the number of pills they took to manage their pain.
The study concluded that acupuncture, in addition to drug treatment for osteoarthritis of the knee, was more effective than drug treatment alone. The results were based on a comparison of the before-and-after measures participants used to rate their condition. Those receiving real acupuncture reported less pain and stiffness, had better physical function, and took significantly fewer drugs than those receiving the placebo acupuncture. This last finding is particularly interesting since a sizable number of patients do not tolerate the adverse effects caused by anti-inflammatory medicines.
This study supports previous findings about acupuncture’s effects; however, its positive results must be interpreted with its limitations. For example, it is challenging to develop an adequate placebo for acupuncture needling, and there is no guarantee that the subjects in this study could not tell the difference between real and fake acupuncture. In addition, twelve weeks may have been too short to thoroughly evaluate the effects of the intervention.
How Does This Affect You?
Although some studies suggest that acupuncture can control symptoms of chronic disease, like other conventional treatments, it is not a cure and does not work for everyone. While the results of this study are intriguing, before you embark on a trial of acupuncture for your arthritis, consider the following:
- Acupuncture is not a quick-fix therapy, and you will likely need frequent, regular treatments in the beginning; if successful, you may eventually be able to control your pain with occasional maintenance treatments
- While some insurance companies provide partial coverage for acupuncture treatments, long-term treatment can be expensive
- Acupuncture is extremely safe in the hands of an experienced, licensed practitioner. Ask your doctor to help you find a reputable acupuncturist in your community. He or she should know about your plans to try acupuncture, so it can be incorporated into you overall treatment plan.
American Academy of Medical Acupuncture
National Center for Complementary and Alternative Medicine
Hochberg M. Presentation to the American College of Rheumatology. San Antonio, Texas. October 2004.
Horstman J. Acupuncture. Arthritis Today . October 2004. Available at http://www.arthritistoday.com . Accessed on November 22, 2004.
Vas J, Mendez C, Perea-Milla E, et al. Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial. British Medical Journal . 2004; 329: 1216-1219.
Last reviewed Nov 24, 2004 by ]]>Richard Glickman-Simon, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.