Acupuncture Reduces Knee Pain

Acupuncture is effective in relieving osteoarthritis knee pain, new research suggests, but placebo acupuncture appears to also do the job.

As reported in the Annals of Internal Medicine, acupuncture was 53.1-percent successful in treating symptoms of knee osteoarthritis. However, a sham procedure that looked like acupuncture, but provided no actual benefit, was a close second with a success rate of 51.0 percent.

Still, the authors are reluctant to dismiss acupuncture as a treatment for knee osteoarthritis. The findings support a role for acupuncture as part of the treatment of “patients with pain and functional limitations due to osteoarthritis of the knee, even if the mechanisms of its effects remain unclear,” they write. Acupuncture could add to the effects of more conservative therapy and reduce the need for pain medications.

The findings stem from a study of more than 1,000 patients who had pain due to osteoarthritis for at least six months. In addition to undergoing six physiotherapy sessions and receiving anti-inflammatory drugs as needed, the patients were randomly assigned to undergo 10 sessions of traditional Chinese acupuncture, 10 sessions of sham acupuncture, or 10 physician visits within a six-week period. If the treatment was viewed as successful, the patient could receive five additional sessions or visits.

The sham acupuncture consisted of minimal depth needling at points away from recognized traditional Chinese acupuncture sites, lead author Dr. Hanns-Peter Scharf, from the University of Heidelberg in Germany, and colleagues note. Successful treatment was defined as a 36 percent or greater improvement in osteoarthritis index scores.

As noted, the two acupuncture treatments achieved success rates of around 52 percent each. By contrast, the success rate with conservative therapy was just 29.1 percent. Compared with conservative therapy, the two forms of acupuncture were roughly 74 percent more likely to be effective.

More study is needed to determine if the mechanism of acupuncture’s effect is linked to the physiologic effects of needling, to more intense contact with the health provider or to a placebo effect, the authors conclude.

– Reuters

SOURCE: Annals of Internal Medicine, July 4, 2006.

Dr. Hooper’s Comment

This study confirms what we see in practice; Acupuncture is quite effective in the treatment of knee pain, and even if it does not fully resolve the condition, it helps to reduce the need for harmful drug medications.

Of continuing debate is the effect of “sham” acupuncture. What the authors of this study fail to identify is that even “sham” acupuncture does stimulate the central nervous system in a similiar manner to “real” acupuncture.

Sham acupuncture points are usually very close to the real ones; and if the sham point is on the meridian of the “real point”, it has virtually the same effect as needling the “real point”. The effect on the local tissues, the brain stem and the cerebral cortex (your brain) are very similiar no matter which point you use. That is why “sham” acupuncture works!

However this should not take away from the very real value of Acupuncture for those patients with joint pain and discomfort.