Acupuncture May Help Knee Arthritis

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Acupuncture May Help Knee Arthritis: Short-Term Benefit Seen in Study;

Long-Term Effects Unclear By Miranda Hitti

WebMD Magazine Reviewed By Brunilda  Nazario, MD

July 7, 2005 -- Acupuncture may offer some relief from

osteoarthritisAcupuncture may offer some relief from osteoarthritis in the knee

- at least in the short run.

Researchers report the finding in The Lancet. They studied nearly 300 people

with knee osteoarthritis.

Acupuncture's long-term effects on knee osteoarthritis now need to be tested,

write the researchers. They included Witt, MD, of Berlin's Institute of

Social Medicine, Epidemiology, and Health Economics.

Osteoarthritis is the most common form of arthritis;Osteoarthritis is the most

common form of arthritis; it causes degeneration of body joints. It develops

when cartilage, the lining of joints that allows smooth movement between

opposing bones, starts to break down. Swelling and inflammation in the

affected joint are a major cause of pain and disability. Osteoarthritis most

often affects the fingers, hips, knees, feet, or spine.

Year-Long Study, 2-Month Treatment

Witt's study lasted one year. Acupuncture treatments only lasted for eight

weeks.

Some patients got 12 sessions of real acupuncture over eight weeks. Others

got fake acupuncture treatments.

The fake acupuncture didn't place or use needles correctly. Patients were told

that two different types of acupuncture were being tested. They didn't know

that one procedure was phony.

For comparison, a third group didn't get either treatment right away. Instead,

they went on an eight-week waitlist for real acupuncture.

All patients were also allowed to take pain-relieving drugs during the study.

Treatment for osteoarthritis is based on reducing pain and inflammation using

anti-inflammatoryTreatment for osteoarthritis is based on reducing pain and

inflammation using anti-inflammatory medications and physical therapy.

Short-Term Results

Patients completed surveys about knee pain and functional disability eight

weeks, six months, and one year into the study.

Real acupuncture came out on top in the first survey. Patients getting real

acupuncture had bigger improvements in knee pain and function than the

other two groups. Those receiving real acupuncture treatment reported

significantly lower scores on pain and disability compared with participants in

the other groups.

At eight weeks, about half of the real acupuncture group had improved their

scores by at least 50%.

The same level of improvement was reported by 28% of those getting fake

acupuncture and 3% of those on the waitlist, write the researchers.

Longer View

Longer View

Those patterns didn't hold in the follow-up surveys.

At six months and one year, there weren't significant differences between the

groups, write the researchers.

Those on the waitlist eventually got real acupuncture. They followed the same

pattern as the first real acupuncture group -- short-term improvement that

faded after treatment ended.

Second Opinion

Acupuncture for knee osteoarthritis is also covered in a Lancet editorial.

" Certainly, a major benefit patients report is that acupuncture makes them feel

better. Making patients feel better is important, " write biochemist

and colleagues. They work at the Pain Research Unit at Churchill

Hospital in Oxford, England.

Possibly, some trials have failed to adequately measure that benefit, they

continue.

But " we are still some way short of having conclusive evidence that

acupuncture is beneficial in arthritis or in any other condition, other than in

a

statistical or artificial way, " write and colleagues.

" Acupuncture is widely used by patients with chronic pain although there is

little evidence of its effectiveness, " write Witt and colleagues.

Third Viewpoint

Experts from the U.S. Department of Health and Human Services see

acupuncture a little differently.

Two years ago, they issued an assessment of acupuncture for osteoarthritis.

They had reviewed 19 studies on the topic. Not all dwelt on knee arthritis.

Most studies showed some benefit from acupuncture compared with no

treatment, the review states. However, it also states that real acupuncture

didn't have an edge over sham acupuncture in most studies.

Overall, " the evidence was probably sufficient' to justify acupuncture as a

second- or third-line treatment for a patient who isn't responding to

conventional treatments, not tolerating medication, or is experiencing

recurrent pain, " states the review.

But the evidence didn't justify using acupuncture as an initial treatment, the

review continues.

In 1997, a panel of scientists from the National Institutes of Health stated

that

while acupuncture studies were mixed, they had seen " promising " results for

acupuncture in adults with postoperative and chemotherapy-related nausea

and vomiting, as well as postoperative dental pain.

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SOURCES: Witt, C. The Lancet, July 9, 2005; vol 366: pp 136-143. WebMD

Medical Reference from Healthwise: " Osteoarthritis: Topic Overview. " ,

A. The Lancet, July 9, 2005; vol 366: pp 100-101. U.S. Department of Health

and Human Services Public Health Service: " Technology Assessment:

Acupuncture for Osteoarthritis. " NIH: " Acupuncture Consensus Development

Conference Statement. " News release, The Lancet.