Research supports acupuncture for OA pain

Research supports acupuncture for OA pain
October, 2007
By Shawn Thistle, DC
Chiropractic Economics

Baby boomers are growing older, which means they may suffer from a number of age-related problems, including osteoarthritis (OA) Û a common, disabling, and costly condition.

Most treatment guidelines published to date recommend a multimodal pharmacologic and nonpharmacologic approach until the condition progresses and warrants a total knee replacement. Many patients would prefer to avoid surgery and explore treatment alternatives to help them maintain their active lifestyle and enjoy a multitude of sporting and leisure activities.

Many of these patients seek chiropractic care in search of conservative treatment options.

KNEE OA SUMMARY

Common symptoms of knee OA include pain, loss of motion, stiffness, and joint crepitus (noise) with movement. This condition can be associated with severe loss of function and mobility, as well as a general decline in quality of life. It can also severely inhibit middle-aged athletes from reaching their potential.

The most common medical intervention is oral anti-inflammatory medications (NSAIDs). For patients who are unresponsive or decline this treatment, alternative management strategies are available, including manual therapies, exercise, and nutritional supplements, such as glucosamine sulphate.

Another effective alternative in controlling knee pain is acupuncture.

ACUPUNCTURE FOR KNEE OA

Chinese acupuncture has evolved over thousands of years, forming a cornerstone of traditional Chinese medicine (TCM). Once thought of as a mystical form of Eastern medicine, acupuncture has grown from its debut in North America more than 30 years ago to one of the most popular alternative therapies in the contemporary healthcare marketplace.

A natural corollary of this trend has been a continuing integration of acupuncture into a Western medicine model. Utilizing a blend of ancient methods and modern biomedical concepts, practitioners of many disciplines (such as physiotherapy, medicine, and chiropractic) are regularly incorporating acupuncture into their practices.

Many patients receive acupuncture treatment not only as a stand-alone therapy, but also as an integrated modality in a variety of healthcare environments. AcupunctureÌs popularity has been further bolstered by the increasing attention it is being paid in scientific circles. Numerous trials demonstrating its effectiveness have recently been published in major medical journals.

Knee OA has been the topic of three major trials,1, 2, 3 all of which have shown acupuncture treatment to be superior to traditional treatments or enhance results when combined with traditional treatments.

In a recent systematic review and meta-analysis of acupuncture for peripheral joint arthritis,4 authors concluded: ÏConsidering its favorable safety profile, acupuncture seems an option worthy of consideration particularly for knee OA.Ó

It is important to note that in each study, the sham or placebo acupuncture group also improved. In two studies, the sham acupuncture procedure involved inserting needles at ÏnontraditionalÓ or ÏirrelevantÓ points, which suggests that acupuncture may have a nonspecific systemic effect on pain. This trend of beneficial effects of acupuncture regardless of insertion site has also been reported in acupuncture trials on low-back pain5 and tension-type headache.6

For many people contemplating surgery or stronger prescription medications, acupuncture could provide sufficient pain relief to allow proper rehabilitation and strengthening of the knees. This could significantly delay, or eliminate the need for, invasive surgery that requires lengthy rehabilitation.

In a manual medicine environment, the addition of acupuncture to manual therapy and rehabilitation has the potential to improve patient outcomes for knee OA, and allows your patients to maintain active lifestyles and athletic endeavors.

References

1 Vas J et al. Acupuncture as a comple-mentary therapy to the pharmacological treatment of osteoarthritis of the knee: randomized controlled trial. BMJ 2004; 329(7476):1216. Epub 2004 Oct 19.

2 Berman BM et al. Effectiveness of acupun-cture as adjunctive therapy in osteoarthritis of the knee: A randomized, controlled trial. Ann Int Med 2004; 141: 901-910.

3 Sharf H et al. Acupuncture and knee osteoarthritis: A three-armed randomized trial. Ann Int Med 2006; 145(1): 12-20.

4 Acupuncture for peripheral joint osteo-arthritis: A systematic review and meta-analysis. Rheumatol 2006; 45: 1331-1337.

5 Brinkhaus B et al. Acupuncture in patients with chronic low back pain. Arch Int Med 2006; 166: 450-457.

6 Melchart D et al. Acupuncture in patients with tension-type headache: randomised controlled trial. BMJ 2005; 331: 376-382.
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