Acupuncture – A Promising Therapy for Osteoarthritis of the Knee
Osteoarthritis also known as degenerative joint disease is the most common form of arthritis in America. Presently over 43 million Americans suffer from osteoarthritis. Over two-thirds (68%) afflicted are 55 years and older. 1
Osteoarthritis is characterized by joint degeneration and loss of cartilage resulting in joint stiffness, pain, swelling, and loss of joint function. Generally, the hands and weight-bearing joints, such as knees, hip, and spine are affected by osteoarthritis. If severe, osteoarthritis can be very debilitating, interfering with work, activity, and psychological health. Americans who have heavily relied on conventional medical treatments for osteoarthritis such as analgesics, aspirin and non-steroidal anti-inflammatory drugs (NSAIDS), corticosteroid injections, and even joint replacement surgery are concerned by the numerous, dangerous side effects of these therapies and are looking for a safer, less invasive approach. Vioxx, a COX-2 selective inhibitor pain killer once touted as an effective drug for osteoarthritis was recently pulled off the market in September 2004 because of its increased risk of strokes and heart attacks. In addition, the Food and Drug Administration (FDA) has recently issued a public health advisory recommending doctors limit the use of arthritis painkillers, Celebrex and Bextra to patients in response to news that a clinical trial suggested that the Celebrex could carry an increased risk of heart attacks and strokes. The FDA recommends that in the meantime doctors should use over-the-counter pain relievers such as ibuprofen and aspirin for as many patients as possible. However, ibuprofen and aspirin also have worrisome side effects of their own, which includes gastric upset, gastrointestinal bleeding, ulcer formation, and kidney damage. According to some experimental studies, aspirin and NSAIDS have also shown to accelerate cartilage destruction and inhibit cartilage synthesis, possibly promoting the progression and severity of osteoarthritis. 2
Recent news, that acupuncture was found to be a promising treatment for osteoarthritis, stirred up hope for a safer and more effective solution. A large, randomized, controlled trial, recently published in the Annals of Internal Medicine found that acupuncture can provide significant pain relief and improve function in patients who have osteoarthritis of the knee. Researchers from the University of Maryland selected 570 patients 50 years or older with osteoarthritis of the knee to participate in the trial. None of the study participants had ever experienced acupuncture, had not had knee surgery in the previous six months, and had not used steroids or similar injections. Patients were divided into three groups, true acupuncture, sham acupuncture, and patient education. The first group received 23 true acupuncture sessions over 26 weeks. The control groups either received 23 sham acupuncture sessions over 26 weeks or 6 two-hour arthritis education sessions over 12 weeks. Sham acupuncture is a technique where a device is used to create a needle-like sensation without using real needles. The patients' pain and knee function were assessed using standard arthritis research survey instruments and measurement tools, such as the Western Ontario McMasters Osteoarthritis Index (WOMAC). By week 8, participants receiving acupuncture were showing a significant increase in function and by week 14 a significant decrease in pain, compared with the sham and control groups. 3 Overall, compared to baseline assessments those who received acupuncture had a 40 percent decrease in pain and a nearly 40 percent improvement in function. Dr. Stephen Straus Director of National Center for Complementary and Alternative Medicine (NCCAM) states that, “For the first time, a clinical trial with sufficient rigor, size, and durationhas shown that acupuncture reduces the pain and functional impairment of osteoarthritis of the knee. These results also indicate that acupuncture can serve as an effective addition to a standard regiment of care and improve quality of life for knee osteoarthritis sufferers.”
1. Elders M. The increasing impact of arthritis on public health. J Rheumatology Supp 2000 Oct;60:6 2. M.J. Shield, “Anti-Inflammatory Drugs and Their Effects on Cartilage Synthesis and Renal Function,” Eur J Rheumatol Inflam 13 (1993): 7-16 3. Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC, “Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial”, Ann Intern Med, 2004 Dec 21;141(12):901-10
