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Category Archives: Arthritis & Joints
This is an introduction to acupuncture for joint problems, including osteoarthritis, rheumatoid arthritis, general stiffness, and rheumatic aches and pains.
In 2013, Arthritis Research UK reported on the evidence for the effectiveness of twenty-five complementary therapies for musculoskeletal pain. Acupuncture was the most effective therapy for treating osteoarthritis.
Arthritis and related conditions, are the most common long-term complaint in the UK. They affect more than nine million adults. In the 35 to 44 age group, 18% of people have experienced arthritis or joint pain. This rises to 49% in the 55 to 64 age group. Acupuncture has been found to be very effective in helping sufferers manage the condition. It can help with pain relief without the side-effects associated with drugs. It can also help stiffness and improve range of movement.
Beginning with osteoarthritis, you might already have had a diagnosis from your GP, or an X-ray of the affected joint. I find osteoarthritis is usually responsive to acupuncture. Because it is a degenerative condition, the sooner you start treatment, the better the results tend to be. Acupuncture is unable to reverse significant joint damage which has already occurred.
Realistic objectives are to reduce pain, reduce your intake of painkillers and anti-inflammatories, and to slow further deterioration of the joint. Knees, hips and fingers present for treatment most commonly.
Moving to rheumatoid arthritis, patients I see are usually under the regular care of either their rheumatologist or GP. Acupuncture can work effectively alongside any medication which has been prescribed. Because a systemic disease process is at work here, there is a greater need to treat the underlying imbalances which Chinese medicine is capable of identifying, as well as attending to the most painful joints.
Other Joint Problems
Finally, we have general stiffness problems and those rheumatic aches and pains which might have defied clear diagnosis. Sometimes, the symptoms are focal at the site of an old injury. Other times, they are more widespread, and so we bear in mind possibilities such as the pains being menopausal, induced as side-effects of medication, or arising from other diseases. I need to fully examine the surrounding area and find out about your lifestyle. I will ask you about the influence of the weather on your joints. If it is a factor, patients are most likely to report damp, cold or sudden weather changes affect them.
Diet and lifestyle can be crucial when helping joint problems, and I will often give you some self-help measures to implement. These will usually be simple but effective.
Below you can read the results of some of the research which has been undertaken into acupuncture for joint problems.
A team researchers at the University of Coimbra, Portugal, studying acupuncture for rheumatoid arthritis of the hand, has concluded it is effective at reducing pain and disability. They randomly assigned 105 patients, mean age 57, to either true acupuncture, sham acupuncture or a waiting list control. True acupuncture was associated with significantly improved pain, pressure pain threshold, hand grip and arm strength. The number of swollen and/or tender joints also significantly decreased. Health status and quality of life significantly improved with acupuncture.
Sham acupuncture was associated with no significant changes, other than pain improvement. Those on the waiting list showed an overall worsening. The researchers state that the rigorous design of this randomised controlled trial avoids major problems of other studies such as nonspecific effects, weak allocation of acupoints, or lack of objective assessment of effects. They go on to point out the nonpharmacologic and nontoxic nature of acupuncture, which constituted an effective and well-tolerated treatment.
(Effectiveness of Acupuncture on Pain, Functional Disability, and Quality of Life in Rheumatoid Arthritis of the Hand: Results of a Double-Blind Randomized Clinical Trial. Journal of Alternative & Complementary Medicine, January 2019.)
A systematic review by authors at Stanford University’s Department of Medicine and the University of Bologna, has concluded that acupuncture and electrotherapy can reduce opioid consumption after total knee replacement (arthroplasty). A total of 39 randomised trials involving almost 2400 patients, were examined. The trials studied a variety of drug-free interventions including passive motion, preoperative exercise, cryotherapy, electrotherapy and acupuncture. Moderate-certainty evidence showed that acupuncture reduced and delayed opioid use, as did electrotherapy. There was also low-certainty evidence that acupuncture improved pain, based on patients’ visual analogue scores. None of the other therapies showed any significant effect on pain or opioid use.
(Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review & Meta-analysis. Journal of the American Medical Association Surgery, 18 October 2017.)
Authors in China have undertaken a systematic review of trials of electro-acupuncture for knee osteoarthritis. They examined 11 randomised controlled trials involving a total of nearly 700 participants. Meta-analysis suggested electro-acupuncture was more effective than medication, and standard acupuncture alone. It reduced pain intensity and improved physical function without any serious adverse events reported. The results implied electro-acupuncture should be given for at least four weeks, for 20-30 minutes per session.
UK researchers assessing economic data on twelve non-pharmacological interventions for osteoarthritis of the knee, have found acupuncture and TENS (transcutaneous electrical nerve stimulation) to be cost-effective. The authors looked at 88 randomised controlled trials covering 7500 patients. They based cost-effectiveness estimations on a threshold of £20-30 000 per quality-adjusted life year; this is the same threshold used by NICE when establishing whether a treatment is a cost-effective use of NHS resources.
The authors noted that while acupuncture is not yet recommended by NICE as a treatment for knee osteoarthritis, their calculations suggest some interventions which are recommended (insoles, braces and manual therapy) are unlikely to be cost-effective.
(Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee. PLoS One, 7 March 2017.)