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Category Archives: Arthritis & Joints
Under this heading, you will find an introduction to acupuncture for joint problems, including osteoarthritis, rheumatoid arthritis, general stiffness, and rheumatic aches and pains.
In 2013, medical research charity Arthritis Research UK, published a report looking at the evidence for the effectiveness and safety of twenty-five complementary therapies commonly used by people with 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 are thought to 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 in research to be very effective in helping sufferers manage the condition. It can help with pain relief without the side-effects associated with drugs, and it can help stiffness and improve range of movement.
Beginning with osteoarthritis, you might already have had a diagnosis from your GP, or even an X-ray of the affected joint. In general, I find osteoarthritis is quite responsive to acupuncture, and 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. My realistic objectives are to reduce the 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 in my practice, but other joints crop up aswell.
Moving to rheumatoid arthritis, patients I see are usually under the regular care of either their rheumatologist or GP, and 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, aswell as attending more locally to the most painful joints.
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 possiblities 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, find out all about your lifestyle, and I will ask you about the influence of the weather on your joints; if it is a factor, I find 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 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.)
Acupuncture is more effective than physiotherapy for symptoms of osteoarthritis of the knee, and this may be due to its ability to promote repair of knee cartilage, Chinese researchers suggest. Fifty patients aged between 30 and 80, were randomly allocated to receive either acupuncture or physiotherapy. Acupuncture was given on alternate days for four weeks. Physiotherapy was given five times a week for four weeks.
Both groups showed significant reductions in osteoarthritis symptom scores, although the acupuncture group displayed significantly greater reductions in total symptom scores and specifically pain, stiffness and function. MRI scans of knee cartilage suggested that its hydration and biochemical composition had improved in the acupuncture group, but not in the physiotherapy group. The research team suggest that acupuncture may promote repair of knee cartilage.
(Influence of acupuncture in treatment of knee osteoarthritis and cartilage repairing. American Journal of Translational Research, September 2016.)