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.)
Researchers in Spain have completed a randomised, controlled trial showing that acupuncture treatment produces significant reductions in the pain of shoulder impingement syndrome. A total of 68 patients (mean age 33) were randomised to receive either true acupuncture, or sham acupuncture at non-acupoints. Treatment was given once a week for four weeks.
Immediately after treatment, pain intensity in the true acupuncture group decreased by 44mm on the visual analogue scale, compared with only 20mm in the sham acupuncture group. At three month follow-up, pain reduction in the true acupuncture group was 88mm, compared with 20mm in the sham group, showing a lasting benefit. Shoulder function scores also showed clinically meaningful changes associated with true acupuncture. No adverse effect were recorded.
The authors conclude that the use of acupuncture to treat impingement syndrome seems to be a safe and reliable technique to achieve clinically significant results and could be implemented in the therapy options offered by health services.
(Acupuncture treatment of shoulder impingement syndrome: A randomized controlled trial. Complementary Therapies in Medicine, April 2016.)
Researchers have found that acupuncture in addition to usual rehabilitation training after arthroscopic meniscus repair, can significantly improve knee function compared to usual care alone.
Sixty patients, aged 35 to 70, who had undergone cartilage repair were randomly allocated to receive either standard rehabilitation training alone or standard training plus acupuncture. Acupuncture was given once daily for two months, whilst rehabilitation exercises took 30 minutes per day over the same period. Knee function parameters were measured in the two groups before treatment and at the one and two month points. Compared with usual care alone, the acupuncture group showed significantly improved joint function, correction of abnormal gait, increased motor function of the lower leg and improved balance during walking.
(Effect of acupuncture combined with rehabilitation training on walking function after arthroscopic meniscus repair. Journal of Acupuncture & Tuina Science, April 2015.)
Clinicians at a specialist joint replacement centre in Minnesota, USA report that acupuncture seems to be a useful adjunct to drugs to control pain following total hip or knee replacement. Data from a sample of 2500 patients who were offered postsurgical acupuncture alongside the usual opioid drugs, showed an average 45% reduction in short-term pain. In fact 41% of the patients had been in moderate to severe pain prior to acupuncture, and this fell to only 15% after acupuncture.
(Acupuncture provides short-term pain relief for patients in a total joint replacement program. Pain Medicine, June 2015.