Category: Arthritis & Joints

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.

A meta-analysis undertaken by researchers at the University of Manitoba in Canada, shows that the use of acupuncture to manage osteoarthritis is associated with a significant reduction in symptoms. The authors looked at twelve trials involving a total of 1763 participants, published over a 24 year span, and which compared acupuncture with sham acupuncture, no treatment or usual care. Nine trials were conducted in physiotherapy outpatient departments and three were conducted in GP practices.

Acupuncture was found to be associated with significant improvements in pain intensity, functional mobility and health-related quality of life. Greater pain reduction was associated with acupuncture lasting more than four weeks. The authors conclude that current evidence supports the use of acupuncture as an alternative to the usual analgesics.

(Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complementary & Alternative Medicine, 23 August 2014.)

An analysis commissioned by the UK’s National Institute for Health Research, of a number of good quality, randomised, controlled trials, shows acupuncture should be considered one of the most effective treatments for short-term alleviation of knee pain from osteoarthritis.

The researchers conducted a network meta-analysis, allowing comparison between multiple interventions which have been used to treat the same condition. Data was gathered from 114 studies, in which over 9700 patients were treated with 22 different modalities. Eight modalities, including acupuncture, were found to have provided statistically significant pain reductions compared with standard care. When only higher quality trials were considered, only acupuncture and muscle-strengthening exercises demonstrated any benefit; both these approaches were significantly better than standard care alone, with acupuncture being better than muscle-strengthening, standard care, weight loss and aerobic exercise.

Acupuncture also outperformed most of the physical therapies recommended by the National Institute for Health and Care Excellence (NICE) in its guidelines on the treatment of osteoarthritis of the knee. In fact, although this study did not assess cost-effectiveness or disability, little evidence was found to support the current NICE guidelines. Acupuncture had an effectiveness comparable with that of drug treatments, and the report’s authors recommend it is considered to be an evidence-based treatment with a credible role in the management of pain due to knee osteoarthritis.

(Acupuncture and Other Physical Treatments for the Relief of Pain due to Osteoarthritis of the Knee: Network Meta-Analysis. Osteoarthritis Cartilage, September 2013.)

You can view this comprehensive, 206 page report at http://www.york.ac.uk/inst/crd/CRD_Reports/crdreport40.pdf.