Acupuncture for Rheumatoid Arthritis

Acupuncture in Exeter: acupuncture for rheumatoid arthritis. 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.)

Acupuncture after Knee Surgery Reduces use of Opioids

Research from Stanford University: acupuncture after knee surgery reduces the use of opioids.
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.)

Electro-acupuncture Effective for Knee Osteoarthritis

Research from China: electro-acupuncture for knee osteoarthritis. 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.

(Electro-Acupuncture is Beneficial for Knee Osteoarthritis: The Evidence from Meta-Analysis of Randomized Controlled Trials. American Journal of Chinese Medicine, 2017.)

Acupuncture and TENS Cost-Effective for Knee Osteoarthritis

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 may Promote Repair of Knee Cartilage

Acupuncture for arthritis: treatment of osteoarthritis of the knees
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.)