First of all, acupuncture and Chinese herbology (TCM) are
effective and present a much more favorable risk to benefit
relationship than than surgery, steroids or NSAIDs to treat arthritis.
Even for patients who eventually need a joint replacement, acupuncture
and Chinese medicine before and after the surgery can aid in pain
relief, speed of rehabilitation, and to correct complications of
surgery. Acupuncture therapy and TCM prepared herbs formula are individualized to
each patient's presentation whether the diagnosis is osteoarthritis,
rheumatoid arthritis or other forms. |
Acupuncture Relieves Pain and Improves Function in Knee Osteoarthritis .
NIH News Advisory:
National Institutes of Health
National Center for Complementary and Alternative Medicine (NCCAM)
Acupuncture
provides pain relief and improves function for people with
osteoarthritis of the knee and serves as an effective
complement to standard care. This landmark study was funded by the
National Center for Complementary and Alternative Medicine (NCCAM) and
the National Institute of Arthritis and Musculoskeletal and Skin
Diseases (NIAMS), both components of the National Institutes of Health.
The findings of the study--the longest and largest randomized,
controlled phase III clinical trial of acupuncture ever conducted--were
published in the December 21, 2004, issue of the Annals of Internal
Medicine.(1)
The
multi-site study team, including rheumatologists and licensed
acupuncturists, enrolled 570 patients, aged 50 or older with
osteoarthritis of the knee. Participants had significant pain in their
knee the month before joining the study, but had never experienced
acupuncture, had not had knee surgery in the previous 6 months, and had
not used steroid or similar injections. Participants were randomly
assigned to receive one of three treatments: acupuncture, sham
acupuncture, or participation in a control group that followed the
Arthritis Foundation's self-help course for managing their condition.
Patients continued to receive standard medical care from their primary
physicians, including anti-inflammatory medications, such as COX-2
selective inhibitors, non-steroidal anti-inflammatory drugs, and opioid
pain relievers.
"For the first time, a clinical trial with sufficient rigor, size, and
duration has shown that acupuncture reduces the pain and
functional impairment of osteoarthritis of the knee," said Stephen E.
Straus, M.D., NCCAM Director. "These results also indicate that
acupuncture can serve as an effective addition to a standard regimen of
care and improve quality of life for knee osteoarthritis sufferers.
NCCAM has been building a portfolio of basic and clinical research that
is now revealing the power and promise of applying stringent research
methods to ancient practices like acupuncture."
"More than 20 million Americans have osteoarthritis. This disease is
one of the most frequent causes of physical disability among adults,"
said Stephen I. Katz, M.D., Ph.D., NIAMS Director. "Thus, seeking an
effective means of decreasing osteoarthritis pain and increasing
function is of critical importance."
During the course of the study, led by Brian M. Berman, M.D., Director
of the Center for Integrative Medicine and Professor of
Family Medicine at the University of Maryland School of Medicine,
Baltimore, Maryland, 190 patients received true acupuncture
and 191 patients received sham acupuncture for 24 treatment sessions
over 26 weeks. Sham acupuncture is a procedure designed
to prevent patients from being able to detect if needles are actually
inserted at treatment points. In both the sham and true
acupuncture procedures, a screen prevented patients from seeing the
knee treatment area and learning which treatment they received.
In the education control group, 189 participants attended six, 2-hour
group sessions over 12 weeks based on the Arthritis Foundation's
Arthritis Self-Help Course, a proven, effective model.
On joining the study, patients' pain and knee function were assessed
using standard arthritis research survey instruments and
measurement tools, such as the Western Ontario McMasters Osteoarthritis
Index (WOMAC). Patients' progress was assessed at 4, 8, 14,
and 26 weeks. By week 8, participants receiving acupuncture were
showing a significant increase in function and by week 14 a significant
decrease in pain, compared with the sham and control groups. These
results, shown by declining scores on the WOMAC index, held through
week 26. Overall, those who received acupuncture had a 40 percent
decrease in pain and a nearly 40 percent improvement in function
compared to baseline assessments.
"This trial, which builds upon our previous NCCAM-funded research,
establishes that acupuncture is an effective complement to conventional
arthritis treatment and can be successfully employed as part of a
multidisciplinary approach to treating the symptoms of osteoarthritis,"
said Dr. Berman.
Acupuncture--the practice of inserting thin needles into specific body
points to improve health and well-being--originated in
China more than 2,000 years ago. In 2002, acupuncture was used by an
estimated 2.1 million U.S. adults, according to the Centers
for Disease Control and Prevention's 2002 National Health Interview
Survey.(2) The acupuncture technique that has been most studied
scientifically involves penetrating the skin with thin, solid, metallic
needles that are manipulated by the hands or by electrical stimulation.
In recent years, scientific inquiry has begun to shed more light on
acupuncture's possible mechanisms and potential benefits, especially in
treating painful conditions such as arthritis.
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(1). Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AMK, Hochberg MC. Effectiveness of Acupuncture as Adjunctive Therapy
in Osteoarthritis of the Knee: A Randomized, Controlled Trial. Annals of Internal Medicine. 2004; 141(12):901-910.
(2). Barnes P, Powell-Griner E, McFann K, Nahin R. CDC Advance Data Report #343. Complementary and Alternative Medicine
Use Among Adults: United States, 2002. May 27, 2004.
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