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Acupuncture to Treat Knee Osteoarthritis

According to a recent study, acupuncture provides pain relief and improves function for people with osteoarthritis of the knee and serves as an effective complement to standard care.

The multi-site study team, including rheumatologists and license acupuncturists, enrolled 570 patients, aged 50 or older with osteoarthritis of the knee. Participants had significant pain in their knees that month before joining the study, but had never experienced acupuncture, had not had surgery in the previous six months and had not used steroid or similar injections. The participants in this study 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 care from their primary physicians. It is important to note that patients continued to receive standard medical care from their primary physicians, including anti-inflammatory medications.

The findings of the study – the longest and largest randomized, controlled phase III clinical trial of acupuncture ever conducted – were published in the Dec. 21, 2004 issue of the Annals of Internal Medicine.

“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, MD, MCCAM 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.

During the course of the study, led by Brian M. Berman, MD, 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. Meanwhile, in the education control group, 189 participants attended six, two-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. Throughout the study, patients’ progress was assessed at four, eight, 14, and 26 weeks. By week eight, 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 held through week 26. Overall, those who received acupuncture had a 40% decrease in pain and a nearly 40% 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,” Berman said.