Osteoarthritis (OA) has a major impact on patients' mobility and quality of life but the anti-inflammatory drugs used to treat it are associated with a number of side effects. In recent years, patients have turned increasingly to acupuncture to relieve the chronic pain associated with OA.Degenerative knee osteoarthritis (OA) can be treated with physical therapy, medications, or surgery .
Joint osteoarthritis is no longer considered just a "wear-and-tear" type of arthritis. Obesity and the excess weight and load associated with obesity are major factors. But now we know there are inflammatory effects of adipose (fat) tissue that also contribute to joint destruction. Weight loss and exercise aren't always easy solutions but they are the most successful in addressing all of the local and systemic effects of obesity.
What we do know from studies so far is that acupuncture reduces pain and improves knee function . we have another piece of information about results using acupuncture based on the severity of OA.
It seems to yield the best results when the disease has just started and the joint surface is not damaged or worn unevenly. Treatment of this kind is also more likely to be successful when the patient is not overweight. Patients who exercised and strengthened the legs also had better results.
Patients with chronic pain due to OA of the knee or the hip who were treated with acupuncture in addition to routine care showed significant improvements in symptoms and quality of life compared with patients who received routine care alone
But letís go back to the notion that environment is not a factor in OA among Europeans and their descendants. What about the role of obesity, joint injury, sports activity, and overuse of the joints through work and play? We have always thought osteoarthritis is a degenerative disease from joint wear and tear. But the complete absence of this disease in Africa and Asia where heavy physical activity is so common makes that belief obsolete.
We recommend the use of acupuncture for osteoarthritis. Patients should be informed that the results may be temporary but could buy them some time before needing a knee replacement.and acupuncturist's experience is the most important factor in treatment outcome. Given that the biologic mechanism of acupuncture is still unclear.
OBJECTIVE: To compare the effectiveness of acupuncture with other relevant physical treatments for alleviating pain due to knee osteoarthritis.
DESIGN: Systematic review with network meta-analysis, to allow comparison of treatments within a coherent framework. Comprehensive searches were undertaken up to January 2013 to identify randomised controlled trials in patients with osteoarthritis of the knee, which reported pain.
RESULTS: Of 156 eligible studies, 114 trials (covering 22 treatments and 9,709 patients) provided data suitable for analysis. Most trials studied short-term effects and many were classed as being of poor quality with high risk of bias, commonly associated with lack of blinding (which was sometimes impossible to achieve). End of treatment results showed that eight interventions: interferential therapy, acupuncture, TENS, pulsed electrical stimulation, balneotherapy, aerobic exercise, sham acupuncture, and muscle-strengthening exercise produced a statistically significant reduction in pain when compared with standard care. In a sensitivity analysis of satisfactory and good quality studies, most studies were of acupuncture (11 trials) or muscle-strengthening exercise (9 trials); both interventions were statistically significantly better than standard care, with acupuncture being statistically significantly better than muscle-strengthening exercise (standardised mean difference: 0.49, 95% credible interval 0.00-0.98).
CONCLUSIONS: As a summary of the current available research, the network meta-analysis results indicate that acupuncture can be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term. However, much of the evidence in this area of research is of poor quality, meaning there is uncertainty about the efficacy of many physical treatments.
PMID: 23973143 [PubMed - in process]