Acupuncture Offers Osteoarthritis Treatment Without Side Effects – Study

Acupuncture's absence of side effects may prove beneficial to osteoarthritis sufferers following results from a recent study that demonstrated the alternative therapy is effective in treating the condition.

Improved physical function without side effects among study participants receiving acupuncture "contrasts to current pharmacologic therapies for osteoarthritis that have side effects that may rival in severity the arthritis symptoms themselves," Brian Berman, MD, University of Maryland School of Medicine, Baltimore, et al., conclude in the Dec. 21 Annals of Internal Medicine.

The randomized, controlled trial compared acupuncture to placebo in 570 patients during a 26-week period. Participants were allowed to continue receiving medical care and their usual medications during the study. Authors tracked medication usage across study groups to ensure that changes in medication were not the cause of outcome differences.

Participants were age 50 and older and suffered from osteoarthritis of the knee. Patients had no previous experience with acupuncture and had not undergone knee surgery within the past six months.

The finding that acupuncture improved pain and function scores among recipients is timely given recent warnings surrounding pain relievers often used to treat osteoarthritis.

Merck withdrew the COX-2 inhibitor Vioxx from the market in September after preliminary study results showed the drug's users were at an increased risk of heart attack when compared to placebo.

More recently, studies have suggested Pfizer's Celebrex and Bayer's Aleve may also increase risk of cardiovascular events.

The study divided patients into three 190-person groups, only one of which actually received the CAM therapy. The "true acupuncture" participants underwent 23 sessions of treatment over the 26-week period, which gradually tapered from two sessions per week to one session per month.

The "sham acupuncture" group received a treatment developed to mimic the feel of acupuncture without actual needle insertion. In both the "sham" and "true" groups, a screen was used to block vision of the legs and treatments were administered according to the same schedule.

The third group was an "education control" group of participants who received six two-hour sessions based on the Arthritis Self-Management Program and taught by a patient education specialist.

Assessments of the three groups were conducted at baseline, and at four, eight, 14 and 26 weeks after randomization.

Primary outcomes were measured as changes in pain scores and function scores according to the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included a patient global assessment, in which participants were asked how their knee osteoarthritis was affecting them.

Subjects receiving true acupuncture began experiencing statistically significant decrease in pain at the 14-week mark, when WOMAC pain scores decreased by 3.63 points, compared to 2.68 for sham acupuncture participants.

Function scores for the true acupuncture group showed a significantly greater improvement when compared to sham treatments at eight, 14 and 26 weeks, the authors state. The WOMAC function score for true acupuncture recipients improved by nearly 40% over baseline at week 14, they add.

At the end of the study, the patient global assessment showed that patients receiving true acupuncture showed "significantly greater" changes from baseline (15%) than their counterparts (6%).

Berman et al. conclude the results "demonstrate that true traditional Chinese acupuncture is safe and effective for reducing pain and improving physical function in patients with symptomatic knee osteoarthritis who have moderate or greater pain despite background therapy with analgesic or anti-inflammatory therapy."

Since improvements in condition were observed among those participants who continued their regular medications and treatments throughout the study, the authors also determine that "acupuncture may have an important role in adjunctive therapy as part of a multidisciplinary integrative approach" to treating symptoms of knee osteoarthritis.