New Support for Acupuncture in Knee Arthritis

Acupuncture Complements Drug Therapy for Knee Osteoarthritis Pain

From the WebMD Archives

Nov. 18, 2004 -- Adding acupuncture to standard treatment for knee arthritis helps patients feel less pain, a new study shows.

The findings come from a research team led by Jorge Vas, MD, chief medical officer at the pain treatment unit of Dos Hermanas Health Center in Dos Hermanas, Spain.

Vas and colleagues treated 88 knee osteoarthritis patients with diclofenac - a standard anti-inflammatory painkiller. Half the patients got 12 weekly acupuncture treatments, too. The other half got sham acupuncture using authentic-looking retractable needles that did not penetrate their skin.

The results: Those who got real acupuncture took less of their pain medication than those who got fake acupuncture. Yet they had less pain, less stiffness, and better physical function.

Vas isn't surprised. Over the last seven years, he's treated more than 100,000 pain patients with acupuncture.

"Acupuncture doesn't work for everyone," Vas tells WebMD. "But for patients seen earlier in the course of knee arthritis, 75% to 85% have less pain and more mobility."

Vas and colleagues report their findings in the Nov. 20 issue of the British Medical Journal. Their study appears on the heels of an October 2004 presentation to the American College of Rheumatology by Marc Hochberg, MD, PhD, of the University of Maryland. In a study of 570 knee arthritis patients, Hochberg's team reported similar findings to those of Vas and colleagues. Acupuncture reduced pain and stiffness and improved physical function.

Doctors, Patients Slow to Accept Acupuncture

Acupuncture is a Chinese medical practice based on improving the flow of energy through the body. It's not like Western medical treatments, which try to heal what ails you. Instead, Chinese medicine tries to get the body to heal itself, says Ka-Kit Hui, MD, professor of medicine and director of the UCLA Center for East-West Medicine.

"The body has an innate, intrinsic healing response," Hui tells WebMD. "It is only when the body cannot repair itself that a problem becomes chronic. With chronic arthritis pain, the body cannot reset the pain/no-pain balance. In contrast with Western medicine, acupuncture and massage and even some physical therapies work through stimulating the body to heal."

Erin Arnold, MD, a rheumatologist at the Illinois Bone and Joint Institute in Morton Grove, treats many of her arthritis patients with acupuncture in combination with medical treatments.

"Among doctors who deal with chronic pain, there is an appreciation of complementary therapies such as acupuncture," Arnold tells WebMD. "It is reasonable to think that in situations where there is chronic pain - where the pain can come from many places and not just the joint -- that no one single therapy provides relief."

Arnold says doctors are becoming more open to referring arthritis patients for acupuncture. But she says many doctors still do not accept it.

"I just gave a talk at medical grand rounds, and most of the doctors were enthusiastic. But quite a few were very pessimistic," she says. "When I talk to students about the theory behind this, at the end of my talk, I say people need to make a leap of faith and be open to the experience of their patients. So I think people will slowly come around."

Hayes Wilson, MD, chief of rheumatology at Piedmont Hospital in Atlanta, says doctors are willing to accept any treatment that helps their patients.

"I think we rheumatologists are pretty open minded," Wilson tells WebMD. "Speaking for myself, I am a pragmatist. I am for anything that works for my patients. There is a group of patients acupuncture works for, a minority of patients, and that is absolutely fine with me."

Wilson says that one of his partners treats arthritis patients with acupuncture and tells him that it works well - with one drawback.

"It is not a cure," Wilson says. "You have to keep coming back. In my experience, patients do it for a while and sort of lose interest."

Show Sources

SOURCES: Vas, J. British Medical Journal, Nov. 20, 2004; vol 329: pp 1216-1219. Jorge Vas, MD, chief medical officer, pain treatment unit, Dos Hermanas Health Center, Dos Hermanas, Spain. Ka-Kit Hui, MD, professor of medicine and director, Center for East-West Medicine, University of California, Los Angeles. Erin Arnold, MD, rheumatologist, Illinois Bone and Joint Institute, Morton Grove. Hayes Wilson, MD, chief of rheumatology, Piedmont Hospital, Atlanta.
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