Tag Archives: Arthritis

Arthritis – Condition Resources

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.

Acupuncture has been shown to have the ability to help various types of pain, including chronic pain, and to modulate inflammatory responses as well as to reduce the activity in the areas of the brain associated with pain and stress.

Osteoarthritis: Since 2005, there have been over than 50 NHS publications recommending acupuncture for osteoarthritis (largely knee or hip) and many more worldwide (Birch et al 2018).

A large (n=20827) meta-analysis of 39 studies showed acupuncture to be significantly superior to usual care and to sham (non-specific acupuncture point usage), for patients with osteoarthritis and other painful conditions (all p <.001; Vickers et al, 2018).  Additionally, clear evidence was found in this meta-study that that the effects of acupuncture persisted over time.

For patients with osteoarthritis pain, acupuncture improved pain relief compared to sham at short-term and at six-month follow up. When compared to wait list controls, acupuncture showed a clinically significant improvement in short term pain relief.  A randomised controlled trail in patients with osteoarthritis of the knee or hip, showed a significant difference at three months between acupuncture and routine care (Reinhold et al, 2008; Manheimer et al, 2010).

Knee Pain: A systematic review and meta-analysis of 17 trials, showed significant benefits whereby in patients in study groups having received acupuncture, this was associated with significantly reduced chronic knee pain 12 weeks (Zhang et al, 2017).  Specifically comparing treatments including acupuncture in osteoarthritic knee pain, Corbett et al’s (2013, n=9709) systematic review and network meta-analysis found that acupuncture could be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term: Acupuncture was ranked second out of 21 physical treatments in this study.  The team also clarified that further research is also warranted in this area, due to the quality of the research available in some treatment areas across the studies.

Acupuncture can be cost effective, according to an RCT (n=60); acupuncture was offered to patients with knee osteoarthritis who were going to be referred for orthopaedic surgery by their GP, with acupuncture a third were able to avoid surgery which also represented a cost-saving of £100,000 per year [to the NHS]” (White et al, 2016).

Hip osteoarthritis: There is less research in this area, although it is growing, a systematic review (Manheimer et al, 2018; n=413, for 6 trials) found Acupuncture beneficial as an add-on to usual GP care, with a small but significant benefit for physical quality of life.

Many mechanisms of action have been investigated in animal models as well as in humans to measure brain activity associated with pain and the levels of biomarkers associated with inflammation.

You may also find this useful: Rheumatoid Arthritis page

References:

Birch, S., Lee, M.S., Alraek, T. and Kim, T.H., 2018. Overview of treatment guidelines and clinical practical guidelines that recommend the use of acupuncture: a bibliometric analysis. The Journal of Alternative and Complementary Medicine, 24(8), pp.752-769.

Corbett, M.S., Rice, S.J.C., Madurasinghe, V., Slack, R., Fayter, D.A., Harden, M., Sutton, A.J., Macpherson, H. and Woolacott, N.F., 2013. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis and cartilage, 21(9), pp.1290-1298.

Manheimer E, Cheng K, Linde K, Lao L, Yoo J, Wieland S, et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database of Systematic Reviews 2010, Issue 1.

Manheimer, E., Cheng, K., Wieland, L.S., Shen, X., Lao, L., Guo, M. and Berman, B.M., 2018. Acupuncture for hip osteoarthritis. Cochrane Database of Systematic Reviews, (5).

Reinhold T, Witt CM, Jena S, Brinkhaus B, Willich SN. Quality of life and cost-effectiveness of acupuncture treatment in patients with osteoarthritis pain. Eur J Health Econ 2008;9(3):209-19.

Vickers, A.J., Vertosick, E.A., Lewith, G., MacPherson, H., Foster, N.E., Sherman, K.J., Irnich, D., Witt, C.M., Linde, K. and Acupuncture Trialists’ Collaboration, 2018. Acupuncture for chronic pain: update of an individual patient data meta-analysis. The Journal of Pain, 19(5), pp.455-474.

White, A., Tough, L., Eyre, V., Vickery, J., Asprey, A., Quinn, C., Warren, F., Pritchard, C., Foster, N.E., Taylor, R.S. and Underwood, M., 2016. Western medical acupuncture in a group setting for knee osteoarthritis: results of a pilot randomised controlled trial. Pilot and feasibility studies2(1), pp.1-8.

Zhang, Q., Yue, J., Golianu, B., Sun, Z. and Lu, Y., 2017. Updated systematic review and meta-analysis of acupuncture for chronic knee pain. Acupuncture in Medicine, 35(6), pp.392-403.

Helen
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