I Want To Try Acupuncture For The Osteoarthritis In My Knee... Does It Work?

The role of many complementary and alternative therapies for arthritis have come under careful scrutiny recently. Some therapies seem to work while others are a short step from snake oil. The difficult problem is separating the truly effective therapies from the ones that really dont work.

In arthritis this is more of a problem than many other conditions because the placebo response in clinical trials involving drugs used to treat arthritis can be as high as 40 per cent! What that means is that the mind plays a huge role in determining whether a given therapy will work... or not.

Osteoarthritis (OA) is the leading cause of disability among older adults. The joint most affected is the knee. The prevalence, disability, and costs related to knee OA are expected to skyrocket in the next 25 years because of the aging of the population.

Non-steroidal anti-inflammatory drugs have been the mainstay of therapy for OA of the knee. However, NSAIDS are only a bit better than placebo in the short term relief of OA pain. Also, NSAIDS are associated with many side effects including gastrointestinal bleeding, hypertension, and cardiovascular complications. Acetaminophen is sometimes used for mild OA pain; however, it also has potential problems including liver toxicity and the potential for kidney damage.

Non-drug therapies that have been proven to be effective include exercise and weight loss. Unfortunately, both of these often are difficult to do for patients with OA.

Acupuncture has been studied in a number of open and randomized clinical trials. Current evidence suggests that acupuncture may be an effective treatment for older patients with OA of the knee.

However, it has been difficult to fully assess the effectiveness because of the possibility of a strong placebo effect. Patient expectations and preferences may color the potential measurement of effectiveness of acupuncture as a treatment modality.

Acupuncture does seem to have a real biologic effect.

One problem with assessing the effectiveness of acupuncture has to do with clinical trial design as well as technique, settings, protocol design, and proficiency of the acupuncturists.

Acupuncture appears to be safe. This is born out by the short term improvement in pain and function compared with placebo.

The consensus is that it should be considered as part of a multidisciplinary approach to the management of OA of the knee. (Manheimer E, et al. Annals Int Med. 2007; 146: 868-877.)

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About the Author :Nathan Wei Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info: http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html Arthritis Treatment