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.

  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 don't 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.)

About The Author: 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.arthriti s-treatment- and-relief. com/arthritis- treatment. html
Arthritis Treatment

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