Acupuncture and arthritis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Does acupuncture work for arthritis? Conflicting studies have been published and that trend continues. Here are some examples from the literature.

A recent observational study of 736 osteoarthritis (OA) patients treated with acupuncture as part of routine clinical care by German doctors found statistically and clinically significant improvements in pain, disability, and quality of life both immediately after treatment and six months later. (Linde K, Weidenhammer W, Streng A, et al. Acupuncture for osteoarthritis pain: an observational study in routine care. Rheumatology 2006; 45:222-227).

Physicians were asked to screen the first six patients born in a specific month who presented with headache, chronic low back pain, or OA for inclusion in the observational study. Inclusion criteria included radiographically confirmed polyarthritis, primary hip OA, dysplastic hip OA, posttraumatic hip OA, other secondary hip OA, primary knee OA, posttraumatic knee OA, other secondary knee OA, thumb OA, and primary, posttraumatic, or other secondary OA of other joints. Inclusion criteria also included pain in the relevant joint for at least six months. Exclusion criteria included inflammatory polyarthritis and infectious arthropathy.

Patients completed modified versions of the Pain Questionnaire of the German Society for the Study of Pain (DGSS) before the first acupuncture session, after the last session, and six months after the first session. This included the Pain Disability Index (PDI), a scale for assessing sensory and affective aspects of pain, a depression scale, and the Short Form 36 (SF-36) to assess health-related quality of life. It also included rating scales for pain intensity and frequency. Patients with hip or knee OA also filled in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

The main outcome measures were average pain during the last four weeks on a numerical rating scale, the PDI, the physical-component scale from the SF-36, and the WOMAC sum score.

Of the 1443 identified OA patients, 1167 met the inclusion criteria, but only 736 patients (treated by 602 different physicians) had completed questionnaires at all three time points and were included in the analysis.

Patients received a mean of 8.7 acupuncture treatments, with a median treatment cycle duration of 43 days.

The authors concluded, "After treatment and six months after inclusion, patients reported less pain, medication use, and disability; better physical health and mental health; better scores for sensory and affective aspects of pain; and lower depression scores. All changes were statistically highly significant (p<0.001) in all subgroups except for mental health in patients with hip osteoarthritis."

This study mirrors the results found in two previous studies of acupuncture in arthritis.

• Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee. A randomized controlled trial. Ann Intern Med 2004; 141:901-910.

• Ezzo J, Hadhazy V, Birch S, et al. Acupuncture for osteoarthritis of the knee. A systematic review. Arthritis Rheum 2001; 44:819-825.

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