Acupuncture treated arthritis abstract articles
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.
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From the National Institutes of Health...
According to the NIH Consensus Statement on Acupuncture, there have been many studies on acupuncture's potential usefulness, but results have been mixed because of complexities with study design and size, as well as difficulties with choosing and using placebos or sham acupuncture.
However, promising results have emerged, showing efficacy of acupuncture, for example, in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations--such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low-back pain, carpal tunnel syndrome, and asthma--in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. An NCCAM-funded study recently showed that acupuncture provides pain relief, improves function for people with osteoarthritis of the knee, and serves as an effective complement to standard care.7 Further research is likely to uncover additional areas where acupuncture interventions will be useful.
NIH has funded a variety of research projects on acupuncture. These grants have been funded by NCCAM, its predecessor the Office of Alternative Medicine, and other NIH institutes and centers.
To determine the effectiveness of acupuncture, two recent clinical trials were conducted and published in the Annals of Internal Medicine.
Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee
A Randomized, Controlled Trial
Brian M. Berman, MD; Lixing Lao, PhD; Patricia Langenberg, PhD; Wen Lin Lee, PhD; Adele M.K. Gilpin, PhD; and Marc C. Hochberg, MD
21 December 2004 | Volume 141 Issue 12 | Pages 901-910
Background: Evidence on the efficacy of acupuncture for reducing the pain and dysfunction of osteoarthritis is equivocal.
Objective: To determine whether acupuncture provides greater pain relief and improved function compared with sham acupuncture or education in patients with osteoarthritis of the knee.
Design: Randomized, controlled trial.
Setting: Two outpatient clinics (an integrative medicine facility and a rheumatology facility) located in academic teaching hospitals and 1 clinical trials facility.
Patients: 570 patients with osteoarthritis of the knee (mean age [±SD], 65.5 ± 8.4 years).
Intervention: 23 true acupuncture sessions over 26 weeks. Controls received 6 two-hour sessions over 12 weeks or 23 sham acupuncture sessions over 26 weeks.
Measurements: Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores at 8 and 26 weeks. Secondary outcomes were patient global assessment, 6-minute walk distance, and physical health scores of the 36-Item Short-Form Health Survey (SF-36).
Results: Participants in the true acupuncture group experienced greater improvement in WOMAC function scores than the sham acupuncture group at 8 weeks (mean difference, –2.9 [95% CI, –5.0 to –0.8]; P = 0.01) but not in WOMAC pain score (mean difference, –0.5 [CI, –1.2 to 0.2]; P = 0.18) or the patient global assessment (mean difference, 0.16 [CI, –0.02 to 0.34]; P > 0.2). At 26 weeks, the true acupuncture group experienced significantly greater improvement than the sham group in the WOMAC function score (mean difference, –2.5 [CI, –4.7 to –0.4]; P = 0.01), WOMAC pain score (mean difference, –0.87 [CI, –1.58 to –0.16];P = 0.003), and patient global assessment (mean difference, 0.26 [CI, 0.07 to 0.45]; P = 0.02).
Limitations: At 26 weeks, 43% of the participants in the education group and 25% in each of the true and sham acupuncture groups were not available for analysis.
Conclusions: Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.
Acupuncture versus Placebo for the Treatment of Chronic Mechanical Neck Pain
A Randomized, Controlled Trial
Peter White, PhD, BSc; George Lewith, DM, FRCP; Phil Prescott, PhD, DIC, ARCS, BSc; and Joy Conway, PhD
21 December 2004 | Volume 141 Issue 12 | Pages 911-919
Background: Despite substantial increases in its popularity and use, the efficacy of acupuncture for chronic mechanical neck pain remains unproved.
Objective: To compare acupuncture and placebo for neck pain.
Design: A randomized, single-blind, placebo-controlled, parallel-arm trial with 1-year follow-up.
Setting: The outpatient departments of 2 major hospitals in the United Kingdom, 1999 to 2001.
Patients: 135 patients 18 to 80 years of age who had chronic mechanical neck pain. Eleven patients withdrew from treatment, and 124 completed the primary end point.
Measurements: The primary outcome was pain 1 week after treatment, according to a visual analogue scale. Secondary outcomes were pain at other time points, score on the Neck Disability Index and the Short Form-36, and use of analgesic medications.
Interventions: Patients were randomly assigned to receive, over 4 weeks, 8 treatments with acupuncture or with mock transcutaneous electrical stimulation of acupuncture points using a decommissioned electroacupuncture stimulation unit.
Results: Both groups improved statistically from baseline, and acupuncture and placebo had similar credibility. For the primary outcome (weeks 1 to 5), a statistically significant difference in visual analogue scale score in favor of acupuncture (6.3 mm [95% CI, 1.4 to 11.3 mm]; P = 0.01) was observed between the 2 study groups, after adjustment for baseline pain and other covariates. However, this difference was not clinically significant because it demonstrated only a 12% (CI, 3% to 21%) difference between acupuncture and placebo. Secondary outcomes showed a similar pattern.
Limitations: All treatments were provided by 1 practitioner. Although the control was credible, it did not mimic the process of needling. A nonintervention group was not present to control for regression to the mean.
Conclusions: Acupuncture reduced neck pain and produced a statistically, but not clinically, significant effect compared with placebo. The beneficial effects of acupuncture for pain may be due to both nonspecific and specific effects.
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