Osteoarthritis: Easing the Pain: Can the Ancient Healing Art of Acupuncture Help Relieve the Persistent Pain of Osteoarthritis?
Perry, Patrick, The Saturday Evening Post
Recently, a landmark study demonstrated that acupuncture not only provides pain relief, but also improves function for people suffering with osteoarthritis of the knee, the most common form of the disease.
The largest-ever clinical trial of acupuncture for knee osteoarthritis was funded by the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health. The trial results, published in the Annals of Internal Medicine, support the healing art as a beneficial component in the standard of care for people suffering from the painful condition. The multisite study team, including rheumatologists and licensed acupuncturists, enrolled 570 patients aged 50 or older with osteoarthritis of the knee. Participants experienced significant knee pain before joining the study but had never experienced acupuncture. The results were clear.
"For the first time, a clinical trial with sufficient rigor, size, and duration has shown that acupuncture reduces the pain and functional impairment of osteoarthritis of the knee," said Stephen E. Straus, M.D., NCCAM director. "These results also indicate that acupuncture can serve as an effective addition to a standard regimen of care and improve quality of life for knee osteoarthritis sufferers. NCCAM has been building a portfolio of basic and clinical research that is now revealing the power and promise of applying stringent research methods to ancient practices like acupuncture."
The Post spoke with Brian M. Berman, M.D., director of the Center for Integrative Medicine and professor at the University of Maryland School of Medicine, as well as principal investigator of the national acupuncture study.
Post: Could you share findings from your recent four-year study on acupuncture?
Dr. Berman: We studied osteoarthritis, the most common form of arthritis that affects about 21 million people a year in the United States alone. Our study focused on the most common form of the disease, osteoarthritis of the knee. Using conventional medical approaches, we know we don't have all the answers for this chronic health disorder and often don't give adequate pain relief for our patients. Because there is no cure to date for osteoarthritis, treatment focuses on improving pain and physical function. We use nonpharmacologic approaches, such as weight loss, education, exercise, and physical therapy, and also offer different medications, if the nonpharmacologics aren't effective. These don't always work and pose potential side effects, especially for the elderly.
We have recently learned about the side effects of COX-2 inhibitors and other NSAIDs, so people are looking for safe, effective, alternative treatments, not forgoing conventional medical care but rather adding complementary therapies, including acupuncture.
Acupuncture has been around for more than 2,000 years. In the United States, there are about 5 million visits per year for acupuncture treatments, very often for pain-related problems such as osteoarthritis.
Reviewing the scientific literature, we noted that the results of trials of acupuncture for osteoarthritis were mixed. Some small studies demonstrated a beneficial effect in reducing pain, while others didn't.
Twelve years ago, we launched a small pilot study of 12 patients and followed this up with a study of 73 patients, both showing acupuncture to be safe and effective as an adjunctive therapy for osteoarthritis of the knee. Finally, we conducted the present study of 570 patients with osteoarthritis who had failed on their standard care and still experienced moderate to severe pain of the knee.
Participants in the trial were randomized into one of three groups--one group received true acupuncture, a second group received a sham acupuncture procedure, and a third group received an education program that the Arthritis Foundation promotes as a part of standard care. The group receiving true and sham acupuncture received 23 acupuncture treatments over a 26-week period, while remaining on background medical therapy. …