The longest and largest clinical trial of acupuncture ever conducted shows that the traditional Chinese treatment provides significant pain relief and functional improvement for people with arthritis of the knee, and serves as an effective complement to Western-style medical care. The landmark findings were published in the December 21 edition of the US medical journal, Annals of Internal Medicine.
The study, conducted in the US, was funded by the National Center for Complementary and Alternative Medicine (NCCAM) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Both are components of the National Institutes of Health (NIH).
"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," NCCAM Director Stephen E. Straus, MD, said in a NIH news advisory issued on Monday in the US.
Acupuncture is the practice of inserting thin needles into specific body points to improve health and well-being, a traditional method originated in China more than 2,000 years ago.
In the study, led by Dr. Brian M. Berman of the University of Maryland School of Medicine, researchers enrolled 570 patients aged 50 or older with arthritis of the knee. All participants had significant pain in the month before joining the study, but had never experienced acupuncture, knee surgery, or steroid injections.
The participants were randomly assigned to receive one of three treatments: acupuncture, sham acupuncture or participation in a control group that followed the Arthritis Foundation's self-help course for managing their condition.
During the study, 190 patients received true acupuncture, 191 patients received sham acupuncture for 24 treatment sessions over 26 weeks, and 189 attended six, two-hour group self-help sessions over 12 weeks. Sham acupuncture is a procedure designed to prevent patients from being able to detect if needles are actually inserted at treatment points.
All patients' pain and knee function were assessed using standard arthritis research survey instruments and measurement tools.
Overall, those who received acupuncture showed a 40 percent decrease in pain and a nearly 40 percent improvement in function compared to baseline assessments.
"This trial, which builds upon our previous NCCAM-funded research, establishes that acupuncture is an effective complement to conventional arthritis treatment and can be successfully employed as part of a multidisciplinary approach to treating the symptoms of osteoarthritis," said Berman.
Berman noted that the results built upon those of studies that have been conducted during the past 11 years. "The effect is not huge," he added, "but none of the things we do with osteoarthritis patients have a huge effect."
When releasing the findings, researchers cautioned against extrapolating them to other common arthritis symptoms without further study. Other studies on pain relief have presented conflicting results.
For example, in a second study published in the same edition of Annals of Internal Medicine, Dr. George Lewith, a senior research fellow at the University of Southampton in England, and his team compared acupuncture with electrical stimulation of acupuncture points in 135 patients with neck pain.
In that study, acupuncture reduced the neck pain in statistically measurable amounts, but not enough to make a difference to patients.
Nevertheless, the University of Maryland study is the most significant proof yet that acupuncture is a useful and safe treatment for some illnesses, and it comes at a time when several of the Western pain medications commonly used to treat arthritis have been linked to heart attacks and strokes.
Other studies are under way to test whether acupuncture can reduce high blood pressure or ease depression.
(China.org.cn, Xinhua News Agency December 22, 2004)
