Acupuncture for osteoarthritic pain: an observational study in routine care

March 30, 2006

K. Linde1, W. Weidenhammer1, A. Streng1, A. Hoppe1 and D. Melchart1,2

1 Centre for Complementary Medicine Research, Department of Internal

Medicine II, Technische Universität München, Kaiserstrasse 9, 80801 Munich,

Germany and 2 Division of Complementary Medicine, Department of Internal

Medicine, University Hospital, Zurich, Switzerland.

Correspondence to: K. Linde. Centre for Complementary Medicine Research,

Department of Internal Medicine II, Technische Universität München,

Kaiserstrasse 9, 80801 Munich, Germany. E-mail: Klaus.Linde

de

Objective. To investigate characteristics and outcomes of patients

undergoing acupuncture treatment for osteoarthritic pain under conditions of

routine care in the framework of statutory health insurance in Germany.

Methods. Patients with chronic pain due to osteoarthritis (ICD-10 diagnoses

M15 to M19) treated with acupuncture as the leading form of therapy were

included in an observational study. Detailed questionnaires including

instruments to measure pain intensity (numerical rating scales from 0 to 10)

disability (Pain Disability Index) and quality of life (SF-36) were filled

in before treatment, after treatment and at 6 months. Patients suffering

from osteoarthritis of the knee and hip also filled in the Western Ontario

and McMaster Universities (WOMAC) Osteoarthritis Index questionnaire.

Results. A total of 736 patients were included in the main analysis. Seventy

(10%) patients and 278 (38%) patients, respectively, suffered exclusively

from primary osteoarthritis of the hip or knee, 239 (33%) from another type

of osteoarthritis and 149 (20%) had more than one affected joint. On average

patients received 8.7 ± 3.1 acupuncture treatments. Statistically

significant and clinically relevant improvements were seen in all subgroups

both after treatment and at 6 months in all major outcome measures. In

patients with osteoarthritis of the hip, the WOMAC sum score was 47.9 ± 20.7

at baseline, 34.8 ± 20.0 after treatment and 33.1 ± 22.2 at 6 months. The

respective values in patients with osteoarthritis of the knee were 51.7 ± 20

9, 34.1 ± 23.3 and 34.6 ± 25.1.

Conclusions. In this study, patients with chronic pain due to osteoarthritis

reported clinically relevant improvements after acupuncture treatment. Due

to the uncontrolled design and the high proportion of patients lost to

follow-up, the study findings must be interpreted cautiously.

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