Study: Acupuncture Effective for Arthritis

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Study: Acupuncture Effective for Arthritis

By Salynn Boyles

WebMD Medical News Reviewed By Brunilda Nazario, MD

on Monday, December 20, 2004

 

Dec. 20, 2004 -- An ancient Chinese medical treatment that has been used by

millions of Americans finally has a stamp of approval from western medicine. In

what investigators are calling a " landmark " study, acupuncture was found to

reduce pain and improve movement among patients with osteoarthritis of the knee

when used with other treatments.

Findings from the study, funded by the National Institutes of Health, were

reported at a Monday news conference and are published in the Dec. 21 issue of

the Annals of Internal Medicine.

The director of the NIH's National Center for Complementary and Alternative

Medicine (NCCAM) called the investigation the " largest, longest, and most

rigorous study of acupuncture " ever conducted. He said the 2,000-year-old

practice

can now be considered a " new " addition to therapies for degenerative

osteoarthritis.

Principal investigator Brian M. Berman, MD, of the Center for Integrative

Medicine at the University of Maryland, said osteoarthritis of the knee was a

logical choice for the large, government-funded acupuncture study because so

many

people with the condition have already turned to alternative medicines.

" (Osteoarthritis) is a big public health problem affecting many millions of

people in the U.S., " he said. " It is associated with a significant reduction in

quality of life and is an area where traditional medicine does not have all

the answers. Adequate pain relief is often not achieved, and many drugs have

undesirable side effects, especially in the elderly. "

Traditional Treatments Under Fire

The safety of the most widely prescribed of the traditional medicines -- the

pain relievers known as Cox-2 inhibitors -- has been much in the news lately.

The arthritis drug Vioxx was voluntarily pulled from the market earlier this

fall after a large trial linked its use to an increase in heart attacks and

strokes. In another trial, reported last week, Pfizer's popular Cox-2 inhibitor

Celebrex was also found to increase heart attack risk. The company says it has

no plans to pull Celebrex from the market until it studies the data.

Just under a third of the patients in the acupuncture trial were also taking

a Cox-2 inhibitor. But study co-investigator Marc Hochberg, MD, PhD, said

Monday that the Cox-2 inhibitors have not been shown to be superior to other

pain

relievers for the treatment of osteoarthritis.

He added that recent studies suggest that side effects such as ulcers and

bleeding that result from the prolonged use of nonsteroidal anti-inflammatory

drugs such as ibuprofen and naproxen can be minimized by also taking ulcer

drugs,

known as proton-pump inhibitors or H2 blockers.

" There is actually very little indication for the use of Cox-2 selective

inhibitors in managing patients with symptomatic osteoarthritis, " Hochberg said.

 

40% Improvement With Acupuncture

 

40% Improvement With Acupuncture

The newly reported study included 570 patients with knee osteoarthritis who

were already taking anti-inflammatory drugs or other pain relievers. The

patients continued on their pain relievers during the 26-week trial, but a third

of

them also got aggressive acupuncture treatments consisting of 23 total

sessions. Another group of patients unknowingly got sham acupuncture, which

involved

the use of fake needles to mimic the real needles used for true acupuncture. A

third group underwent an intensive 12-week education course on the management

of osteoarthritis.

All the patients were assessed at weeks 4, 8, 12, and 26 for pain and knee

function. By week 8, the patients who got the true acupuncture were showing

significant increases in knee function, and by week 14 they showed significant

decreases in pain compared with the sham acupuncture and the education groups.

The acupuncture group had a 40% decrease in pain as compared with their

initial pain scores. They also experienced a 40% improvement in function at the

end

of the trial, and there were no major treatment-related side effects.

Research in animals suggests that acupuncture works by affecting genes

involved in the production of chemicals within the body that regulate pain. But

it

is not yet clear if the ancient practice can actually slow progression of the

degenerative joint condition, says Stephen I. Katz, MD, PhD, director of the

National Institute of Arthritis and Musculoskeletal and Skin Diseases, which

co-sponsored the study.

" More than 20 million Americans have osteoarthritis, " Katz said. " This

disease is one of the most frequent causes of physical disability among adults.

Seeking an effective means of decreasing osteoarthritis pain and increasing

function is of critical importance. "

 

 

 

SOURCES: Joint press conference on acupuncture for osteoarthritis study,

Monday, Dec. 20. Berman, B. Annals of Internal Medicine, Dec. 21, 2004; vol 141,

pp 901-910. Stephen E. Straus, MD, director, National Center for Complementary

and Alternative Medicine. Stephen I. Katz, MD, PhD, director, National

Institute of Arthritis and Musculoskeletal and Skin Diseases. Brian Berman, MD,

and

Marc Hochberg, MD, PhD, Center for Integrative Medicine, University of Maryland

School of Medicine.