Poking needles under your skin doesn’t exactly sound soothing. But evidence is growing that acupuncture may help people with rheumatoid arthritis (RA). In a 2011 Chinese study in the Chinese Journal of Integrative Medicine, researchers at the China Academy of Chinese Medical Sciences divided 63 people with RA into two groups. One group had electro-acupuncture and the other traditional acupuncture. The study found that both types of acupuncture significantly lowered tumor necrosis factor-alpha (TNF-alpha) and vascular endothelial growth factor (VEGF). Electro-acupuncture was more effective in lowering VEGF than traditional acupuncture.

“Both TNF-alpha and VEGF are associated with chronic inflammation,” explains Nathan Wei, MD, director of the Arthritis Treatment Center in Frederick, Md. “In particular, TNF-alpha appears to play a pivotal role in the chronic inflammation and joint destruction that characterizes RA. That’s why so many of the biologic medications such as Enbrel [etnaercept], Humira [adalimumab] and Remicade [inflixumab] target TNF-alpha. And that’s why this study is so interesting: Acupuncture has been used to treat the pain of osteoarthritis, but this is one of the few articles I’ve seen where cytokine, or protein messengers, like TNF-alpha and VEGF have been affected in people with RA.”

Electro-acupuncture is much the same as traditional acupuncture. Both use the insertion of tiny needles into a person’s skin at any of the some 2,000 mapped pressure points along what are called meridians or channels. In Chinese terms, acupuncture restores the optimal flow of energy — called Qi (chee) — and balance in the body.

“Electro-acupuncture stimulates the needles with a mild electrical wave form,” says Kathleen Lumiere, DAOM, LAc, a doctor of Chinese Medicine, licensed acupuncturist and faculty member at Bastyr University in Seattle. “The intensity could be one-thousandth or one-millionth of the amount of energy in an incandescent light bulb so it’s a really mild stimulation. It’s the frequency of the stimulation that matters. Each frequency has distinct [biological and physical] effects.”

For this study, the frequency was likely low, says Lumiere, similar to the frequency of restorative, regenerating sleep, or delta waves, in a sense allowing the body to “believe” it’s in delta sleep.

“Electro-stimulation may have been more effective because it offers more consistent stimuli,” says Lumiere. “If a practitioner was tapping the needle two times a second, you might have a similar result but that would be exhausting.”