9/2/10 A new study suggests that compared to a placebo, acupuncture may not be helpful for treating knee osteoarthritis pain.
“It might be disappointing, but data is data. And I think it’s better to know the truth,” says lead author Maria Suarez-Almazor, MD, PhD, chief of rheumatology at the MD Anderson Cancer Center in Houston. “My patients – I don’t tell them not to do it. If they ask me, what I’ll tell them is the studies don’t show there’s a lot of benefit. And if there is, it’s quite small. However we know that acupuncture is quite safe, so if you want to try it, by all means try it.”
Acupuncture is used by many people with osteoarthritis, or OA, and it involves using thin needles to stimulate specific points on the body in hopes of removing blockages to channels of energy known as meridians.
Traditional Chinese medical experts believe this will allow energy to flow properly through the body, leading to a balanced state.
A recent study by the National Center for Complementary and Alternative Medicine estimated that 3.1 million adults in the U.S. are treated with acupuncture annually.
For the new study, published in the September issue of Arthritis Care & Research, researchers used real and fake (or placebo) procedures developed by a Chinese acupuncturist on 455 knee OA patients over a period of six weeks.
The traditional Chinese method activated meridian points using deep needles and electric stimulation. The sham method used shallow needles, and while the electrical machine was turned on at the beginning of the procedure, it was turned off before needles were used and no electrical stimulation was given.
Researchers say when they tabulated pain scores, there were no differences between those who received traditional Chinese acupuncture and those who got the sham procedures. Both groups saw about a one-point reduction in pain.
A survey, taken after the study's conclusion, suggests that that sham procedure was convincing. About half of that group thought they had received the real acupuncture.
Dr. Suarez-Almazor says she’s not saying acupuncture never works. But she says her findings indicate traditional acupuncture is not effective at relieving the chronic pain that comes with knee OA.
“For this condition, and in general for chronic musculoskeletal pain, the results have been somewhat disappointing,” Dr. Suarez-Almazor says.
“Other studies have shown benefit, but when you compare the benefits of acupuncture to the control or sham group, the effect tends to be quite modest – very, very small and it could be questionable whether it has any clinical significance. Of course many patients improve, but that’s not necessarily related to the acupuncture because patients in control groups improve, too. The human brain is very powerful.”
That leads to the study’s other finding – that a clinician’s communication style affects a patient’s outcome.
Acupuncturists in this study were trained to deliver treatment with two communication styles: The high-expectation style involved practitioners telling patients they were optimistic acupuncture would help because they had previously had a high degree of success with the procedure, while the other group received a more neutral message that the treatment might or might not work for them.
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