Acupuncture relieves pain and improves function in knee osteoarthritis significantly better than sham acupuncture, at least in the short term, according to the findings of a randomized controlled study.
Over the long term, however, real and sham acupuncture provide about the same benefits. And patients in both groups improved more than patients who had neither treatment, according to Claudia Witt, M.D., and her colleagues (Lancet 2005;366:136–43).
The investigators randomized 294 patients with knee osteoarthritis to acupuncture (149), minimal acupuncture (75), or a waiting list (70). Both acupuncture groups received 12 30-minute sessions over 8 weeks.
The true acupuncture group received needle stimulation at acupuncture points as identified by traditional Chinese medicine practices.
Minimal acupuncture consisted of superficial needling at nonacupuncture points and these needles were not manipulated.
At 8 weeks, response rates, defined as at least a 50% improvement on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), were 52% in the acupuncture group, 28% in the minimal acupuncture group, and 3% in the wait list group.
At baseline, the median WOMAC pain score was 51. After 8 weeks, the mean baseline-adjusted WOMAC score decreased to 27 in the acupuncture group and 36 in the minimal acupuncture group.
The score did not change significantly in the wait list group.
On all WOMAC subscales measuring pain, stiffness, and physical function, the acupuncture group showed significantly greater improvement than did the minimal acupuncture and wait list groups.
The percentage of patients taking analgesics decreased from 42% to 22% in the acupuncture group, 38% to 23% in the minimal acupuncture group, and 52% to 45% in the waiting group.
Improvements at 8 weeks persisted in both acupuncture groups throughout the 52 weeks of follow-up.
However, the differences between the groups were no longer significant at 26 or 52 weeks.
In an accompanying editorial, Andrew Moore, Ph.D., and Henry McQuay, M.D., who conduct pain research at Churchill Hospital, Oxford, England, said that while using needles “still has little long-term benefit without continuing acupuncture,” the technique obviously benefits patients (Lancet 2005;366:100–1).
“Certainly, a major benefit patients report is that acupuncture makes them feel better,” they said. “Making patients feel better is important.”