The longest and largest clinical trial of acupuncture ever
conducted shows that the traditional Chinese treatment provides
significant pain relief and functional improvement for people with
arthritis of the knee, and serves as an effective complement to
Western-style medical care. The landmark findings were published in
the December 21 edition of the US medical journal, Annals of
Internal Medicine.
The study, conducted in the US, was funded by the National
Center for Complementary and Alternative Medicine (NCCAM) and the
National Institute of Arthritis and Musculoskeletal and Skin
Diseases (NIAMS). Both are components of the National Institutes of
Health (NIH).
"For the first time, a clinical trial with sufficient rigor,
size, and duration has shown that acupuncture reduces the pain and
functional impairment of osteoarthritis of the knee," NCCAM
Director Stephen E. Straus, MD, said in a NIH news advisory issued
on Monday in the US.
Acupuncture is the practice of inserting thin needles into
specific body points to improve health and well-being, a
traditional method originated in China more than 2,000 years
ago.
In the study, led by Dr. Brian M. Berman of the University of
Maryland School of Medicine, researchers enrolled 570 patients aged
50 or older with arthritis of the knee. All participants had
significant pain in the month before joining the study, but had
never experienced acupuncture, knee surgery, or steroid
injections.
The participants were randomly assigned to receive one of three
treatments: acupuncture, sham acupuncture or participation in a
control group that followed the Arthritis Foundation's self-help
course for managing their condition.
During the study, 190 patients received true acupuncture, 191
patients received sham acupuncture for 24 treatment sessions over
26 weeks, and 189 attended six, two-hour group self-help sessions
over 12 weeks. Sham acupuncture is a procedure designed to prevent
patients from being able to detect if needles are actually inserted
at treatment points.
All patients' pain and knee function were assessed using
standard arthritis research survey instruments and measurement
tools.
Overall, those who received acupuncture showed a 40 percent
decrease in pain and a nearly 40 percent improvement in function
compared to baseline assessments.
"This trial, which builds upon our previous NCCAM-funded
research, establishes that acupuncture is an effective complement
to conventional arthritis treatment and can be successfully
employed as part of a multidisciplinary approach to treating the
symptoms of osteoarthritis," said Berman.
Berman noted that the results built upon those of studies that
have been conducted during the past 11 years. "The effect is not
huge," he added, "but none of the things we do with osteoarthritis
patients have a huge effect."
When releasing the findings, researchers cautioned against
extrapolating them to other common arthritis symptoms without
further study. Other studies on pain relief have presented
conflicting results.
For example, in a second study published in the same edition of
Annals of Internal Medicine, Dr. George Lewith, a senior
research fellow at the University of Southampton in England, and
his team compared acupuncture with electrical stimulation of
acupuncture points in 135 patients with neck pain.
In that study, acupuncture reduced the neck pain in
statistically measurable amounts, but not enough to make a
difference to patients.
Nevertheless, the University of Maryland study is the most
significant proof yet that acupuncture is a useful and safe
treatment for some illnesses, and it comes at a time when several
of the Western pain medications commonly used to treat arthritis
have been linked to heart attacks and strokes.
Other studies are under way to test whether acupuncture can
reduce high blood pressure or ease depression.
(China.org.cn, Xinhua News Agency December 22, 2004)