Journal: Pain, Volume 147, Issues 1-3, pages 60-66
Abstract: Neurobiological mechanisms invoking the release of endogenous opioids and depression of stress hormone release are believed to be the basis of acupuncture analgesia. This study compared plasma beta-endorphin and cortisol levels with self assessment scores of intensity of pain, before and after 10 days of electro-acupuncture treatment in patients suffering from chronic pain as a result of osteoarthritis knees. Forty patients of either sex over 40 years with primary osteoarthritis knee were recruited into a single-blinded, sham-controlled study. For electro-acupuncture group the points were selected according to the Traditional Chinese Medicine Meridian Theory. In the sham group needles were inserted at random points away from true acupoints and no current was passed. Both groups were treated for 10 days with one session every day lasting for 20-25min. Pre- and post-treatment Western Ontario and McMaster Universities (WOMAC) index of osteoarthritis knee and Visual Analogue Scale (VAS) for pain were recorded and blood samples were taken for the measurement of plasma cortisol and beta-endorphin levels. Following electro-acupuncture treatment there was a significant improvement in WOMAC index and VAS (p=0.001), a significant rise in plasma beta-endorphin (p=0.001), and a significant fall in plasma cortisol (p=0.016). In conclusion electro-acupuncture resulted in an improvement in pain, stiffness and disability. Of clinical importance is that an improvement in objective measures of pain and stress/pain associated biomarkers was shown above that of a sham treatment; hence demonstrating acupuncture associated physiological changes beyond that of the placebo effects.
Acupuncture and Osteoarthritis of the Knee: A Review of Randomized, Controlled Trials
Journal: Family and Community Health, Volume 31, Issue 3, pages 247-254.
Abstract: Osteoarthritis of the knee is a major cause of disability among adults. Treatment is focused on symptom management, with nonpharmacologic therapies being the preferred first line of treatment. Acupuncture is considered a potentially useful treatment for osteoarthritis. The objective of this article is to review the English-language articles, indexed in MEDLINE or CINAHL, describing randomized, controlled trials of the effects of needle or electroacupuncture on knee osteoarthritis. Ten trials representing 1456 participants met the inclusion criteria and were analyzed. These studies provide evidence that acupuncture is an effective treatment for pain and physical dysfunction associated with osteoarthritis of the knee.
The Effectiveness of Acupuncture on Pain and Mobility in Patients with Osteoarthritis of the Knee: A Pilot Study
Journal: The Journal of Nursing Research, Volume 16, Issue 2, pages 140-148.
Abstract: Acupuncture has been repeatedly reported to relieve pain associated with osteoarthritis of the knee. As the vast majority of information on the effectiveness of acupuncture on this condition is based on data collected in Western countries, little is known about patients with osteoarthritis of the knee in Asian countries. In this pilot clinical study, acupuncture was incorporated into the standard care for adult patients with osteoarthritis of the knee to determine its contribution to pain relief and improved mobility. In a prospective, non-randomized controlled study, patients with osteoarthritis of the knee were separated into two groups. The first (the experimental group; n = 12) was scheduled for up to 8 sessions of acupuncture in addition to standard care, while the second (the control group; n = 12) received standard care only. Measurements using the six-minute walking distance test, pain visual analogue scale, and osteoarthritis of the knee outcome measurement were taken at baseline and after 4 weeks. Both study and control groups showed significant improvement with respect to time effects in terms of six-minute walking distance, pain visual analogue scale, pain domain and mobility domain scores determined by the osteoarthritis of the knee outcome measurement (p < .01), after adjusting for covariables. However, improvements measured in the study group did not differ significantly from those in the control group. Patients with osteoarthritis of the knee seemed to experience clinical improvements in six-minute walking distance, pain relief and mobility when their standard care was supplemented with acupuncture.