Acupuncture can make a profound difference to knee pain.
Recommended in the BMJ and by American Rheumatologists
A recent 'Clinical Review' article in the British Medical Journal discussed the management of osteoarthritis of the knee. This is the "wear and tear" type of arthritis. Acupuncture was given a good showing. They said that there had been a number of trials of acupuncture in the treatment of osteoarthritis of the knee - "these show significant and clinically relevant reductions in pain". Further the American College of Rheumatology guidelines "recommend acupuncture for patients with moderate to severe pain who are candidates for joint replacement but are unwilling or unable to have the operation".
A piece of research from Denmark showed how effective acupuncture can be for knee osteoarthritis, even with severe disease. In this study one in four of the patients who were on the waiting list for knee replacement were able to cancel the operation because they were so much better following a course of acupuncture. Even those who were not helped sufficiently to cancel the operation still had some benefit from pain relief while they were waiting; 80% of the whole number had less pain and stiffness.
Interestingly, a more recent review study suggested that the longer term effects of acupuncture for arthritis of the knee were more significant than short term effects.
Why not just take the drugs?
One of the benefits of using acupuncture for knee arthritis is that patients may avoid having to take anti-inflammatory medication, such as NSAIDs. Taking long term NSAIDs can have severe side effects. It is reckoned that there are about 2500 deaths a year in the UK caused by NSAIDs - these are mainly related to intestinal bleeds - but there are other serious ADRs (adverse drug reactions). It is well recognised that NSAIDs increase the risk of heart attacks and strokes, but may also cause kidney damage and erectile dysfunction. More recently research has shown that the likelihood of developing dementia increases by 66%, and Alzheimer’s Disease is 57% more likely.
Cancel that knee op?
The value of knee arthroscopy has also been called into question. In an interesting study carried out in the US, a group of patients having arthroscopy for osteoarthitis of the knee was compared with a group who did not have the proper operation, but just a couple of small incisions around the knee to mimic the operation (sham). Over 2 years of follow up, the real operation group did no better than the sham group, and at certain points over the follow up period the sham group reported more improvement!
Danish study on knee arthritis and acupuncture can be found at;
Manheimer E et al. Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med 2007; 146: 868–77.
Breitner J, et al "Risk of dementia and AD with prior exposure to NSAIDS in an elderly community-based cohort" Neurology 2009; 72(17): DOI: 10.1212/WNL.0b013e3181a18691 .
You can read a summary of the research here on Medscape; http://www.medscape.com/viewarticle/438238.