OSTEOARTHRITIS: NIH RECOMMENDS ACUPUNCTURE

Results were published for a landmark study on acupuncture conducted by the NIH (National Institutes of Health) in
December 2004. Based on the differences in scores between acupuncture and control groups, scientists stated that their results “Demonstrate that true traditional Chinese acupuncture is safe and effective for reducing pain and improving physical function in patients with symptomatic knee osteoarthritis who have moderate or greater pain despite background therapy with analgesic or anti-inflammatory therapy. This trial . . . 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 study leader Dr. Brian Berman of the University of Maryland School of Medicine in Baltimore.1

Never before has a study on acupuncture in the United States been lauded with such direct language stating acupuncture’s effectiveness in treating disease. Dr. Stephen Strauss, director of the National Center for Complementary and Alternative Medicine (NCCAM) noted, “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”. “There is a certain irony that we find out that the ancient practice of acupuncture is safe and effective, (even) as we also find some of the newer modern pain medications like Vioxx turn out to be more dangerous than previously thought,” Straus told The Early Show on CBS. “The lesson is that by applying modern research standards, we can learn from thoughtful practitioners from two thousand years ago instead of dismissing them because they developed their ideas differently. 1

“The beauty of this study is that it addresses a major public health problem, and provides evidence that acupuncture is a good option for patients who suffer,” he continued. Straus stressed that, “Degenerative arthritis is a chronic illness . . [acupuncture] does cause significant clinical benefit in reducing pain and allowing people to be more mobile. Anythingthat can do that is an advantage.” 2

In the largest clinical study of acupuncture reported in the United States to date, the multi-site study team, including
rheumatologists and licensed acupuncturists, enrolled 570 patients, aged 50 or older with osteoarthritis of the knee. The patients all had significant pain in their knee the month before joining the study, but had never experienced acupuncture, had not had knee surgery in the previous 6 months, and had not used steroid or similar injections.
Participants were randomly assigned to receive one of three treatments: 190 received acupuncture, 191 underwent sham acupuncture and 189 followed the Arthritis Foundation’s self-help course for managing their condition. The patients also continued to receive standard medical care from their primary physicians, including anti-inflammatory medications and pain relievers.

While pain scores decreased among participants in all three groups, the most significant reduction was seen in patients receiving true acupuncture. The researchers said that by week 8, participants receiving acupuncture were showing a significant increase in function and by week 14 a significant decrease in pain, compared with the sham and control groups. Overall, the scientists said those who received acupuncture had a 40 percent decrease in pain and a nearly 40 percent improvement in function. By the end of the study, average pain scores among acupuncture patients had decreased more than twice as much as patients in the education group.

The research was supported by the National Center for Complementary and Alternative Medicine and the National
Institute of Arthritis and Musculoskeletal and Skin Disease. The complete study, “Effectiveness of Acupuncture as
Adjunctive Therapy in Osteoarthritis of the Knee: a randomized, Controlled Trial,” can be ordered from the Annals of
Internal Medicine Web site: www.annals.org .

1 Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AMK, Hochberg MC. Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee: A
Randomized, Controlled Trial. Annals of Internal Medicine. 2004; 141(12): 901-910.
2, 3 “Acupuncture Helps Ease Arthritis”, CBSNews.com, Dec.20 2004.

Acupuncture Helps Ease Arthritis

WASHINGTON, Dec. 20, 2004

The ancient Chinese therapy of acupuncture can help ease pain and improve movement for people with arthritis of the
knee, a new study concludes.
“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,” said Dr. Stephen E. Straus, director of the National Center for
Complementary and Alternative Medicine.

“These results also indicate that acupuncture can serve as an effective addition to a standard regimen of care and
improve quality of life for knee osteoarthritis sufferers,” Straus said in a statement.

“There is a certain irony that we find out that the ancient practice of acupuncture is safe and effective, (even) as we also find some of the newer modern pain medications like Vioxx turn out to be be more dangerous than previously thought,”

Straus told The Early Show. “The lesson is that by applying modern research standards, we can learn from thoughtful practitioners from two thousand years ago instead of dismissing them because they developed their ideas differently.

“The beauty of this study is that it addresses a major public health problem, and provides evidence that acupuncture is a good option for patients who suffer,” he continued.

How does acupuncture do it? “That’s a very important question, and a large area of research,” Strauss tells The Early
Show co-anchor Hannah Storm. “The best evidence so far suggests that acupuncture needles can cause the release of chemicals in our nervous system that naturally control our sensation of pain. How it does it, we’re not sure. But this is a very exciting area to pursue.”
Straus stressed to Storm that, “There are no miracle cures. Degenerative arthritis is a chronic illness. There is no evidence that acupuncture will prevent the progression of the disease, but it does cause significant clinical benefit in reducing pain and allowing people to be more mobile. Anything that can do that is an advantage.”

He adds that, “We are currently supporting a very large study, asking whether acupuncture relieves low back pain, another important health condition. And it’s reasonable to think it might be beneficial for arthritis of the hip or the shoulder, but we haven’t studied that yet.”

In the largest clinical study of acupuncture reported to date, researchers studied 570 patients age 50 and over with osteoarthritis of the knee. The multi-location study was led by Dr. Brian M. Berman of the University of Maryland School of
Medicine in Baltimore.

Acupuncture involves inserting thin needles into specific body points to stimulate the body and improve health and wellbeing.

The patients all reported significant pain in their knee the month before joining the study, but had never experiencedacupuncture, had not had knee surgery in the previous six months and had not used steroid or similar injections. The participants were divided into three groups – 190 received acupuncture, 191 underwent sham acupuncture and 189 followed the Arthritis Foundation’s self-help course for managing their condition. The patients also continued to receive standard medical care from their primary physicians, including anti-inflammatory medications and pain relievers. In both the sham and true acupuncture procedures, a screen prevented patients from seeing the knee treatment area and learning which treatment they received. In the sham acupuncture group needle guides and needles were taped to the skin so the patients would feel some sensation, but the needles were not actually inserted. The researchers said that by week eight patients receiving acupuncture began showing a significant increase in function and by week 14 a significant decrease in pain, compared with the sham and control groups.

Overall, the scientists said, those who received acupuncture had a 40 percent decrease in pain and a nearly 40 percent improvement in function. “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.

The results were reported in Monday’s issue of Annals of Internal Medicine.

The research was supported by the National Center for Complementary and Alternative Medicine and the National Institute of Arthritis and Musculoskeletal and Skin Disease.