Needling Arthritis Away

Arthritis patients might owe Richard Nixon some gratitude. Besides inaugurating a warmer era of diplomacy between two superpowers, President Nixon's 1972 visit to China spurred a new period of cultural exchange, which consequently introduced acupuncture to a new generation of American doctors. Now, more than thirty years later, a growing body of evidence indicates acupuncture can effectively compliment a drug regimen, moderate exercise and proper nutrition.

Most recently, the National Institutes of Health funded a 26-week, randomized controlled trial, believed to be the most comprehensive study of arthritis and acupuncture to date. The findings were presented at the American College of Rheumatology's annual meeting in October 2004 and published in the December 2004 Annals of Internal Medicine.

The trial used 570 patients with a median age of 65.5, two thirds of which were white women. Rather than an "either/or" trial comparing a placebo to a drug, this trial placed patients in three groups: the "true" acupuncture group, the "sham" acupuncture group wherein needles were furtively taped and not inserted, and a self-help course about living with arthritis. Those in the education group were considered the controls as all 570 patients continued taking their medication throughout the trial.

After 23 sessions in 26 weeks, the true acupuncture group reported "significantly greater" reductions in pain, improvements in knee function and farther distances in a six-minute walk. On the WOMAC index, the true acupuncture group showed decreased pain scores by a difference of 3.79 points while the sham acupuncture group showed smaller reductions of 2.92 points.

Acupuncture originated in China during the Han Dynasty, approximately 2,500 years ago. The practice centers on the idea that the body is powered by an energy flow called Qi, pronounced "chi". Qi travels along channels that correspond with twelve vital organs including the heart, lungs, and gallbladder. A condition, arthritis, impotence or otherwise, spells an imbalance in the body's Qi. No wider than .02 inches, the needles are inserted into specific body locations to correct the disrupted energy balance.

Because acupuncture comes from a different conception of well-being and because it employs a different vocabulary to analyze affliction, Western medical evaluation is difficult and some institutional suspicion remains. Though set against the talk of "needle nonsense" thirty years ago, that suspicion is subsiding. Since upgraded from "experimental medical device", the FDA now has professional standards for needle sterility as it does for scalpels and syringes. And in a pro acupuncture consensus statement, the NIH mentioned evidence of acupuncture's altered blood flow and pituitary gland stimulation.

Still, no one is considering acupuncture become the main source of treatment. "Complimentary and Alternative Medicine" is the phrase commonly used to describe the treatment. Alternative medicine or not, acupuncture appears to be gaining some influential allies and has the reduced pain indices and improved walking distances to explain why.

Article References
Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. : Ann Intern Med. 2004 Dec 21;141(12):901-10.

http://www.vet-task-force.com/Acuref1.htm, site accessed 4/13/2005.

Acupuncture. NIH Consensus Statement 1997 Nov 3-5; 15(5):1-34.

Soeken KL. Selected CAM therapies for arthritis-related pain: the evidence from systematic reviews. Clin J Pain. 2004 Jan-Feb;20(1):13-8.

Ernst E. Musculoskeletal conditions and complementary/alternative medicine. Best Pract Res Clin Rheumatol. 2004 Aug;18(4):539-56.