[color=darkblue:f346f87e5d]Chinese traditional acupuncture provides pain relief and improves function for people with arthritis of the knee and serves as an effective complement to standard care, the US National Institutes of Health (NIH) said in a research report.
The landmark findings were published in the Annals of Internal Medicine to be released on Wednesday.
The research, the longest and largest clinical trial of acupuncture ever conducted, 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 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 arthritis of the knee," NCCAM Director Stephen E. Straus said in a NIH press release on Tuesday.
"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 arthritis sufferers," he said.
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 a survey conducted in 2002 by the US Centers for Disease Control and Prevention (CDC), the practice had been used by 2.1 million American adults.
In the study, researchers enrolled 570 patients aged 50 or older with arthritis of the knee. Participants had significant pain in their knee the month before joining the study, but had never experienced acupuncture, knee surgery, or steroid injections thereafter.
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. Sham acupuncture is a procedure designed to prevent patients from being able to detect if needles are actually inserted at treatment points.
Other 189 participants attended six, two-hour group sessions over 12 weeks based on the self-help course. And all patients' pain and knee function were assessed using standard arthritis research survey instruments and measurement tools.
Overall, those who received acupuncture had a 40 percent decrease in pain and a nearly 40 percent improvement in function compared to baseline assessments.
In their article titled "Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee", the researchers concluded that "acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for arthritis of the knee when compared with credible sham acupuncture and education control groups."[/color:f346f87e5d]
With regards to efficacy of acupuncture in reducing pain in the knee for arthritis sufferers, do I understand correctly that they have to continue the treatment indefinitely beyond the study period to enjoy the reduced pain benefit?
If the treatment continues for a long time, will the pain receptors become used to it, and stop responding in the same way; has there been a long term trial to show this? In Western medicine, a limitation of painkillers in some patients with chronic pain is that the body adapts in its pain threshold after some time and it becomes necessary to increase the dosage of painkillers to achieve the same amount of pain relief.
Can I extrapolate the results to assume the similar outcome for arthritis involving other joints? Or would different acupoints and meridians be subject to different responses?
Maybe since TCM is based not on a biochemical model of the body but on an energetic model, as Hugo said in [url=http://www.ontcm.com/forum/viewtopic.php?t=4]his post[/url], the pain threshold adaptation is bypassed. After all, pain is the result of a series of biochemical reactions.
(Then again, those biochemical reactions can be the result of, and produce, chemical energy themselves. So who knows.)
If this is true, I can see how herbal medicine might be more prone to be adapted to for painkilling since it's more Yin (therefore more matter-related) than acupuncture which is more Yang (more energy-related). Which reminds me of the idea of herbal microdosages I mentioned in [url=http://www.ontcm.com/forum/viewtopic.php?t=35]this post[/url]. Low dosages of a herbal treatment might avoid or delay the body's adaptation to the herbal medication.
Or maybe all of this doesn't matter too much, since good chinese medical treatment will try to get to the root of the problem, pain being only a symptom of an illness.
Interesting subject, a long-term trial would be nice indeed.
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