Acupuncture fails to hit the mark for chronic knee pain

Acupuncture fails to hit the mark for chronic knee pain

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By Lucy Piper, Senior medwireNews Reporter
06 October 2014
JAMA 2014; 312: 1313–1322

medwireNews: Research findings do not support the use of needle or laser acupuncture for treating chronic knee pain in patients older than 50 years.

“Although needle and laser acupuncture improved pain after treatment compared with control, improvements were not sustained at 1 year and were of a clinically unimportant magnitude”, lead researcher Rana Hinman (University of Melbourne, Victoria, Australia) and team report.

The findings support recommendations by The American Academy of Orthopaedic Surgeons and the National Institute for Health and Care Excellence against the use of acupuncture for knee osteoarthritis.

For the study, which followed a Zelen design, 282 people, aged at least 50 years, volunteered to be observed for a year. They were then randomly assigned to receive no acupuncture, needle acupuncture, laser acupuncture or sham laser acupuncture. Consent for the procedures was sought after randomisation in order to minimise the positive effects of patients knowingly volunteering for an acupuncture trial.

Treatment was declined by 13% to 19% of patients, leaving 71 patients who received no acupuncture, 70 who received needle acupuncture, 71 laser acupuncture and 70 sham laser acupuncture. Treatment was delivered once or twice weekly up to a maximum of eight to 12 sessions over a period of 12 weeks.

At 12 weeks, needle and laser acupuncture groups showed modest improvements in pain compared with control groups, with an average 1.1 and 0.8 point improvement, respectively, on a numeric rating scale of 0 to 10, where higher scores indicated worse pain. But the improvement was not enough to meet the minimal clinically important difference of 1.8 and did not persist at 1 year.

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