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Acupuncture failed to reduce chronic knee pain.

Neither traditional nor laser acupuncture is more effective than sham acupuncture at lessening pain or improving function in patients older than 50 years who have moderate to severe chronic knee pain, a study showed.

In a randomized, partially blinded clinical trial, 282 participants aged 50 and older were randomly assigned to receive traditional needle acupuncture (70 patients), laser acupuncture (71 patients), sham laser acupuncture (70 patients), or no acupuncture (71 control subjects) in 20-minute sessions delivered once or twice weekly for 12 weeks.

At baseline, all the participants reported having moderate to severe knee pain and morning stiffness lasting less than 30 minutes on most days. They completed detailed questionnaires at baseline, 12 weeks, and 1 year measuring pain on walking or standing, physical function, activity restriction, health-related quality of life, and global change in knee pain and function over time, said Rana S. Hinman, Ph.D., of the Centre for Health, Exercise, and Sports Medicine, University of Melbourne, and her associates.

At 12 weeks and at 1 year, there were no significant differences in any of these outcomes between active acupuncture and sham acupuncture. Both needle and laser acupuncture improved pain at 12 weeks, compared with no acupuncture, but this improvement was "of a clinically unimportant magnitude" and did not persist, the investigators reported (JAMA 2014 Sept. 30 [doi:10.1001/ jama.2014.12660]).

Clinical guidelines vary with regard to acupuncture for knee osteoarthritis. The American College of Rheumatology "conditionally recommends" the treatment in patients who are candidates for arthroplasty, the Osteoarthritis Research Society International is "uncertain" about its efficacy, the European League Against Rheumatism failed to reach consensus on the treatment and doesn't address it in final recommendations, the American Academy of Orthopedic Surgeons "cannot recommend" it, and the National Institute for Health and Care Ex-cellence's guidelines recommend against it. "The findings from our trial support these latter recommendations," Dr. Hinman and her associates wrote.


Caption: Chronic knee pain was no better with active than sham acupuncture at 1 year.


Key clinical point: Acupuncture did not decrease chronic knee pain in patients over 50.

Major finding: No pain or function outcomes were significantly different between active and sham acupuncture at 12 weeks or 1 year.

Data source: A randomized, partially blinded Zelen-design clinical trial involving 282 older patients with moderate to severe knee pain who were treated for 12 weeks and followed for 1 year.

Disclosures: This study was funded by the National Health and Medical Research Council of Australia and the Australian Research Council. Dr. Hinman reported receiving royalties from the sale of the Gel Melbourne OA shoe (Asics), and her associates reported numerous ties to industry sources.

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Article Details
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Author:Moon, Mary Ann
Publication:Internal Medicine News
Article Type:Clinical report
Date:Oct 15, 2014
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