Acupuncture ‘does not improve chronic knee pain’


  • New study found needle and laser acupuncture was no more helpful than sham acupuncture in middle-aged patients with chronic knee pain
  • Australian scientists studied effects on 282 patients over the age of 50
  • Divided into four groups – one received no acupuncture, one treated with needles, another with laser and the last received sham laser acupuncture 
  • Findings suggest ‘no real or direct effect’ of acupuncture, lead author said

Lizzie Parry for MailOnline

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Acupuncture does not improve chronic knee pain in middle-aged people, experts said today.

Their new study found real acupuncture using needles and lasers was no more helpful than sham acupuncture.

It specifically looked at the effects of acupuncture on chronic knee pain in people aged 50 or over. 

Rana Hinman, lead author from the University of Melbourne, said the team of researchers were surprised at their results.

She said: ‘It is surprising that our study showed acupuncture was not effective compared to sham acupuncture, because many people with chronic knee pain report that treatment with acupuncture is beneficial for their symptoms.’

Scientists in Australia found acupuncture does not improve chronic knee pain in middle-aged people. File photo

Previous studies has found acupuncture is effective, although the benefits compared to mock acupuncture have been generally small and of questionable benefit, she said.

Her team found many people over the age of 50 are plagued with chronic knee pain, and many turn to alternative treatments, including acupuncture.

Acupuncturists often use a combination of traditional Chinese and Western techniques with needles and low-intensity lasers.

But the effectiveness of laser acupuncture has been questioned, the researchers said.

To test whether needle or laser acupuncture is more effective than no acupuncture, the scientists divided 282 patients over the age of 50 with chronic knee pain and morning stiffness into four groups.

The knee pain targeted in the study is common with osteoarthritis – the result of normal joint wear and tear over the years.

One group received no acupuncture at all.

Another received needle acupuncture, another laser acupuncture, while the last group received sham laser acupuncture.  

Patients received eight to 12 treatments over three months. Each treatment session lasted about 20 minutes.

The laser and sham laser treatments looked the same to both patients and acupuncturists, but the laser was not turned on for the sham group.

The patients rated their average knee pain and physical function on questionnaires at the beginning of the study, after three months of treatment and again at one year.

There were ‘modest improvements’ in pain at three months in the needle and laser acupuncture groups compared to the no-treatment group, but not compared to the sham group.

Researchers looked at the effects of laser acupuncture, pictured, and needle treatment on 282 patients. File picture

And there were no differences between any of the groups on measures of knee pain and function after one year.

This suggests that there were no ‘real’ or ‘direct’ effects of needle or laser acupuncture, Dr Hinman said. 

The improvements patients felt were likely due to the placebo effect.

‘Acupuncture tends to be more effective for people who believe in the benefits of acupuncture,’ she said. 

‘In our study, people did not know that were signing up for an acupuncture study, so our participants were less likely to be ‘believers’ in acupuncture, which probably explains why acupuncture was ineffective in our study.’

The new results are very similar to those of a review of individual patient data in 2012, said Andrew Vickers.

Dr Vickers, who led the previous review, is an attending research methodologist at Memorial Sloan Kettering Cancer Center in New York City and was not involved in the new study.

The new review may have found a benefit from real acupuncture compared to sham acupuncture if the study included more people, he said.

‘About three million Americans try acupuncture per year, and chronic pain is the most common indication,’ he said.

People with chronic pain should see a pain specialist, as there are many options for treatment, including acupuncture, he said.

‘As the authors suggest, the findings of this study are applicable to patients with moderate to severe persistent knee pain, and acupuncture may be effective in some people with neuropathic (nerve related) pain,’ said Dr. Abhishek Abhishek, an arthritis researcher and associate professor at the University of Nottingham.

The UK’s National Institute for Clinical Excellence and Health does not recommend acupuncture for treating knee osteoarthritis, but does recommend it for persistent low back pain as it can be effective in that scenario, Dr Abhishek, who was not part of the new study, said.

As alternatives to acupuncture, Dr Hinman said physical therapy, knee braces and exercise can all help alleviate chronic knee pain.

The new study was published in the Journal of the American Medical Association.

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