Doctor - Does Acupuncture Work for Arthritis?

Traditional Chinese medicine has used acupuncture to relieve pain as well as to cure disease. During an acupuncture session, a practitioner will insert thin needles into the skin at any one of more than 2,000 carefully defined meridian points. The ancient theory of why acupuncture is effective is that needle insertion restores qi (life force) flow throughout the channels of the body. When qi is at optimal levels, there is harmony with the universal forces of yin and yang. This leads to improved health and relief of pain.

While the traditional acupuncture approach has been to use the needles by themselves, modern acupuncturists may rotate the needles or apply low levels of electric current to improve the effectiveness of the procedure. Sometimes acupressure is also given during the same session. Moxibustion which is the use of herbs that are burned during the procedure is also used. Some practitioners also use "cupping" which is a method where suction cups are applied to meridian points.

Theories as to how acupuncture relieves pain have included the "gate theory" which suggests that pain signals travel along neural pathways through "gates." If a competing stimulus such as acupuncture needles, then pain signals are blocked.

Another theory has to do with endorphin release by the brain due to acupuncture stimulus. Another theory is that acupuncture helps produce analgesic neurotransmitters in the spinal cord.

One large study of acupuncture in osteoarthritis of the knee was performed at the University of Maryland. Researchers compared traditional Chinese acupuncture with sham acupuncture (using either retractable needles or real needles inserted into false pressure points). The study group consisted of 570 patients who reported limited benefits from anti-inflammatory medication and exercise.

The study demonstrated a statistically significant improvement in both pain measures as well as mobility measures in patients receiving real acupuncture versus sham acupuncture.

The authors concluded that "True traditional Chinese acupuncture is safe and effective for reducing pain and improving function in patients with symptomatic knee osteoarthritis who have moderate or greater pain despite background therapy."

Some notes of caution. The effect of acupuncture in relieving pain is not huge. The effects are modest and do take time. The second issue is that the placebo effect undoubtedly enters into the equation.

An interesting study from Dr. George Lewith in Southampton, England used positron emission technology to demonstrate that brain blood flow was altered in a different manner with real acupuncture compared with sham acupuncture therefore validating the concept of a real pain modulating effect of acupuncture on the brain.

Unfortunately, acupuncture does take a long time to work. Dr. Hochberg from the University of Maryland states, "You really have to give acupuncture ... six months in order to get maximum benefits from it."

Another downside is the cost. Generally, the charge is anywhere from 60 to 100 dollars a session. Expect that it will cost about $2,000.00. Fortunately, some insurance carriers will cover the cost.

Acupuncture will not be a substitute for conventional treatment. You should use it in conjunction with your regular arthritis therapy. Make sure you see a licensed practitioner.