Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial.

Abstract

OBJECTIVES:

To analyse the efficacy of acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee, with respect to pain relief, reduction of stiffness, and increased physical function during treatment; modifications in the consumption of diclofenac during treatment; and changes in the patient's quality of life.

DESIGN:

Randomised, controlled, single blind trial, with blinded evaluation and statistical analysis of results.

SETTING:

Pain management unit in a public primary care centre in southern Spain, over a period of two years.

PARTICIPANTS:

97 outpatients presenting with osteoarthritis of the knee.

INTERVENTIONS:

Patients were randomly separated into two groups, one receiving acupuncture plus diclofenac (n = 48) and the other placebo acupuncture plus diclofenac (n = 49).

MAIN OUTCOME MEASURES:

The clinical variables examined included intensity of pain as measured by a visual analogue scale; pain, stiffness, and physical function subscales of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; dosage of diclofenac taken during treatment; and the profile of quality of life in the chronically ill (PQLC) instrument, evaluated before and after the treatment programme.

RESULTS:

88 patients completed the trial. In the intention to treat analysis, the WOMAC index presented a greater reduction in the intervention group than in the control group (mean difference 23.9, 95% confidence interval 15.0 to 32.8) The reduction was greater in the subscale of functional activity. The same result was observed in the pain visual analogue scale, with a reduction of 26.6 (18.5 to 34.8). The PQLC results indicate that acupuncture treatment produces significant changes in physical capability (P = 0.021) and psychological functioning (P = 0.046). Three patients reported bruising after the acupuncture sessions.

CONCLUSIONS:

Acupuncture plus diclofenac is more effective than placebo acupuncture plus diclofenac for the symptomatic treatment of osteoarthritis of the knee.

• Authors: Jorge Vas, Camila Méndez, Emilio Perea-Milla, Evelia Vega, María Dolores Panadero, José María León, Miguel Angel Borge, Olga Gaspar, Francisco Sánchez-Rodríguez, Inmaculada Aguilar, Rosario Jurado
• Journal: BMJ (Clinical research ed.) (BMJ) Vol. 329 Issue 7476 Pg. 1216 (Nov 20 2004) ISSN: 1756-1833 [Electronic] England
• PMID: 15494348 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Diclofenac

Topics

• Acupuncture Therapy
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Combined Modality Therapy
• Diclofenac (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Osteoarthritis, Knee (drug therapy, therapy)
• Pain (prevention & control)
• Pain Measurement
• Quality of Life
• Single-Blind Method
• Treatment Outcome