Welcome to my blog, discover acupuncture with Dr Maggie Ju

Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Tuesday, 30 August 2022

Osteoarthritis pain, can acupuncture help?

 Osteoarthritis is the most common joint condition and the most common form of arthritis which is progressive and degenerative. Osteoarthritis is caused by gradual loss of joint cartilage. It is the leading cause of disability and is associated with major impacts on physical function and mobility. The symptoms include loss of movement and joint pain. Diagnosis is based on radiological changes, and clinical presentation of joint pain; including tenderness, limitation of movement, joint effusion, and variable degrees of localized inflammation. Approximately 10% of men and 18% of women aged 60 years or older have symptomatic osteoarthritis worldwide.

 Osteoarthritis causes joint pain and stiffness. Anyone can get osteoarthritis. There is high risk if you are in late 40s or older women; if you are overweight or have had previous joint injury or another joint condition; if you have physically demanding job which need to have repetitive movements; people with joint injury history are more likely developing the disease later in life. Pain killers are commonly used for pain management. Complementary therapies are increasingly popular as treatments for osteoarthritis, including taichi, acupuncture, yoga, and massage therapy. There is available evidence suggesting that these therapies are safe for use by individuals with osteoarthritis. Positive short-term (less than 6 months) effects in the form of reduced pain and improved self-reported physical functioning were confirmed by research. There is limited information regarding the relative effectiveness of the therapies (which therapy is more effective compared to others). There is also limited information about treatment effects in persons with different joints, different age groups and different stages. Complementary therapies can reduce pain and improve function in adults with osteoarthritis.

Osteoarthritis generally affects joints in the hands, knees, hips and feet. In osteoarthritis cartilage in one or more joints is broken-down and eventually lost which may lead to inflammation. The most common symptom is joint pain. Joint pain is usually worse later in the day and can associated with swelling, stiffness, weakness of muscles around affected joints. Mobility reduction and joint creaking can also occur.

There is no known cure for the disease. Treatment is focusing on reducing pain and together with managing other symptoms. Painkillers are the standard therapy.These include non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and in severe cases, narcotics. NSAIDs and acetaminophen are only effective for short-term relief of osteoarthritic pain and are associated with common adverse effects (e.g. upset stomach).

Can acupuncture help osteoarthritis? Long term use of painkiller can lead to many side effects, some of which are very serious such as bleeding problems associated with aspirin. As a consequence, in more recent years, patients have increasingly used acupuncture to relieve the chronic pain linked with osteoarthritis. 

Acupuncture is reported to be effective in treating chronic pain caused by osteoarthritis. The use of acupuncture in adults with osteoarthritis was associated with significant reduction in pain intensity. Compared to intervention durations of ≤ 4 weeks, longer intervention periods were associated with significant difference reductions in pain intensity. Acupuncture significantly improved functional mobility and health-related quality of life. Longest intervention had the greatest benefits. 

For example, s research studied effectiveness of acupuncture on relieving pain associated with osteoarthritis. This is a randomized, controlled clinical trial with a large number of patients---3633 patients in total. Patients treated with acupuncture showed significantly improvements in symptoms and quality of life compared to those in control group. Acupuncture which is believed invokes the release of endogenous opioid and depression of stress hormone release.

Hand osteoarthritis, acupuncture can help. 

Osteoarthritis can occur at hand. It often occurs at certain spots of hand, such as in the joint located at the base of the thumb, in the joint at the end of the finger and in the joint in the middle of the finger. The symptoms include pain, swelling, deformity and loss of function. Hand osteoarthritis can treated with medications including pain killers and injections of steroids into the affected joint. Other treatments include using finger or wrist splints, resting the joints, heat treatments and physiotherapy and acupuncture etc. Surgical treatment may be needed in some cases. 

Recently there was a study of observation on the efficacy of acupuncture and fire needle therapy for hand osteoarthritis. There were 80 cases in this study. 42 of them were received acupuncture treatment at acupoints including Sanjian (LI3), Zhongzhu (TE3), Houxi (SI3) and fire needle at Ashi points. Other 38 cases received votalin emulgel for local embrocation. Two courses of treatments (one course is 30 days) were given to these patients. After two courses of the treatments, the VAS score of arthralgia, joint function score and the duration of morning stiffness, joint tenderness, and swelling were significantly different from those of before the treatments. The efficacy of acupuncture was superior to that of medication. This study suggested that acupuncture was an effective treatment for hand osteoarthritis.  

References

Marcus Sanders, Alternative Medicine Review (2011) 16, 228-238

Li H et al Zhongguo Zhen Jiu (2013) 33:885-8 

Karner M et al Evid Based Complemennt Alternat Med (2013): 2013:427265

Dai et al Zhongguo Zhen Jiu (2014) 34:329-33

Plaster R et al Acupunct Med (2014) 32:236-41

Shengelia R et al Pain Manag Nurs (2013) 14:e274-88

Manyanga et al BMC Complement Altern Med (2014) 14:312

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