Living with arthritis, and acupuncture.
Arthritis is the swelling and tenderness of one or more joints. The main symptoms of arthritis are joint pain, stiffness and loss of movement, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis causes cartilage in the joints breaking down. Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.
Osteoarthritis
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.
Joint cartilage is the hard, slick coating on the ends of bones forming the joints. It cushions the ends of the bones and allows nearly frictionless joint motion. Daily wear-and-tear damages a joint's cartilage resulting in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be accelerated by a joint injury or infection.
Osteoarthritis also causes changes in the bones and deterioration of the connective tissues that attach muscle to bone and hold the joint together. If cartilage in a joint is severely damaged, the joint lining may become inflamed and swollen.
Osteoarthritis is the leading cause of disability and is associated with major impacts on physical function and mobility. Osteoarthritis generally affects joints in the hands, knees, hips and feet. 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.
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. 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.
Pain killers are commonly used for pain management. 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 seek alternative treatments.
Can acupuncture help 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. For example, 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.
Rheumatoid arthritis
Rheumatoid arthritis is less common than osteoarthritis. In rheumatoid arthritis, the body's immune system attacks the lining of the joint capsule. This lining (synovial membrane) becomes inflamed, swollen and painful. The disease process can eventually destroy cartilage and bone within the joint.
54% of rheumatologists recommend acupuncture treatment in the US
Apart from conventional medicine treatment, doctors have shown openness towards complementary and alternative medicine (CAM) therapy. There is a survey by Manek NJ (2010) about the opinion of rheumatologists in the United States on CAM treating rheumatoid. Six common CAM therapies are included: spinal manipulation, acupuncture, energy medicine, meditation, glucosamine and body work. Most of rheumatologists are likely to recommend CAM therapy. Body work comes first. 70% of rheumatologists think body work is beneficial. 54% or rheumatologists accepted that acupuncture is a beneficial therapy.
Indeed there are many studies on the effectiveness of acupuncture treating patients with rheumatoid arthritis (RA). There was a systematic review by Wang et al (2008). They studied 12 Western and Chinese databases and references. Tender joint pain, morning stiffness were investigated. In eight studies, acupuncture is used 11 weeks on average with about 42 sessions. Needle retention is 24 minutes on average. Results showed that six studies reported a significant reduction of pain in acupuncture group and 4 studies reported a reduction of morning stiffness.
References
Wang C et al Arthritis Rheum (2008) 59:1249-56
Manek NJ et al BMC Complement Altern Med (2010) 28:10-5
