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How helpful would acupuncture be for osteoarthritis of the knee ?

We were asked this question very recently, and we replied:

Can acupuncture help with osteoarthritis of the knee?

It greatly depends on what counts as a 'bad knee'. There is considerable evidence that acupuncture treatment can be highly beneficial in the treatment of osteoarthritis of the knee, as our factsheetplease click here


shows, and serious consideration was given in the NICE discussions on knee treatment to the recommendation for acupuncture as a treatment option within the NHS. Certainly the major German trials, of which you can find a good overview at reported some very good outcomes. The problem for NICE was that the difference between real acupuncture and 'sham' acupuncture (a device that gives a sensation of being needled without actually doing so) was small, and so in the strict terms of the trial it is impossible to say that acupuncture works if a 'pretend' treatment works just as well. However, as one of our medical colleagues pointed out, both forms of acupuncture were far better than conventional treatment, and rather than dismissing acupuncture as no better than sham, people may just as well have been given the treatment anyway and while researchers kept on investigating why both treatments seemed to work.


If the problem is more to do with the muscles and tendons of the knee, there is again a considerable body of evidence which suggests that acupuncture can aid the recovery of function. Many western medical practitioners and physiotherapists use acupuncture as one of the treatment options for treating various knee strains, and Chinese medical theory, while it uses different terminology to describe the restrictions on function, has a similar strategy for local treatment. The great strength of Chinese medicine, however, is that is sees the individual symptom in the context of the way the whole system functions, and a practitioner will try to determine whether this is a local issue and can be treated as such, or whether this is the tip of a larger iceberg.


In any event, they might want to establish why the system was not healing itself. In many cases this is simply to do with people's work, and although some adjustments can be made to how people go about their jobs, it is not always that easy. Modern times have also seen a great burst of jogging and training which both put huge strain on the joints, and there may be a need to ease back on voluntary activities.


In any event, it is worth seeking the advice of a BAcC member local to you so see what they think about the problem. It would be helpful if you can explain what conventional medical tests and treatments have been done to give them a good idea of where the problem appears in investigations like arthroscopy, and so on.   

The question was a little more vague than the one you asked, but the core information in our answer remains the same. You ask, though, 'how helpful?', and this is more difficult to quantify. In many cases of osteoarthritis of the knee and also of the hip, the deterioration has been significant before people seek treatment, and if there has been considerable damage to the joint it is unlikely to respond as well as to treatment in the early stages. The balance which has to be struck is that between the extent to which treatment may bring some relief and the frequency necessary to maintain it. We have been aware of people with unlimited funds who have had treatment weekly for years in order to keep pain and discomfort from inflammation at bay, but the majority of us do not have the same level of financial freedom. Your practitioner, if you did decide to have acupuncture treatment, would be very clear in reviewing with you the cost effectiveness as well as effectiveness of any treatment you had, and ensuring that you were in charge of the process and not feeling drawn into an open-ended drain on your resources.

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