Ask an expert - muscles and bones - arthritis

34 questions

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 factsheet please 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 http://en.wikipedia.org/wiki/German_Acupuncture_Trials 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.   
 

Q:  Can acupunture help me as i suffer with severe arthritis in my left knee doctors have suggested a knee replacement but i am not keen on this being done yet.

 

A:  Osteoarthritis of the knee is one of the conditions for which there is a considerable amount of good evidence suggesting that acupuncture treatment may be an effective option. As our fact sheet shows  please click here
 
the evidence has been consistently good.
 
The one factor which you have to take into account is that if the damage is extensive there may be very great limitations on what help acupuncture can give. Although it can be an effective pain reliever for the short term, the balance between the length of time that it can help and the cost is a delicate one. There are some patients for whom long term expense is not an issue, but for most people operating on stretched budgets there are financial limits to what they can continue to do.
 
Our best advice is that you seek the views of a BAcC member local to you, and ask specifically whether, based on their experience of treating such conditions and your presentation they think they could offer sustained help. It may be that the deterioration is such that treatment will have limited effect, and if you did decide to pursue treatment you would be well advised to set a very tight limit to the first course and to assess very carefully against agreed and measurable outcomes whether the treatment is working. 
 

Q: I have two questions:-


 - Can acupuncture help with arthritis?
 - I have tried my first session of acupuncture. Some needles put on my right side resulted in a steady pain, not because of the needle but from inside. It felt like something was blocked and that I suddenly had a lot of pressure from inside on these points. The Dr removed some of needles and the pain disappeared.  Is that normal to feel pain when getting acupuncture?

 

A:  In answer to your first question, it depends on what kind of arthritis, where it is and how long you've had it. If there has been significant wear and tear on a joint or series of joints, then there will be a physical limitation on how much acupuncture can achieve. Many people with serious hip pains, for example, seek help from acupuncture while they are awaiting surgery, and some pain relief is the best that can realistically be achieved. In other cases, such as osteoarthritis of the knee, for example, there is considerable research evidence
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810544/
 
and please click here
 
 which suggests that acupuncture may be a useful intervention.
 
On the second question, we're not quite sure what you mean by 'pain.' There is often a dull, aching sensation associated with placing the acupuncture needles in the correct place. This is called 'deqi' by the Chinese, and in China itself most patients will not feel satisfied with treatment unless they feel this ache when they are needled. Chinese needling techniques are, as a consequence, quite a great deal more vigorous than those used in the West. If this is the kind of pain which you are experiencing, and the fact that it goes when the needles are removed suggests that it may be, then this is a sign that the treatment may be working.
 
it is always best to discuss this with the person putting the needles in, though. Some people are particularly sensitive to needles, and there are all sorts of adjustments which a practitioner can make to try to reduce any discomfort a person may feel.
 

As you can see from our factsheet on osteoarthritis here
 
there is a substantial amount of good quality research suggesting that osteoarthritis of the knee may well benefit from treatment with acupuncture and moxibustion. We understand that acupuncture was seriously considered for inclusion within the NICE guidelines for the condition on the basis of some of the very large German trials, but a technicality about the results prevented this from happening.
 
As we have to remind people about all osteoarthritic conditions, there comes a point where the degeneration of the joint makes treatment less successful and possibly not worth trying and where surgical intervention becomes the best option, although even at this point there may be some pain relief which treatment can offer. For chronic conditions, however, there appears to be a great deal that acupuncture can do to reduce pain and increase mobility.
 
Each presentation is unique and different, and we would recommend that your mother visits one of our members to get a better assessment of whether treatment may help. The nature of Chinese medicine is to see symptoms within the context of the overall patterns of energy, and this can give the practitioner a much clearer idea of how successful treatment may be and whether there are other health issues which may enrich the diagnosis on which they would base their work.

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