Acupuncture in patients with osteoarthritis of the knee: a randomised trial

Acupuncture has been used for thousands of years for pain treatment, but its efficacy for knee osteoarthritis was still generating doubts within the medical community. Knee osteoarthritis is one of the most common conditions affecting joints, causing intense pain and movement limitation. Conventional treatments include anti-inflammatory medications, which can cause serious side effects such as gastrointestinal bleeding, and joint replacement surgery in the most severe cases. Faced with this reality, many patients seek alternatives such as acupuncture, but until then there was a lack of robust studies that scientifically demonstrated its efficacy.

This study was designed to investigate whether true acupuncture is more effective than minimal acupuncture (placebo) or no treatment in patients with knee osteoarthritis. The research was conducted between March 2002 and January 2003, enrolling 294 patients aged 50 to 75 years, all with confirmed diagnosis of knee osteoarthritis. Participants were randomly divided into three groups: 150 received true acupuncture, 76 received minimal acupuncture, and 74 remained on a waiting list without treatment. True acupuncture followed Traditional Chinese Medicine principles, with needles inserted at specific points related to the knee and at distal points.

Minimal acupuncture used superficial needles at points unrelated to traditional acupuncture, serving as placebo control. Both treatments consisted of 12 sessions of 30 minutes over 8 weeks. The main improvement indicator was the WOMAC Index, which assesses pain, stiffness, and physical function related to osteoarthritis.

Results demonstrated significant benefits of true acupuncture after 8 weeks of treatment. On the WOMAC Index, true acupuncture obtained a score of 26.9 points, compared with 35.8 points for minimal acupuncture and 49.6 points for the untreated group (the lower the score, the better the outcome). This means that patients who received true acupuncture experienced less pain and better joint function. The proportion of patients who had at least 50% improvement was striking: 52% in the true acupuncture group, against only 28% in minimal acupuncture and 3% in the untreated group.

In addition, there was a reduction in pain medication use and improvement in overall quality of life. Side effects were minimal, mainly limited to small bruises at the needle insertion site.

For patients with knee osteoarthritis, these results offer solid scientific evidence that acupuncture can be an effective treatment option. The significant improvement in pain and joint function may represent an important alternative to anti-inflammatory medications, especially for those who cannot use them due to side effects or contraindications. For healthcare professionals, the study provides a scientific basis for considering acupuncture as an integral part of knee osteoarthritis treatment. The demonstrated safety, with minimal adverse effects, makes acupuncture an attractive option for patients seeking less invasive treatments.

However, it is important that acupuncture be performed by duly qualified and trained professionals.

The study presents some important limitations that should be considered. The main concerning finding was that the benefits of acupuncture diminished over time, and after 26 and 52 weeks there was no longer a significant difference between true and minimal acupuncture. This suggests that the effects of acupuncture may be temporary and that booster treatments may be needed to maintain long-term benefits. Another limitation was that many participants were recruited through newspapers, which may not represent all types of patients with knee osteoarthritis.

In addition, although patients did not know which type of treatment they were receiving, acupuncturists obviously did, which could influence results. Despite these limitations, this study represents a valuable contribution to evidence-based medicine in the field of acupuncture, demonstrating that it can offer real and clinically significant relief for patients with knee osteoarthritis, at least in the short term.