Effects of Warm Acupuncture Combined with Meloxicam and Comprehensive Nursing on Pain Improvement and Joint Function in Patients with Knee Osteoarthritis

Knee osteoarthritis is one of the most common and disabling diseases affecting older adults, and a leading cause of pain, restricted movement, and reduced quality of life. This degenerative joint condition causes pain, swelling, and stiffness, and can progress to severe deformity and even physical disability if not adequately treated. Among middle-aged and older adults in China, an estimated 8.1% are affected by knee osteoarthritis, with higher incidence in women, particularly after menopause. Conventional treatment often involves anti-inflammatory and analgesic medications; however, long-term use of these drugs can cause significant adverse effects and shows limited long-term efficacy, making it necessary to seek safer and more effective therapeutic alternatives.

This study aimed to evaluate the effects of combining moxibustion with acupuncture (warm acupuncture), the medication meloxicam, and comprehensive nursing care on pain relief and improvement of joint function in patients with knee osteoarthritis. The research enrolled 81 patients diagnosed with knee osteoarthritis, who were randomly divided into three treatment groups. The control group received meloxicam alone, a nonsteroidal anti-inflammatory drug commonly used to treat arthritis. The traditional Chinese medicine group was treated exclusively with warm acupuncture, a technique that combines insertion of needles at specific body points with the application of heat through moxibustion.

The third group, called the combined group, received both meloxicam and warm acupuncture. All groups received comprehensive nursing care over four weeks of treatment, including disease education, psychological counseling, nutritional advice, and rehabilitation exercises.

The results demonstrated significant benefits of the combined treatment compared with the individual therapies. The group that received warm acupuncture combined with meloxicam showed more pronounced improvements across all assessed measures, including pain reduction, increased mobility, joint stability, walking capacity, and ability to climb and descend stairs. The total efficacy rate of the combined group was 96.3%, significantly higher than the 77.8% of the meloxicam-only group and the 81.5% of the warm-acupuncture-only group. In addition, the time required to observe improvement in clinical symptoms — such as knee pain, swelling, and restricted movement — was notably shorter in the combined-treatment group.

The investigators also analyzed biological markers related to pain and inflammation in the participants' blood, finding more pronounced reductions in pain- and inflammation-promoting substances such as prostaglandin E2, substance P, dopamine, and serotonin in the combined group.

For patients with knee osteoarthritis, these results suggest that combining traditional Chinese medicine with conventional treatment may offer superior benefits compared with either approach alone. Warm acupuncture, which works by regulating the flow of energy and blood according to traditional Chinese medicine, appears to potentiate the anti-inflammatory effects of meloxicam, resulting in faster and more effective symptom relief. For health professionals, the study provides evidence that integrative approaches may be more effective in managing this chronic condition, potentially allowing lower doses of conventional medications and reducing the risk of adverse effects. Comprehensive nursing care also proved essential, highlighting the importance of educational, psychological, and rehabilitative support in patient recovery.

It is important to acknowledge several limitations of this research that may influence interpretation of the results. The study was conducted with a relatively small number of participants over a limited four-week period, which may not be sufficient to evaluate long-term effects of the treatments. In addition, a double-blind design could not be applied to the acupuncture intervention, as both patients and therapists were aware when this treatment was being administered, which may have influenced the results. The study was also conducted exclusively in China, with participants of Asian background, which may limit applicability of the results to other populations.

Despite these limitations, the study provides promising evidence that integrating traditional Chinese medicine with conventional treatment, supported by comprehensive nursing care, may offer a more effective approach to managing knee osteoarthritis, significantly improving patients' quality of life and offering a valuable therapeutic alternative for this disabling condition.