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The ancient Chinese art of acupuncture offers people with arthritis of the knee significant pain relief, but it doesn't seem to help people with chronic neck pain, two studies report today.
Acupuncture, the practice of inserting needles into specific body points, has been practiced for about 2,000 years by the Chinese. But it has never been fully accepted or studied by U.S. physicians or scientists.
The results of the knee study, the largest of its kind, are likely to push doctors and patients to seriously consider the treatment along with standard therapies, says Stephen Straus of the National Center for Complementary and Alternative Medicine. The center is part of the National Institutes of Health, which helped pay for the study.
In 2002, an estimated 2 million Americans used acupuncture, but Straus says the procedure is still underused. ''A study with this clarity and this rigor now will open eyes,'' he says.
Straus says the knee study's results will offer patients with arthritis of the knee another option to relieve pain, a particularly important finding for patients now that Vioxx has been pulled from the market for safety reasons and a key rival, Celebrex, has been linked to heart attacks and strokes.
More than 20 million people in the USA have osteoarthritis, a degenerative and often crippling disease of the joints. The condition is caused by wear and tear on the cartilage, the tissue that cushions the body's joints. In cases of osteoarthritis, the cartilage starts to break down, which often causes excruciating pain.
Brian Berman of the University of Maryland School of Medicine in Baltimore and his colleagues took 190 people who had osteoarthritis of the knee and treated them with acupuncture. They compared that group with 191 people who got sham acupuncture, the use of fake needles that didn't pierce the skin.
People receiving genuine acupuncture experienced a 40% decrease in pain and a 40% improvement in knee function over the course of the 26-week study, he says. In many cases, that translates to a better ability to move about in daily life.
Acupuncture is believed to work by spurring the body to release natural painkilling substances called endorphins, Berman says. But it might not work for all kinds of pain.
A second study, which also appears in today's Annals of Internal Medicine, indicates that acupuncture didn't help people with chronic neck pain, which also can be caused by arthritis, says John Klippel, president of the Arthritis Foundation.
Acupuncture is not a cure, says Straus, who says the people with knee arthritis were already on standard painkillers such as aspirin or ibuprofen.
But with the addition of acupuncture, they got an extra measure of relief, an important finding for people who have scaled back their activities because of inadequate pain relief, Klippel says.
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