Acupuncture ineffective for chronic knee pain

1. Needle and laser acupuncture showed no improvements in average knee pain compared to sham acupuncture at 12 weeks.

2. While needle and laser acupuncture resulted in moderate decreases in pain compared to control at 12 weeks, this treatment effect was not statistically significant and was not maintained at one year.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Chronic knee pain is a common complaint in the older patient population, resulting in decreased quality of life. Current evidence supports the use of acupuncture for osteoarthritis pain. This study randomized patients to receive needle, laser, sham laser, or no acupuncture treatment. Needle acupuncture improved physical function and pain on walking at 12 weeks compared to control. Moderate improvements in pain were seen at 12 weeks with both needle and laser acupuncture compared to control, however, none of these treatment effects were maintained at one year. Limitations of this study include a substantial percentage of patients declining treatment and being lost to follow-up, resulting in a reduction in study power. Additionally, pain was measured using self-reported questionnaires, which could have resulted in reporting bias. Overall, this study demonstrates that acupuncture provides no long-term benefit in treating chronic knee pain in patients older than 50 years of age.

Click to read the study in JAMA

Relevant Reading: Acupuncture treatment for chronic knee pain: a systematic review

In-Depth [randomized, controlled study]: This study compared the effect of needle, laser, sham laser, and no acupuncture treatment in 282 patients older than 50 years of age with chronic knee pain. Following randomization, 13% of participants declined treatment in the sham laser acupuncture group, compared to 19% in the needle and 17% in the laser acupuncture groups. At 12 weeks and one year, there were no significant differences between needle or laser acupuncture and sham laser acupuncture in terms of pain or function. Needle acupuncture showed some improvements in pain, physical function, and pain on walking when compared to no treatment at 12 weeks; however, these effects did not persist over the one-year study period. Laser acupuncture only demonstrated modest improvements in pain compared to control at 12 weeks.

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