San Francisco Acupuncture for Chronic Knee Pain, Osteoarthritis

Kristen Sparrow, MD; San Francisco Acupuncturist

Knee pain can come from many causes, from sprains to meniscal tears, to chrondromalacia of the patella to arthritis. Acupuncture can help many of the causes of knee pain, even osteoarthritis.

Acupuncture for Knee Pain and OsteoarthritisOsteoarthritis, also known as “wear and tear” arthritis, is a common problem for many people after they reach middle age. Knee osteoarthritis is a leading cause of disability in the United States. In 2005, approximately 9 million American adults were diagnosed with knee osteoarthritis. About 55% of people with knee osteoarthritis are older than 65.

Medicines and Surgery can cause side effects or even be dangerous.

kneeWe all know that not everyone can take anti-inflammatory medications such as naproxyn, ibuprofen, or celebrex due to stomach issues and other problems. Cortisone injections can be useless and sometimes make matters worse. Joint replacement operations can be very helpful, but come with a hefty price tag and lots of rehab, and sometimes can be dangerous.

In the largest controlled acupuncture study ever done, it was determined that acupuncture was effective for the pain and disability of knee osteoarthritis. I treat knee pain daily in my San Francisco acupuncture clinic and have had very good results. I have one patient whose mobility has increased dramatically over the one and half years of treatment, and as a side advantage she’s lost 50 pounds.

Treatment course

Chronic Osteoarthritis of the knee:

Patient will need to come for about 8 acupuncture treatments to get the knee pain under control and then weekly for another 4 treatments. Then most patients find monthly acupuncture treatments to be useful to keep pain and swelling under control.

Other types of knee pain:

More acute types of knee pain like tendonitis, trauma, ligament strains and sprain respond quite well with about 6 acupuncture treatments. The patient may or may not need to return for treatment, depending on their condition.

What are the problems with traditional treatments for knee osteoarthritis?

Anti-inflammatories:

There has been much coverage in the media of the problems with anti-inflammatory medications taken on a long terms basis.

  • Gastrointestinal problems- most common problem. Can lead to gastritis or ulcer
  • Increased risk of heart attacks- This is most likely with the newer anti-inflammatory medications such as Celebrex, Vioxx (no longer on the market) but also naproxyn.

Though total knee replacement is better tolerated than hip replacement, there still can be a multitude of problems such as infection, persistent pain, bleeding, uneven leg lengths, even death.

Evidence for Acupuncture for Knee Pain Osteoarthritis of the Knee

The largest controlled acupuncture study ever undertaken was completed in 2004 looking at the effects of acupuncture on osteoarthritis of the knee. It showed that acupuncture is more effective than placebo acupuncture (sham acupuncture) or conventional conservative management. At 26 weeks the acupuncture patients had much improved pain scores and quality of life scores¹.   In another study from Germany, they found that acupuncture helped not only pain and function scores, but also quality of life scores in patients who received acupuncture for chronic osteoarthritis of the hip and knee over a 12 week period. The results were sustained for 6 months². Furthermore, a quality of life and cost-effectiveness study was performed on 479 patients with osteoarthritis of the hip and knee and they found that acupuncture was a cost effective modality to improve pain, function and quality of life scores³.

A recent 2012 survey confirms that acupuncture is effective for osteoarthritis of the knee.

Science:

There is evidence for needling causing active cytoskeletal remodeling in connective tissue fibroblasts⁴, so the results from these studies can be understood from a physiological point of view as actually improving the intrinsic tissue architecture of the knee and hip. Sham acupuncture also improved the pain, function and quality of life scores of the patients in the first study cited, but those results were not sustained for as long as the real acupuncture. This can be explained by the understood global mechanisms acupuncture, including endomorphin-1, beta endorphin, encephalin, and serotonin levels increase in plasma and brain tissue through acupuncture application. It has been observed that the increases of endomorphin-1, beta endorphin, encephalin, serotonin, and dopamine cause analgesia, sedation, and recovery in motor functions. They also have immunomodulator effects on the immune system and lipolithic effects on metabolism⁵.

appointment

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1. Ann Intern Med. 2004 Dec 21;141(12):901-10.   2. Arthritis Rheum. 2006 Nov;54(11):3375-7.   3. Eur J Health Econ.; 2007 Jul 19;   4. J Altern Complement Med. 2007 Apr;13(3):355-60   5. Int J Neurosci. 2006 Feb;116(2):115-25.