Back, Hip, Knee & Leg Pain

2020 Journal of Acupuncture and Tuina Science

In the treatment of knee osteoarthritis, the acupuncture group had significant advantages over sham acupuncture or no-acupuncture groups in relieving pain and improving physical function.

Eight databases were extensively searched up to March 2018. Randomized controlled trials (RCTs) comparing the efficacy of acupuncture with sham acupuncture or no acupuncture for knee osteoarthritis were included. The Cochrane Collaboration’s tool was used for assessing the risk of bias.

A total of 18 RCTs were included, involving a total of 3 522 participants. The results showed that acupuncture was superior to sham acupuncture in relieving pain and improving physical function. In comparison to the no-acupuncture group, the acupuncture group also showed significant advantages in relieving pain and improving physical function. Sensitivity analyses suggested that the results were robust, and Egger’s test found no potential publication bias.

Efficacy and safety of acupuncture for the treatment of knee osteoarthritis: a systematic review and meta-analysis Wang, Tt., Liu, Y., Ning, Zy. et al.

2019 Acupuncture in Medicine

There is moderate evidence of efficacy for acupuncture in terms of pain reduction immediately after treatment for non-specific low back pain ((sub)acute and chronic) when compared to sham or placebo acupuncture.

14 trials (2110 participants) were included in the review, and 9 were included in the meta-analysis. Immediately after the acupuncture treatment we found statistically significant differences in pain reduction between acupuncture and sham or placebo therapy, but there were no differences in function. At follow-up, there were significant differences in pain reduction, but not in function. We conducted subgroup analyses both immediately after treatment and at follow-up.

Evidence of efficacy of acupuncture in the management of low back pain: a systematic review and meta-analysis of randomised placebo- or sham-controlled trials Xiang Y, He J, Tian H, Cao B, Li R.

2019 Medicine

According to high-quality outcomes, acupuncture had more total effective rate, short-term effective rate, and less adverse reactions than western medicine in treating knee osteoarthritis.

Firstly, this overview provides the latest evidence on acupuncture for knee osteoarthritis based on the findings of systematic reviews, which indicated that acupuncture may have more total effective rate, short-term effective rate, and less adverse reactions in treating knee osteoarthritis than western medicine. Secondly, this overview is predesigned, which helps restrict the likelihood of biased decisions in reviewing. Thirdly, comprehensive search strategies were conducted for a wide range of data. Fourthly, independent reviewers were engaged in searching, screening, and assessing the potential studies and there was a high consistency among the reviewers.

The effectiveness and safety of acupuncture for knee osteoarthritis Li, Juan PhDa; Li, Yu-Xi MDb; Luo, Liao-Jun BDb; Ye, Jing BDb; Zhong, Dong-Ling BDa; Xiao, Qi-Wei BDb; Zheng, Hui PhDb; Geng, Chun-Mei MDc; Jin, Rong-Jiang PhDa,∗; Liang, Fan-Rong MDb,∗

2018 Cochrane Database of Systematic Reviews

In people with hip osteoarthritis, at close to 8 weeks, acupuncture plus routine primary physician care may improve pain and function compared to routine primary physician care alone.

Because acupuncture has previously been documented to have a low risk of adverse effects, and because arthritis patients seem to be accepting of acupuncture (Rao 1999), there seem to be few drawbacks to hip OA patients electing to receive acupuncture, other than the additional costs incurred. While some private health insurance plans cover much of the costs of acupuncture, it is not typically covered by governmental health plans, with some exceptions (NICE 2009). Thus, the out‐of‐pocket costs of the acupuncture will vary depending on an individual's health plan. Given the potential disability caused by OA of the hip and the few available treatments, acupuncture may be considered one treatment option, particularly among patients who are not yet ready for a joint replacement or who are unable to tolerate oral NSAIDs. However, patients should be informed that acupuncture probably has little or no effect in reducing pain or improving function relative to sham acupuncture. . Because there are currently no registered ongoing RCTs, this evidence base is unlikely to substantially change in the near future.

Acupuncture for hip osteoarthritis Manheimer E, Cheng K, Wieland LS, Shen X, Lao L, Guo M, Berman BM.

2018 Acupuncture in Medicine

Acupuncture showed a more favourable effect in the treatment of lumbar disc herniation than lumbar traction, ibuprofen, diclofenac sodium and meloxicam.

Thirty RCTs involving 3503 participants were included in the study. Meta-analysis showed that acupuncture had a higher total effective rate than lumbar traction, ibuprofen, diclofenac sodium and meloxicam. Acupuncture was also better than lumbar traction and diclofenac sodium in terms of visual analogue scale (VAS) scores, and better than lumbar traction with respect to Japanese Orthopaedic Association (JOA) scores.

In addition, the total effective rate in five individual trials was greater for acupuncture than for mannitol plus dexamethasone and mecobalamin, ibuprofen plus fugui gutong capsule, loxoprofen, mannitol plus dexamethasone and huoxue zhitong decoction, respectively. Additionally, two individual trials showed a superior effect of acupuncture in VAS scores comparedwith ibuprofen or mannitol plus dexamethasone, respectively.

Acupuncture for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis Tang S, Mo Z, Zhang R.

2017 Acupuncture in Medicine

Acupuncture may be effective at relieving chronic knee pain 12 weeks after acupuncture administration.

Nineteen trials were included in this systematic review. Of these, data from 17 studies were available for analysis. Regarding the effectiveness of acupuncture alone or combined with other treatment, the results of the meta-analysis showed that acupuncture was associated with significantly reduced CKP at 12 weeks on WOMAC pain subscale and VAS. As for safety, no difference was found between the acupuncture and control groups.

Updated systematic review and meta-analysis of acupuncture for chronic knee pain Zhang Q, Yue J, Golianu B, Sun Z, Lu Y.

2015 Evidence-Based Complementary and Alternative Medicine

Acupuncture, either used in isolation or as an adjunct to conventional therapy, provides short-term improvements in pain and function for chronic low back pain.

Sixteen systematic reviews were appraised. Overall, the methodological quality was low and external validity weak. For acute LBP, evidence that acupuncture has a more favorable effect than sham acupuncture in relieving pain was inconsistent; it had a similar effect on improving function. For chronic LBP, evidence consistently demonstrated that acupuncture provides short-term clinically relevant benefits for pain relief and functional improvement compared with no treatment or acupuncture plus another conventional intervention.

Acupuncture for Low Back Pain: An Overview of Systematic Reviews Liu L, Skinner M, McDonough S, Mabire L, Baxter GD.

2015 Evidence-Based Complementary and Alternative Medicine

Acupuncture may be effective in treating the pain associated with sciatica.

A total of 12 studies (involving 1842 participants) were included. Results showed that acupuncture was more effective than conventional Western medicine (CWM) in outcomes effectiveness, pain intensity, and pain threshold. Subgroup and sensitivity analysis found that the results did not change in different treatment method and drug categories substantially. The reported adverse effects were acceptable.

The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis Ji M, Wang X, Chen M, Shen Y, Zhang X, Yang J.

2015 Evidence-Based Complementary and Alternative Medicine

The use of acupuncture may be more effective than drugs and may enhance the effect of drugs for patients with sciatica.

The results of this systematic review suggest that the use of acupuncture may more effectively relieve leg pain/lumbago and improve global assessment of sciatica when compared with NSAID (ibuprofen, meloxicam, and diclofenac) treatment. Moreover, adjuvant acupuncture may enhance the effect of medications in leg pain/lumbago relief. To patients, acupuncture points appear more effective than nonacupoints. Acupuncture is relatively safe and is rarely associated with serious adverse events in patients with sciatica. However, this meta-analysis was lacking in relevant and rigorous RCTs. Because the evidence was limited, higher quality and more rigorously designed clinical trials with larger sample sizes will be needed to further confirm our findings.

Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis Zongshi Qin, Xiaoxu Liu, Jiani Wu, Yanbing Zhai, Zhishun Liu,

2014 BMC Complementary Medicine and Therapies

The use of acupuncture for osteoarthritis is associated with significant reductions in pain intensity, improvement in functional mobility and quality of life.

In this systematic review, we found acupuncture administered to adults with osteoarthritis to be associated with a statistically significant reduction in pain intensity, improved functional mobility and improved health-related quality of life. Reductions in pain were greater in trials with longer intervention periods. Though under-reported and inconsistently described, major adverse events with acupuncture were not reported. Subgroup analyses suggest that acupuncture is most effective for reducing osteoarthritic pain when administered for more than four weeks. Outcome assessment for the majority of trials occurred immediately following the intervention period and thus the durability of treatment effects are unknown.

Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. Manyanga, T., Froese, M., Zarychanski, R. et al.

2011 Evidence-Based Complementary and Alternative Medicine

Acupuncture can provide pain relief to patients with plantar fasciitis.

This study demonstrates that acupoint PC7 has a specific effect for treatment of plantar fasciitis, and that the method of acupuncture treatment is both simple and safe. Further studies comparing acupuncture treatment with an inert placebo and conventional treatment as parallel arms are recommended to further elucidate the efficacy of acupuncture treatment for heel pain.

Acupuncture treatment for plantar fasciitis: a randomized controlled trial with six months follow-up Shi Ping Zhang , Tsui-Pik Yip, Qiu-Shi Li