Acupuncture for arthritis

Osteoarthritis is a chronic joint condition caused by a breakdown of cartilage and the bones beneath the cartilage.

This causes pain, stiffness, swelling, popping noises, and a loss of flexibility in the joint. Osteoarthritis is the most common form of arthritis. About 10 per cent of Canadians have it.

There is no cure so treatment focuses on managing symptoms. Common recommendations include:

• walking aids
• wedged insoles
• physiotherapy
• transcutaneous electrical nerve stimulation (TENS
• cognitive behavioural therapy
• pharmaceutical drugs
• corticosteroid injections.

If mobility of the joint is severely impaired, a joint replacement may be recommended.

Acupuncture is a safe, effective, and cost-efficient treatment for managing osteoarthritis.

A 2017 Comparative Literature Review conducted by John McDonald and Stephen Janz concluded that “current evidence supports the use of acupuncture as an alternative for traditional analgesics in patients with osteoarthritis.”

Acupuncture for knee osteoarthritis:

• Performed better than placebos, muscle-strengthening exercise, tai chi, weight loss, standard care and aerobic exercise (in ranked order).
• Was superior to standard care and muscle-strengthening exercises.
• Significantly reduced pain intensity, improved functional mobility and quality of life.
• Had a greater reduction in pain intensity when treatments continued for more than four weeks.

In general, acupuncture is thought to stimulate the nervous system and cause biochemical changes that promote homeostasis for physical and emotional well being.

In western medical terms, acupuncture works by:

• Stimulating areas of the brain that are known to reduce sensitivity to pain and stress
• Releasing endogenous endorphins and neurohormones which changes the processing of pain in the brain and spinal cord
• Inhibiting pain through the regulation and release of endogenous opioids
• Reducing inflammation by releasing vascular and immunomodulatory factors
• Increasing local microcirculation which helps to reduce swelling and promote healing

From a Chinese medicine perspective, pain is due to poor circulation.

• Is the digestive system too weak to nourish blood?
• Was there trauma?
• Are there other health factors contributing to joint problems?

Once we determine the cause of the poor circulation, we can suggest a treatment.

Sometimes herbal medicine is better, sometimes acupuncture, sometimes both, sometimes neither and a referral for other treatments is best.

It all depends on the underlying cause.

Because we think pain is from improper circulation, we suggest using heat instead of ice for chronic pain.

While ice may be good for inflammation, it also tenses muscles and decreases circulation. Heat relaxes muscles, promotes blood flow, and therefore reduces pain.

That's why we often recommend moxibustion for people suffering from osteoarthritis. Moxibustion is a type of heat therapy that involves burning mugwort and using it to warm specific parts of the body.

A systematic review and meta-analysis from the journal Clinical Rheumatology (July 2011, Volume 30, Issue 7, pp 937–945) suggests that moxibustion can be more effective than drugs for knee osteoarthritis, and that moxibustion can improve outcomes when it’s used in conjunction with conventional drug treatments.

I think that’s pretty impressive

When I was 16, I was diagnosed with osteoarthritis and patellofemoral syndrome of the right knee. I had torn the meniscus in my right knee while playing Capture The Flag.

An orthopedic surgeon implanted three meniscal arrows because the damage was so bad, but unfortunately my knee became septic and I was hospitalized with intravenous antibiotics for a month.

This caused the muscles in my right leg to atrophy and my kneecap to dislocate and grind against the femur.

The surgery helped my knee move properly again even though it became infected, and physiotherapy helped me regain muscle strength. Those procedures, however, did nothing to solve my pain.

After I did seven acupuncture treatments, the pain went away and I had no problems for seven years. It helped me so much that I decided to study acupuncture so I could help others in similar situations.

I continue to get acupuncture periodically when my symptoms flare.

As you can see, I think acupuncture is amazing for osteoarthritis, but don’t just take my word for it.

Research also shows that acupuncture is a great option to help you manage osteoarthritis symptoms. Living with this chronic condition doesn’t mean that you have to suffer with daily pain.

For a detailed summary of the evidence for acupuncture please see the report by John McDonald and Stephen Janz: The Acupuncture Evidence Project: A Comparative Literature Review (Revised Edition).

For additional research on acupuncture for osteoarthritis, please visit the British Acupuncture Council website.

Michael Côté is a Registered Practitioner of Traditional Chinese Medicine. He can be reached at the Okanagan Acupuncture Centre at 1625 Ellis St. in downtown Kelowna.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.