If you are over 40 year old female and you are overweight with knee disease history, you are at great risk of having knee osteoarthritis.You could have pain and swelling in your knee and the pain is accompanied with stiffness and restricted movement. You could have grinding feeling when you move the knee. Osteoarthritis (OA) of the knee is the most common disabling condition and major cause of chronic pain. Knee pain or osteoarthritis affects 25% of people older than 55 year old and one third of populations over 65’s. There is a clear link between knee osteoarthritis and obesity. This may be due to mechanical, hormonal and genetic factors involved. Weight loss has benefit for reducing knee pain associated with knee osteoarthritis in those overweight.
Painkillers are common drugs used to reduce pain. Pharmacological therapies have limited applications because of either gastrointestinal side effects or cardiovascular risks. Research showed that muscle weakness is associated with knee pain, physical dysfunction and progress of the disease. Strengthening muscle is an important aspect of the treatment. Muscle strengthening and aerobic exercises are beneficial for reducing pain and improving physical function in patients with mild to moderate knee osteoarthritis.
Non pharmacological therapies for knee pain are increasingly popular. Complementary therapy is a major part for treatment of knee osteoarthritis. Acupuncture is one of the most commonly used applications and is very effective complementary treatment for knee osteoarthritis. Its use for relieving knee pain is supported by many research data. Lansdown H from the University of York UK performed a pilot study for a randomized control trial to compare effectiveness of acupuncture and usual care for knee osteoarthritis. 10 sessions of acupuncture was given to patients in acupuncture group on weekly basis. They found acupuncture has significantly better effect than usual care in patients with knee osteoarthritis. Corbett MS et al also from the University of York UK compared the effectiveness of acupuncture with other relevant physical treatments for reducing pain caused by knee osteoarthritis. They analysed 114 randomised controlled trials in patients with osteoarthritis of the knee pain. The trials covered 22 treatments and 9709 patients. Compared with standard care, there were eight interventions produced a significant reduction in pain. These interventions were interferential therapy, acupuncture, TENS, pulsed electrical stimulation, balneotherapy, aerobic exercise, sham acupuncture, and muscle-strengthening exercise. Most good quality studies showed that both acupuncture and muscle-strengthening exercise were significantly better than standard care, with acupuncture being significantly better than muscle-strengthening exercise. They concluded that acupuncture can be considered as one of the more effective physical treatments for reducing osteoarthritis knee pain in the short term.
Recently there was more data showing the effectiveness of acupuncture on the treatment of knee osteoarthritis. This research compared the efficacy of different acupuncture methods at different stage of pain development. Patients in stage treatment group were received acupuncture at the tendon points of meridians and electric thermal needling method at the stagnation stage, small needling-knife therapy and bleeding method at the fascia cramp stage and electric thermal therapy with thick silver needles at the tendon lesion stage. Patients in electroacupuncture group received electroacupuncture at all three stages at specific acupoints. They found the total effective rate was 96.1% in the staging treatment group and was 91.1% in the electroacupuncture group. The controlled and remarkably effective rate was better in stage treatment group than that in electroacupuncture group which was also effective.
Cao L et al analysed 14 randomised control trials from July to October 2011, involving 3835 patients with knee osteoarthritis. They found that acupuncture has significantly better effects on reducing pain and restore joint function both in the short term and long term compared to sham acupuncture or standard care.
Acupuncture was shown to be effective in treating knee osteoarthritis, but there was still a debate if it is a specific effect or non specific effect. There is a research report about acupuncture in osteoarthritis of the knee. A new research was just published about acupuncture on knee osteoarthritis. This was a double-blinded randomised trial to identify specific and non specific effects of acupuncture on osteoarthritis of the knee by Karner et al from Heidelberg University Hospital Germany. Karner et al recruited 160 patients aged from 35-82 with knee osteoarthritis in three study centers. These patients were double-blindedly allocated into three groups: classic Chinese acupuncture group, modern acupuncture group and non specific needling. Knee flexibility and pain sensation were tested to measure the effectiveness of the treatment. Their result showed that improvement of knee flexibility was the highest for Chinese acupuncture among three groups, following by modern acupuncture. Pain relief for Chinese acupuncture was also the highest among these groups which was 73% for classic Chinese acupuncture, 64% for modern acupuncture and 48% for non-specific needling. They suggested that there was a specific effect of acupuncture in knee mobility and both non-specific and specific effects of needling in pain relief.
The question is that how many acupuncture treatments are enough to reduce knee pain? How frequent do you need to receive acupuncture treatment? The effects of acupuncture will depend on the stimulation intensity, frequency and repetition, and neurological level at which it is given. The precise location of the needles may less important. How much acupuncture treatment for knee pain is adequate? White A et al reviewed 13 studies. They defined that adequate acupuncture treatment consisted of at least 6 treatments, at least one per week, with at least four points needled for each painful knee for at least 20 minutes; needle sensation achieved in either in manual acupuncture, or electrical stimulation of sufficient intensity to produce more than minimal sensation. They found evidence that acupuncture that meets the adequate criteria is superior to sham placebo for treating chronic knee pain, in both the short term and long term. The results are reliable because the conclusions were drawn from high quality studies of reasonable size from different research groups.
Both manual and electroacupuncture helps knee osteoarthritis
There are a few types of acupunctures, are they all effective for knee pain or some types of acupuncture have better effects than others?
Electroacupuncutre and manual acupuncture are commonly used. Electroacupuncutre is a type of acupuncture which a small electric current is conducted between a pair of acupuncture needles inserted into the skin, while manual acupuncture is that only needles are inserted into the skin without using electric current. Many people think that effect of elecroacupuncture was better than manual acupuncture on knee osteoarthritis, is there any evidence for that? The answer is no. A recent study compared immediate effects of electroacupuncture and manual acupuncture on pain mobility and muscle strength in patients with knee osteoarthritis. They found that both electroacupuncture and manual acupuncture showed a significant reduction in pain intensity and time to run the TUG test after the acupuncture treatment. There were no differences between the groups regarding pain intensity, TUG test, maximum voluntary isometric contraction or pressure pain threshold. They concluded that this study found no difference between the immediate effects of a single session of manual acupuncture and electroacupuncture on pain, muscle strength and mobility in patients with knee osteoarthritis.
There was another study about evaluation on knee osteoarthritis treated with acupuncture. In this study there was 193 patients with knee osteoarthritis involved. After4 weeks of acupuncture treatment joint pain was reduced significantly and joint function was improved significantly as well. The effect was evaluated 4 week after termination of the treatment. This effect last at least 4 week after the termination of treatment. The acupuncture points used in this study include The acupoints in the two groups were Liangqiu (ST 34), Dubi (ST 35), Zusanli (ST 36), Yanglingquan (GB 34), Yinlingquan (SP 9), Xuehai (SP 10), Xiyan (EX-LE 4), Xiyangguan (GB 33).
Case report, knee pain with acupuncture treatment
Though long term effect of acupuncture in treating osteoarthritis is to be confirmed, there are many cases in which long term benefit can be seen clinically. For example Mary was 51, she had knee pain for a few years and she was diagnosed osteoarthritis. Her knee pain was getting worse in winter and getting better in summer. She had difficulty to climb stairs. In last winter, her knees were extremely painful and she hardly walked without pain. She decided to seek help from acupuncture. After first session of acupuncture, she felt less pain. With continuing a few sessions of acupuncture her knee pain was completely gone. A year on another winter arrived, she still did not have any pain on her knees.
Acupuncture reduced pain in patients with osteoarthritis by altering brain cortical thickness and brain activity
Osteoarthritis (OA) is a major health problem among the elderly and is associated with considerable disability. Recent research data have suggested that knee OA patients can benefit from acupuncture treatment. Some studies have shown that acupuncture may produce an analgesic effect through the endogenous descending pain modulatory system. Brain imaging studies have also shown that acupuncture needle stimulation can evoke widespread brain activity changes and modulate the functional connectivity of the pain processing network. A recent research has studied the effect of acupuncture on patients with knee osteoarthritis. Each patient received a total of 6 acupuncture treatment sessions in one month (twice per week for the first two weeks, once per week for the last two weeks). Result has shown that pain reduction in acupuncture group was significantly higher than that for control group. Daily living and quality of life showed significant improvement in acupuncture group compared to control group. Cortical thickness remained static in acupuncture group and decreased in control group. There was significantly stronger brain connectivity in acupuncture group compared to control group. This study has shown that acupuncture treatment can significantly modulate cortical thickness, functional connectivity, and clinical pain rating in OA patients. These results suggest that acupuncture may achieve its therapeutic effect on knee OA pain by preventing cortical thinning and decreases in functional connectivity in major pain related areas, therefore modulating pain in the descending pain modulatory pathway.
Sridhar MS, et al J Bone Joint Surg Br. (2012) 94:433-40.
Iwamoto, Jun et al World J Orthop (2011) 2: 37-42
Lansdown H et al BMC Musculoskelet Disord. (2009) 24;10:130.
Cao L, et al Saudi Med J. ( 2012) 33:526-32.
Corbett MS et al Osteoarthritis Cartilage (2013) 21:1290-8
Cheng Y et al Zhongguo Zhen Jiu (2013) 33 :508-12
Karner M et al Evid Based Complemennt Alternat Med (2013): 2013:427265
White A et al Rheumatology (2007) 46:384-390
Plaster R et al Acupunct Med (2014) Feb 24. doi: 10.1136/acupmed-2013-010489
Chen X et al Sci Rep (2014) 4:6482
Welcome to my blog
Acupuncture specialist for Fertility, Facial rejuvenation, Pain relief.
Based at Kensington and Harley Street Central London.Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Over 25 year research and clinical experiences
Doctor who is passionate about acupuncture
I love what I do, I am good at it and I am always there for my patients. If you come and see me, you will know why I am standing out.
This blog is to introduce latest development and research of acupuncture and offer a chance of awareness of more treatment options for your condition. The blog is for information purpose only.
- My specialised areas include fertility, facial rejuvenation, acne, various pain conditions, chronic fatigue, menopause and hormone regulation with acupuncture treatment.
Practice contact for appointments and addresses
Kensington: for appointments at Anamaya center Kensington (Mondays, Tuesdays, Thursdays, Fridays, Saturdays) please call at 02030110355 or email at email@example.com
Address: 1 Adam and Eve Mews, Kensington, London W8 6UG
2 min walk from High Street Kensington underground stationHarley Street: for appointments at Harley Street (Wednesdays) please call ALO clinic at 02076368845 or email at firstname.lastname@example.orgAddressSuite 3 Harmont House20 Harley Street, London W1G 9PH5 min walk from Oxford Circus underground stationMy background: I became a qualified medical doctor 25 years ago in Western medicine in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Particularly I was trained with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. Furthermore I had training in dermatology and oral and maxilofacial surgery in China. I am dedicated to treat patients with acupuncture and am recognized as one of the world leading acupuncture specialists.
I obtained a PhD degree in the University of Leeds in the UK.
I had post doctoral training and worked as a senior researcher in St George's hospital, London, UK.
I had frequently presented my research findings in the top international conferences in the field.
I have many publications including ebooks and articles.
I have many year clinical experiences. Over the years of practicing, I have developed unique treatment approaches for infertility, skin aging, acne, vulvodynia, neck pain, headache, migraine, shoulder pain, back pain, fatigue, hot flushes, Parkison's disease etc to achieve best treatment results. My devotion and skills are highly praised by my patients. These are examples that my patients say.
- My books--Know your ovary to get pregnant
- ----------------Get pregnant fast naturally
- ----------------Facial Aging, Facial Rejuvenation Acupuncture
- ---------------Acne treatment with acupuncture
- ---------------Vulvodynia, is vulval pain in your mind?
- ---------------Energy, fatigue and acupuncture
- ---------------Headaches, Neck pain and Shoulder pain