After a spate of disconcerting studies about the safety of popular painkillers, there is finally some good news for arthritis sufferers: New research shows that acupuncture works almost as well to relieve pain as expensive drugs like Vioxx and Celebrex.
The study, one of the largest and most elaborate scientific trials ever conducted on an alternative therapy, found that treating patients suffering from osteoarthritis of the knee with acupuncture reduced their pain by about 40 per cent and improved joint movement by almost 40 per cent, when used in conjunction with regular pain drugs.
A second unrelated study found that treating arthritis of the neck with acupuncture was also effective, although the reduction of pain, about 12 per cent, was more modest.
"Traditional Chinese acupuncture is safe and effective for reducing pain and improving physical function in patients with symptomatic knee osteoarthritis," said Dr. Brian Berman, director of the Center for Integrative Medicine at the University of Maryland in Baltimore, Md.
He stressed that acupuncture treatment -- the practice of inserting very fine needles into the skin to stimulate pain relief -- was offered in addition to drug treatments, not as a replacement.
Dr. Berman said that previous studies had given mixed results on the benefits of acupuncture but, in this instance, the research team went to great pains to distinguish between real benefits and the placebo effect -- the belief among patients that a treatment is helpingthem.
In this case, some of the patients were given "sham" acupuncture; they believed they were getting the treatment, but the needles were taped to their skin, not inserted. While they reported suffering less pain than patients who got nothing, the genuine acupuncture patients reported much better pain relief.
Dr. Marc Hochberg, a co-author of the research, noted that no treatment provides complete relief from osteoarthritis pain. He added that acupuncture has a "small but clinically important effect" and works as well as other methods currently available.
To put it in perspective, he noted that other studies have shown the acetaminophen (best known by its brand name Tylenol) reduces pain by about 20 per cent. When acupuncture is added, the benefit is doubled, with pain being reduced by 40 per cent.
Non-steroidal anti-inflammatories, ranging from ibuprofen (Advil, Motrin) through to cox-2 inhibitors (Vioxx, Celebrex), reduce pain in the 30 per cent range.
In the new research, published in today's edition of the Annals of Internal Medicine, patients who received acupuncture for arthritis of the knee had virtually no side effects from the treatment. Acupuncture is also cheaper than cox-2 inhibitors.
Dr. Stephen Straus, director of the National Center for Complementary and Alternative Medicine at the U.S. National Institutes of Health, stressed, however, that the benefits of acupuncture need to be kept in perspective and alternative therapies need to be judged with the same scientific rigour as mainstream treatments.
"Just because acupuncture is 2,000 years old doesn't mean it's magic," he said. "It seems to afford some additional benefits but running to the acupuncturist today isn't going to cure you of this problem today. Osteoarthritis is a chronic disease."
The knee arthritis study involved 570 patients whose average age was 65. They received 23 acupuncture sessions -- with half getting real treatment and the balance sham treatment.
The neck arthritis study involved 135 patients who received eight acupuncture sessions -- again with half getting real treatments and the others mock treatment.
More than four million Canadians -- one in six adults -- suffer from arthritis, a degenerative join condition.
In recent weeks, the popular painkiller rofecoxib (sold under the brand name Vioxx) has been withdrawn from the market after studies showed it increased the risk of heart disease. Serious questions have also been raised about the safety of its principal competitors, celecoxib (Celebrex) and valdecoxib (Bextra).
While these drugs never provided more effective pain relief than much cheaper alternatives like ibuprofen, they were touted as causing fewer gastric bleeds and heavily marketed to physicians and patients as safer.