One of several nondrug pain treatments for arthritis, acupuncture involves inserting fine needles into specific points on the body. The goal is to correct imbalances in the flow of life energy – called chi or qi – thereby stimulating healing. Traditional Chinese medicine describes more than 2,000 acupuncture points (acupoints) connected to 12 main energy channels.
In the West, acupuncture is mainly associated with pain relief, but the 3,000-year-old practice is a complex and comprehensive system of medicine that emphasizes healing the mind and spirit as well as the body.
Acupressure, based on the same principles as acupuncture, uses gentle but deep hand pressure instead of needles to manipulate acupoints and the energy channels associated with them. Shiatsu, a Japanese form of acupressure, may use kneading, stretching and hand pressure to achieve results.
Acupuncture’s more subtle effects – such as feelings of balance, calm and wellbeing – are nearly impossible to measure, so Western research has focused mainly on pain relief. Most early studies were small and of poor quality, leading many researchers to dismiss any benefit as a placebo effect – that is, patients got better simply because they believed the treatment would help.
Then, in 2012, an international team of scientists published results of a rigorous meta-analysis of information from 29 high-quality acupuncture studies involving nearly 18,000 patients. The analysis showed that acupuncture effectively relieved pain in several chronic conditions, including osteoarthritis (OA). Lead author Andrew J. Vickers, PhD, a biostatistician at Memorial Sloan Kettering Cancer Center in New York City, says the study proved the benefits of acupuncture are real, “not some placebo effect.”
Another meta-analysis published in Osteoarthritis and Cartilage in 2013 found that acupuncture was significantly better at relieving OA knee pain than either standard care or exercise.
Some research has also focused on how acupuncture works. In the U.K., a team of scientists led by Hugh MacPherson, PhD, an acupuncturist and senior research fellow at the University of York, used MRI scans to study the brains of people undergoing acupuncture. The tests showed that needling decreased blood flow and neuronal activity in the part of the brain that processes pain. Still other studies suggest that acupuncture may reduce pain and inflammation by influencing the immune system and triggering the release of endorphins – the body’s natural painkillers.
David Canzone, a diplomate of acupuncture and doctor of Oriental medicine who is board-certified in acupuncture orthopedics, has been practicing in Sante Fe, N.M., for 25 years. Many of his patients have OA, and he figures a third of them will eventually need a hip or knee replacement. But, he says, “I’ve had many patients postpone surgery for a number of years because we’re able to control their pain and inflammation. We’re also usually able to limit the amount of pain medication they take, and that’s significant.”
Find a Practitioner
Both Canzone and Skow stress the importance of working with a trained and experienced practitioner. Diplomates of acupuncture have at least four years of academic training at the master’s level, must pass rigorous exams, and meet state licensing and continuing education requirements.
Ideally, Asian bodywork therapists, such as acupressure and shiatsu therapists, should hold two certifications: certified practitioner (CP), The American Organization for Bodywork Therapies of Asia (AOBTA); and diplomate in Asian Bodywork Therapy (ABT), National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).
Information on certified Asian bodywork therapists and acupuncturists is available on the AOBTA and NCCAOM websites.
Author: Linda Rath for the Arthritis Foundation