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Acupuncture and Arthritis

Studies haven’t confirmed acupuncture helps arthritis, but it still may be worth trying.

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It’s been about 2,000 years in the making, but acupuncture has finally gained at least some mainstream acceptance as a medical modality. Research offers limited, but promising, evidence that acupuncture can help with arthritis symptoms.

The theory of acupuncture goes something like this: An essential life energy called qi (pronounced “chee”) flows through the body along 20 invisible channels called meridians. When the flow of this energy is blocked or out of balance, illness or pain results. More than 2,000 acupuncture points connect to the meridians. Stimulating those points with needles, it is said, will correct the flow of qi and alleviate pain.

Acupuncture diminishes pain by “untying muscular straitjackets – releasing tight, spasmed, shortened muscles to their resting state,” explains Tim Rhudy, an acupuncturist practicing in Delmar, New York. It also helps stimulate the release of natural pain-fighting endorphins.

Yet these benefits have been hard to prove, because high-quality studies on the subject of arthritis and acupuncture have been limited. Here’s a look at some of the recent research that has been done:

  • OA. Like previous research, a 2014 study in JAMA found people who had acupuncture had slightly less pain compared with those who had no treatment. The authors concluded the results weren’t significant enough to support recommending acupuncture. Yet for patients in pain, even a limited benefit might be enough to justify trying the treatment.
  • RA. Studies on acupuncture for RA have largely been of poor quality. They haven’t been able to prove the treatment offers any significant improvement in joint swelling, damage, or other measures of the disease. However, acupuncture may help certain people with their pain.

  • Fibromyalgia. In a 2014 review article in Journal of Traditional Chinese Medicine, researchers analyzed the results of nine studies on acupuncture for fibromyalgia. Though a few studies found acupuncture worked better than drugs to manage the condition, most of the studies weren’t well designed. The authors concluded there wasn’t enough evidence to prove acupuncture works better than placebo. They say more research is needed.

Some experts question whether pain relief noted in the studies is real or the result of a placebo effect – patients feeling better simply as a result of having needles applied to their skin. In a 2012 meta-analysis of studies published in JAMA Internal Medicine, researchers found real acupuncture was more effective than placebo at treating chronic pain – but only slightly so; 50% of acupuncture patients said their pain improved by half or more compared, to 42.5% of patients receiving placebo treatments.

Other doctors say that even if acupuncture’s benefits are largely due to a placebo effect, it still could be worth trying. Growing research suggests that fake needles and other placebos may prevent pain signals from reaching the brain and promote other biological changes that could relieve symptoms of osteoarthritis and other conditions.

“If I’m suffering chronic pain and someone offers me an intervention that will improve my symptoms, I’d be thinking, ‘Of course I want that,’” says Andrew L. Avins, MD, a clinical professor of medicine at the University of California, San Francisco. “If our ultimate goal is to help patients achieve their goals, the mechanism is not all that relevant.”

How much of a benefit you receive may depend on the severity of your arthritis, and how often you get treated, Rhudy says. Yet multiple sessions may not be cost effective, considering that acupuncture prices can range from $75 to $200 per session. Medicare and Medicaid won’t cover the cost, but some private health insurance companies will pay, at least to some extent. “Many U.S. insurers do provide some acupuncture coverage,” says C. James Dowden, executive administrator of the American Academy of Medical Acupuncture. “But what conditions they cover vary.”

If you do try acupuncture, ask your doctor to recommend a certified provider. You can also search for an acupuncturist in your area through the National Certification Commission for Acupuncture and Oriental Medicine.

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