Overview – Knee Osteoarthritis
Background: Osteoarthritis is the leading cause of disability in working individuals above 50. In some cases, conventional treatments produce mild and brief pain reduction. However, medications often have adverse effects. Traditional Chinese Medicine (TCM) integrates several therapeutic approaches, including acupuncture, which has shown effective results in treating knee and hip osteoarthritis, minimizing pain, improving functionality, and leading to a better quality of life.
Methods: The present case study included two patients with knee pain due to osteoarthritis. Over the course of six weeks, practitioners treated these patients with acupuncture once a week for thirty minutes, utilizing four local acupoints. Before and after each session, providers performed pain and mobility assessments.
Results: The results were positive, with significantly reduced pain and increased knee joint flexion amplitude and mobility.
Conclusion: Acupuncture was effective as an alternative treatment for knee osteoarthritis, with high levels of improvement over a short period of time.
What is Osteoarthritis?
Osteoarthritis is a chronic degeneration of the joints and is a common condition as we age, sometimes leading to disabling pain and joint dysfunction. Clinically, osteoarthritis manifests as pain, typically with a gradual onset that worsens over time. The condition features swollen joints, morning stiffness, muscle atrophy, narrowing of the joint space, and spur and cyst formation.
Osteoarthritis of the knee is a complex condition that includes systemic disease, constitutional factors, and biomechanical factors. Interestingly, women have a higher incidence and severity due to the effect of hormones. Fluctuations of estrogen and progesterone in young women and loss of these hormones during menopause contribute to the differences in gender prevalence.
Western Treatment of Osteoarthtis
Allopathic medicine typically treats knee osteoarthritis conservatively or surgically. Conservative treatment includes:
- Pain medication
- Physical therapy
- Patellar taping
- Walking aids
- Thermal agents
- Weight loss
- Tai Chi
- Swimming
- Water aerobics
- Resistance exercises
The American College of Rheumatology recommends most of the previous non-pharmacological approaches in the initial stages of the disease.
In addition, common interventions include analgesics, anti-inflammatories, and corticosteroids. Doctors prescribe medications like glucosamine, chondroitin, acetaminophen, oral and topical NSAIDs, tramadol, intraarticular corticosteroid injections, duloxetine, and opioids. In addition, physical therapy and occupational therapy can also help control pain, improve joint function, and improve quality of life. Surgical options include joint-preserving and joint-replacing.
Adverse Effects of Western Treatment
Although conventional approaches have their merits, one cannot ignore the adverse side effects such as toxicity, anesthesia complications, and infection. That’s where acupuncture shines as an alternative therapeutic approach for knee osteoarthritis conditions. Acupuncture delivers consistent results in pain reduction and rehabilitation of motor abilities, improved functionality, and quality of life.
And now, acupuncture is accepted among the medical community as a legitimate medical procedure with significant analgesic and anti-inflammatory effects. In addition, acupuncture is considered superior to a placebo in randomized controlled trials. However, even with studies corroborating its benefits, there is still a debate within the scientific community regarding how acupuncture works.
Knee Osteoarthritis Case Study
This knee osteoarthritis case involved two patients suffering from knee osteoarthritis with constant pain. The research team evaluated the effectiveness of acupuncture as a treatment procedure, using a protocol based on the needling of four local acupoints to treat pain and increase joint mobility. Researchers selected the patients in this knee osteoarthritis case study according to the following inclusion and exclusion criteria.
Inclusion criteria included:
- Clinical signs of osteoarthritis
- Diagnosis of knee pain
- Mobility issues
- Impairment in daily living activities (such as going up and down stairs)
Exclusion criteria included:
- Pregnancy and lactation.
- Psychiatric or neurological disorders.
- The presence of inflammatory autoimmune disease.
- A history of substance abuse.
Patients in the Knee Osteoarthritis Case Study
Subject A was a 46-year-old woman, formerly a cook in a private hospital, currently unemployed, with acute pain in the knee and signs of osteoarthritis detected by imaging tests. She began acupuncture to address intense pain and loss of mobility. The patient used crutches during the rehabilitation period.
Subject B was a 56-year-old woman, formerly a secretary, currently unemployed, suffering from knee osteoarthritis. She had fallen down a flight of stairs in December 2010 and had two surgeries (2010 and 2012). The patient took pain medication daily and decided to start acupuncture after two years of constant pain and mobility problems.
Acupuncture Treatment for Knee Osteoarthritis
The intervention consisted of six 30-minute acupuncture sessions spaced one week apart. The researchers evaluated pain levels before and after the treatment with a numeric pain rating scale. This scale is frequently used in adults with chronic pain and is scored by choosing a number between 0 (no pain) and 10 (extreme pain). In addition, researchers performed the mobility range tests at the beginning and 10 min after each session.
A qualified TCM practitioner performed the acupuncture treatments, and the points used in this study included: ST34 Liang Qiu, ST36 Zu San Li, SP9 Yin Ling Quan, and SP10 Xue Hai.
Knee Treatment Results
Subjects A and B reported clear improvements in their condition as their acupuncture treatments progressed (pain scores dropped from 9.5 to 2 and from 9 to 1 in subjects A and B, respectively). These promising results allowed them to stop taking conventional medication for pain.
Other authors have often reported the analgesic effect of acupuncture. These effect can be induced by local tissue stimulation, resulting in the release of inflammatory-related substances, vasodilatation, and the increase of serotonin and immune cells. In addition, , as well as by a hypothalamus activation and related endorphins release.
Subjects A and B experienced increased mobility and range of motion following treatment in this knee osteoarthritis case study. In addition, knee flexion increased from 45° with pain to 160° without pain in subject A and from 90° to 160° in subject B. In this process, subject A abandoned the use of crutches.
Assessing Pain in the Subjects
Regarding pain, Subject A experienced the most significant improvements during weeks 1 through 3, averaging 36% relief each time, with a final gain of 79%. Subject B improved 47% each time, with an overall improvement of 89%. One week after each treatment, Subjects A and B had average regressions in pain of 19% and 29%, respectively.
Regarding knee joint flexion, Subject A started worse than Subject B. Subject A experienced a 50% improvement in mobility immediately after the first session and continued improvement over the following five treatments. The average per-session and overall improvement percentages were 29% and 72% for Subject A and 13% and 42% for Subject B.
Considering that Subject B’s condition was better, the improvements per session were not as significant as Subject A’s and remained almost stable during the experimental period. However, researchers noticed regressions one week after each session in knee flexion, with scores falling on average 17% and 6% for Subjects A and B, respectively.
Excellent Results
The overall assessment of pain relief and knee flexion improvements presented in this knee osteoarthritis case study is highly satisfactory. Patients achieved high improvement percentages, averaging 84% for pain and 57% for joint flexion mobility within a modest intervention period of six weeks.
Knee flexion mobility per session (an average of 21%) was higher than the outcomes reported in similar studies showing only 9% in one and 16% in another. Although the beneficial effects of acupuncture are shown here in just two patients, and the small sample can skew results, our study supports the thesis that acupuncture is an effective therapeutic tool in treating knee osteoarthritis.
Conclusions
The investigators in this knee osteoarthritis case study found that acupuncture effectively brought significant pain relief and improved knee joint mobility. The two subjects initially presented with extreme pain (9.5 and 9 out of 10 on the pain scale) and reduced joint flexion amplitude (45° and 90°). However, the total pain relief achieved through acupuncture was 79% and 89% for subjects A and B, respectively. Regarding mobility and range of motion, they also experienced considerable improvements in knee flexion angles from 45° to 160° in subject A (a gain of 72%) and 90° to 155° in subject B (an improvement of 42%).
These outcomes are an excellent example of a successful intervention that can contribute to the debate about the methodological standardization of acupuncture in treating knee osteoarthritis.
Next Steps
At Raleigh Acupuncture, we’ve successfully treated knee pain quite similar to the patients in this knee osteoarthritis case. So try acupuncture and see how to overcome arthritis pain safely and naturally.
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Reference
Teixeira J, Santos MJ, Matos LC, Machado JP. Evaluation of the Effectiveness of Acupuncture in the Treatment of Knee Osteoarthritis: A Case Study. Medicines. 2018; 5(1):18. https://doi.org/10.3390/medicines5010018
Focus Keyphrase: Knee Osteoarthritis Case
Photo by Marcus Aurelius: https://www.pexels.com/photo/woman-in-red-knit-sweater-sitting-by-the-table-4063788/
What our Clients are Saying
My knees were so bad with arthritis that I couldn’t play golf. My wife did research on the internet and said acupuncture might help. I went in not expecting much. He told me it would take three to six treatments to see if it would work. My case was tougher because I’m overweight. Sure enough, after five treatments the pain started easing. I needed twelve treatments total, but my knees improved so much I’m playing golf again. I go in for what he calls tune-ups every month, but I don’t mind. The acupuncture keeps my knees not hurting. I’ve recommended it to my golf buddies and they’ve had success as well.
Raleigh Acupuncture was recommended by a friend after I mentioned my insomnia and dependency on a sleeping pill. My apprehension was short lived because of the results of my visits to Dr. Mark. With acupuncture treatments and Chinese herbs I was able to begin sleeping well and continue to do so. Dr. Mark is a good listener and encourages his patients in all health issues as well as the original purpose for treatment. Consequently, my knees are stronger and I’m walking better and with more confidence. I haven’t had the need for a cortisone shot in a year and a half. Occasionally, I would use a cane and it’s now somewhere gathering dust. Also, I had a persistent headache that my primary physician had no solution for, and after two acupuncture treatments it’s a thing of the past. Hot flashes were another issue that was treated successfully. I am so grateful to have found a knowledgeable and caring person to treat my ailments, many of which I thought would only grow worse as I aged. Generally, I feel healthier.
I had been getting botox injections for my face over the past five years, and it worked well. But a friend said that acupuncture could get more lasting results in a more natural way. I inquired at Raleigh Acupuncture and was surprised at how affordable it was. They explained that as an added bonus, I would receive acupuncture to help other issues at the same time that they treated my face. So I took the opportunity to deal with some arthritis in my hands and a bad knee. The facial rejuvenation was amazing. It happens over the course of 12 weeks and I literally saw wrinkles disappear! After each treatment I felt so relaxed. I’m hooked on acupuncture now, both for my face and the rest of me. The staff at Raleigh Acupuncture are very professional, friendly and skilled. I felt safe and comfortable during each visit.
I love to play golf, that’s my passion. But I’m overweight and my knees hurt so bad I couldn’t even walk the course. My wife told me to try acupuncture. These guys were straight with me, said to try six treatments to see if my knees would respond. I’ll tell you, nothing happened at first. But, by the sixth treatment my knees starting feeling better. I got six more treatments after that and now I’m playing golf again. They don’t hurt so much any more. From a 10 out of 10, now they’re at a 3. I can live with that.
My knees were so bad I couldn’t walk down the stairs without holding on to the railing for dear life. I’m also deathly afraid of needles. So they used extra tiny needles on my knees and in three treatments my knee pain was gone. Incredible! I highly recommend Raleigh Acupuncture for anyone with knee pain.
This was my first time trying out acupuncture. I had a great experience and was made to feel very comfortable with the whole process. The treatment I received on my knee definitely helped with my tendinitis. I would recommend Raleigh Acupuncture to anyone.
All of my joints were hurting. I’ve got fibromyalgia and it effects me by making my joints hurt. The pain would move around from place to place, first the hip, the next day the shoulder, then the knee, etc. The practitioner at Raleigh Acupuncture explained that the best way to treat my kind of moving joint pain was to treat me holistically. Instead of treating the hip one day, the shoulder the next, they treated the root of the pain. They said this type of treatment would also improve my mood and my sleep. Right on all counts. I started feeling better after the second treatment. It’s like all of the joints just settled down and stopped giving me trouble. I had less flares and the intensity of the pain went way down. My sleep is better, not just because I have less pain. I’m more relaxed and less stressed. I’ve made this treatment a regular part of my life. I’m very grateful.
I had terrible pain in my hands from arthritis, especially my thumbs. I could not even open a jar anymore – there was no strength. My neighbor was seeing an acupuncturist at Raleigh Acupuncture, so I made an appointment. They were so sweet. I was apprehensive about the needles, but they told me they would use extra small ones, which I hate to admit, but I couldn’t even see without my glasses. They put needles in my hands, arms and in different places on my legs as well. I believe it made a substantial difference. My hands stopped hurting all the time and my grip strength increased. My thumbs still give me some trouble, but not nearly like before. I’d say I am 80% improved with my arthritis. Now I have all of my friends going to them!
