PEARLS No. 245, April 2010, written by Brian R McAvoy

Clinical question
How effective is acupuncture for treating peripheral joint osteoarthritis (OA)?

Bottom line
Overall, the studies suggest people with OA find meaningful benefits from acupuncture, although these benefits may be largely mediated through placebo effects. People who received acupuncture had a 1 point greater improvement in pain on a scale of 0Ð20 after 8 weeks (5% absolute improvement), and a 1 point greater improvement after 26 weeks (2% absolute improvement). For physical function, acupuncture produced a 3 point greater improvement after 8 weeks (4% absolute improvement), and a 1 point greater improvement after 26 weeks (2% absolute improvement).  

Caveat
Sham-controlled trials showed statistically significant benefits; however, these benefits were small, did not meet pre-defined thresholds for clinical relevance, and were probably due at least partially to placebo effects from incomplete blinding. Possible side effects of acupuncture treatment include minor bruising and bleeding at the site of needle insertion.  

Context
OA is a major cause of pain and functional limitation. Few pharmacological treatments are safe and effective. The objective of this review was to compare the effects of traditional needle acupuncture with a sham, another active treatment, or with a waiting list control, for people with OA of the knee, hip or hand.  

Cochrane Systematic Review
Manheimer E et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Reviews 2010, Issue 1. Article No. CD001977. DOI: 10.1002/14651858.CD001977.pub2. This review contains 16 studies involving 3498 participants.