Objectifying Specific and Nonspecific Effects of Acupuncture: A Double-Blinded Randomised Trial in Osteoarthritis of the Knee


Introduction:  Acupuncture was recently shown to be effective in the treatment of knee osteoarthritis. However, controversy persists whether the observed effects are specific to acupuncture or merely nonspecific consequences of needling. Therefore, the objective of this study is to determine the efficacy of different acupuncture treatment modalities. 

Materials and Methods:  We compared between three different forms of acupuncture in a prospective randomised trial with a novel double-blinded study design. One-hundred and sixteen patients aged from 35 to 82 with osteoarthritis of the knee were enrolled in three study centres. Interventions were 1.) individualized classical acupuncture, 2.) modern semi-standardized acupuncture, and 3.)non-specific needling.  Blinded outcome assessment comprised knee flexibility and changes in pain according to the WOMAC score. 

Results and Discussion:  Improvement in knee flexibility was significantly higher after individualized classical Chinese acupuncture (10.3 degrees; 95% CI 8.9 to 11.7) as compared to modern semi-standardized acupuncture (4.7 degrees; 3.6 to 5.8).  All methods achieved pain relief, with a patient response rate of 48 percent for non-specific needling, 64 percent for modern semi-standardized acupuncture, and 73 percent for individualized classical acupuncture.

Conclusion:  This trial establishes a novel study design enabling double blinding in acupuncture studies. The data suggest a specific effect of acupuncture in knee mobility and both non-specific and specific effects of needling in pain relief.

Plain Talk Commentary:  This unique study compared 3 groups of acupuncture, with the group performing the best - offering the most relief - being the individualized care group.  The fake-point and standardized (all patients had the same points needled) groups also relieved, but less so. The real strength of Chinese medicine, no matter the modality - eg. acupuncture, moxibustion, or Chinese herbal medicine - is our highly individualized approach to treatment, which this new study clearly validates.


Max Karner, Frank Brazkiewicz, Andrew Remppis, et al; Evidence-Based Complementary and Alternative MedicineVolume 2013 (2013), Article ID 427265

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