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Osteoarthritis of the Knee and Acupuncture

As the cold winter sets in some of you may find that those knees have become a little bit achy. The term arthritis is often mentioned when such aches and pains begin to surface over time. This is a condition that we treat regularly here at Mount Merrion Physiotherapy. Let’s look at a bit more detail into the meaning of the term 'osteoarthritis'.

Osteoarthritis refers to a clinical condition of joint pain accompanied by varying degrees of functional limitation and reduced quality of life. It is the most common form of arthritis and one of the leading causes of pain and disability worldwide. Knees, hips and small hand joints are most commonly affected. Although pain and reduced function are common signs of osteoarthritis, structural changes often occur without the presence of such accompanying symptoms. Contrary to popular belief, osteoarthritis is not caused by ageing and does not necessarily deteriorate over time

So what exactly is osteoarthritis?

It is a metabolically active repair process that takes place in all joint tissues and involves localised loss of cartilage and remodelling of adjacent bone. Joint trauma, whether it is due to a specific incident or gradual wear and tear, may trigger the need for this repair process. Osteoarthritis often compensates for the initial trauma, resulting in a structurally altered but symptom-free joint. In some people however, either because of overwhelming trauma or compromised repair potential, the process cannot compensate, resulting in continuing tissue damage, abnormal bone growth and eventual presentation of symptomatically painful osteoarthritis. The joint surfaces may become misshapen causing the joint to become unstable or ‘loose’ and painful therefore affecting the physical function and ability of the knee.

How can osteoarthritis be managed?

Evidence has shown that a combined treatment approach is most effective when treating knee osteoarthritis. However it may be the case that high pain levels are affecting a patient’s ability to partake in the exercise that is crucial in the management of osteoarthritis.

Recent studies by Witt et al (2005) and White et al (2007) found that a course of medical acupuncture significantly decreased pain levels and therefore improved function in patients with chronic knee osteoarthritis.

A Cochrane review in 2010 also found that the use of medical acupuncture significantly improved pain and function at 8 weeks post treatment. This pain relief and function was maintained when assessed at 26 weeks post treatment indicating the long term benefits of the use of acupuncture in osteoarthritis.

Evidence based recommendations by the National Institute of Clinical Excellence state that exercise should be a core treatment for people with osteoarthritis, irrespective of age, co-morbidity, pain severity or disability. This exercise should include local muscle strengthening and general aerobic fitness.

Here at Mount Merrion Chartered Physiotherapy we adopt a combined treatment approach in the treatment of knee osteoarthritis, incorporating acupuncture, manual therapy and exercise prescription. To date we have had excellent results with our patients allowing them to return to normal function and the activities that they enjoy.

by Paula Morgan. 

References:
Manheimer E, Linde K, Lao L, Bouter LM, Berman BM. Meta-analysis: acupuncture for osteoarthritis of the knee .Ann Intern Med 2007;146(12):868-77. PM:17577006

National Institute for Health and Clinical Excellence (2008) Osteoarthritis the care and management of osteoarthritis in adults

Scharf HP, Mansmann U, Streitberger K, Witte S, Kramer J, Maier C et al. Acupuncture and knee osteoarthritis: a
three-armed randomized trial. Ann Intern Med 2006;145(1):12-20. PM:16818924

Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S et al. Acupuncture in patients with osteoarthritis of
the knee: a randomised trial. Lancet 2005;366(9480):136-43. PM:16005336

White A, Foster NE, Cummings M, Barlas P. Acupuncture treatment for chronic knee pain: a systematic review.
Rheumatology (Oxford) 2007. PM:17215263

Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S et al. Acupuncture in patients with osteoarthritis of
the knee: a randomised trial. Lancet 2005;366(9480):136-43. PM:16005336


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