World's Energy

By Nigel Hawkes
A medical experiment proves that the ancient Chinese practice of inserting needles to ease pain may help some arthritis sufferers

ACUPUNCTURE can reduce pain and improve mobility in patients suffering from arthritis by 40 per cent, scientists have found.

The news comes from one of the biggest scientific trials of the ancient Chinese treatment, carried out by a research team from the National Institutes of Health in America. At the same time a smaller trial in Britain has suggested that acupuncture might be effective in relieving chronic neck pain.

A total of 570 patients, aged 50 and older, with osteoarthritis of the knee took part in the American trial. All had suffered significant pain in their knee the month before joining the trial but had never been treated with acupuncture before.

They were assigned at random to one of three treatments: genuine acupuncture, "sham" acupuncture or a self-help course that teaches patients to manage their own condition.

Throughout the 26-week trial participants continued to receive their normal medical care, including anti-inflammatory drugs and pain relievers.

By the eighth week patients who received genuine acupuncture showed a significant increase in function compared with the sham treatment and self-help groups, the research team report in Annals of Internal Medicine. By Week 14, they were also experiencing a significant decrease in pain.

Pain was reduced by about 40 per cent and mobility improved by almost 40 per cent in the volunteers receiving acupuncture.

The trial, led by Brian Berman, of the University of Maryland School of Medicine in Baltimore, was funded by the National Centre for Complementary and Alternative Medicine (NCCAM) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases — both of the National Institutes of Health in the United States.

Stephen Straus, the director of NCCAM, said: "For the first time a clinical trial with sufficient rigour, size, and duration has shown that acupuncture reduces the pain and functional impairment of osteoarthritis of the knee. These results also indicate that acupuncture can serve as an effective addition to a standard regimen of care and improve quality of life for knee osteoarthritis sufferers."

Sham acupuncture, which has been employed in a number of other trials, has been criticised for not providing a foolproof control condition. It is claimed that even if needles are not placed in the correct treatment points they might trigger a response in the patient. Because of the difficulty of faking needle insertion, designing acupuncture trials is notoriously difficult.

Acupuncture, which originated in China more than 2,000 years ago, is based on the idea that energy, or qi, flows along channels called meridians in the body. Practitioners say that they block or stimulate these channels by inserting thin needles at precise points and manipulating them.

A British study, also published in Annals of Internal Medicine, reached a different conclusion, finding that both genuine and sham acupuncture appeared to reduce neck pain.

Researchers at the University of Southampton compared genuine and sham treatments from the same therapist on 124 patients with chronic neck pain aged between 18 and 80.

Over 12 weeks both groups reported a decrease in pain levels of more than 60 per cent. George Lewish, who led the trial, attributed the success with sham treatments to "the non-specific yet powerful effects which are probably part of the treatment process".

Acupuncture is a form of Chinese medicine that involves inserting fine needles into precisely-defined places on the body

It is based on the idea that "life force" flows through the body along fixed "meridians" and that the blockages of these pathways causes illness. The insertion of needles is believed to unblock the pathways

There is no evidence, to scientific Western eyes, of the existence of the meridians, or the twelve pulses, six in each wrist, that are used to diagnose disease

Acupuncture needles come in nine different types, each with a different purpose. The angles and speed of insertion and whether a needle is twisted, pumped or left in place depend on the disorder

There is no strong evidence that acupuncture can cure disease, but there is evidence that it can help to control pain. The reason for this is probably that the pain pathways are influenced by the needles, which may block the transmission of nervous stimuli

A secondary effect is that of suggestion, or the placebo effect — the fact that people tend to feel better when they are being treated, almost regardless of the treatment

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