Researchers from the Third Affiliated Hospital of Fujian University of Traditional Chinese Medicine have demonstrated that warm needle acupuncture is an effective treatment for knee osteoarthritis (KOA). The study compared the efficacy of conventional pharmaceutical treatment with biomedicine combined with warm needle acupuncture for KOA, showing significant benefits of the latter.
The study, published in the Fujian Journal of Traditional Chinese Medicine, observed that warm needle acupuncture alleviates pain, improves mobility, and enhances proprioception in patients with KOA. The mechanism of this treatment may involve adjusting neuromuscular control, altering lower limb biomechanical loading patterns, and enhancing joint stability, thereby promoting the restoration of tendons and bones.
Proprioceptive Indicators and Evaluation Methods
Proprioceptive indicators, including test execution time, average trace error in the horizontal direction, stability, and total load standard deviation, were recorded. Additionally, knee pain severity and knee joint functional impairment were assessed using the Numeric Rating Scale (NRS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS), respectively.
Significant Improvements in the Acupuncture Group
The warm needle acupuncture group exhibited more significant improvements in all proprioceptive indicators compared to the control group, particularly in the average trace error in the horizontal direction. This group also showed noticeable improvements in pain severity and knee joint functional impairment.
Study Details
The study included 60 KOA patients from the Rehabilitation Department outpatient clinic of the Third Affiliated Hospital of Fujian University of Traditional Chinese Medicine. Participants were randomly divided into a regular pharmaceutical control group and a warm needle acupuncture treatment group, each containing 30 patients. Two patients from each group dropped out during the study.
Patients were aged between 40 and 75 years, had a K-L grade of ≥II in the affected knee joint on X-ray, and an NRS score ≥3. Exclusion criteria included patients with meniscal or cruciate ligament injury, rheumatism, gout, severe lower limb joint deformities, history of surgery or arthroscopy, severe visceral diseases, psychiatric disorders, metabolic abnormalities, bone tumors, those on immunosuppressants or corticosteroids, and pregnant or lactating women.
Treatment Protocol
Patients were advised to avoid lifting heavy weights during the study. For severe pain requiring medication, they were given Celebrex capsules (Pfizer Inc., USA) at a dosage of 200 mg daily, with all related data recorded.
The warm needle acupuncture group utilized two sets of acupoints:
Group 1:
- ST35 (Dubi)
- EX-LE04 (Neixiyan)
- SP10 (Xuehai)
- ST34 (Liangqiu)
- SP9 (Yinlingquan)
- GB34 (Yanglingquan)
- GB40 (Qiuxu)
Group 2:
- GB31 (Fengshi)
- BL40 (Weizhong)
- BL55 (Heyang)
Patients were positioned supine for Group 1 points and prone for Group 2 points. Disposable acupuncture needles (0.30 mm × 50 mm) were used, with specific insertion depths and directions for each acupoint. Single-handed insertion technique was adopted. For Neixiyan, needles were inserted toward the superior lateral direction with a depth of 25–40 mm, and the needles at Dubi were inserted with the same depth toward the superior medial direction. The insertion length at Qiuxu was 15–20 mm and the remaining points were 25–30 mm.
The treatment involved mild reinforcing and attenuating to stimulate deqi, followed by the application of ignited moxa sticks (18 mm × 28 mm) for 20 minutes per point. Each session lasted approximately 40 minutes, administered every other day, three times a week, for four weeks.
Conclusion
The study concluded that warm needle acupuncture is a highly effective treatment for KOA, providing significant improvements in pain relief, mobility, and proprioception. This promising alternative therapy could offer hope for many patients suffering from this debilitating condition.
Source: Wang Xiaoling, Jian Jiawei, Chen Xiaohong, Xie Qiurong, Guo Hanlin, Huang Xinwei, Liu Zexu, “Clinical Observation on Treating Knee Osteoarthritis with warm needle acupuncture,” Fujian Journal of TCM, May 2023, 54(5).
