Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial.
OBJECTIVE
To analyse the efficacy of acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee, with respect to pain relief, reduction of stiffness, and increased physical function during treatment; modifications in the consumption of diclofenac during treatment; and changes in the patient's quality of life.


METHODS
Randomised, controlled, single blind trial, with blinded evaluation and statistical analysis of results.


METHODS
Pain management unit in a public primary care centre in southern Spain, over a period of two years.


METHODS
97 outpatients presenting with osteoarthritis of the knee.


METHODS
Patients were randomly separated into two groups, one receiving acupuncture plus diclofenac (n = 48) and the other placebo acupuncture plus diclofenac (n = 49).


METHODS
The clinical variables examined included intensity of pain as measured by a visual analogue scale; pain, stiffness, and physical function subscales of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; dosage of diclofenac taken during treatment; and the profile of quality of life in the chronically ill (PQLC) instrument, evaluated before and after the treatment programme.


RESULTS
88 patients completed the trial. In the intention to treat analysis, the WOMAC index presented a greater reduction in the intervention group than in the control group (mean difference 23.9, 95% confidence interval 15.0 to 32.8) The reduction was greater in the subscale of functional activity. The same result was observed in the pain visual analogue scale, with a reduction of 26.6 (18.5 to 34.8). The PQLC results indicate that acupuncture treatment produces significant changes in physical capability (P = 0.021) and psychological functioning (P = 0.046). Three patients reported bruising after the acupuncture sessions.


CONCLUSIONS
Acupuncture plus diclofenac is more effective than placebo acupuncture plus diclofenac for the symptomatic treatment of osteoarthritis of the knee.
Vas
Jorge
J
Pain Treatment Unit, Centro de Salud Dos Hermanas A (Distrito Sanitario Sevilla-Sur), 41700 Dos Hermanas, Spain. jvas@acmas.com
Méndez
Camila
C
Perea-Milla
Emilio
E
Vega
Evelia
E
Panadero
María Dolores
MD
León
José María
JM
Borge
Miguel Angel
MA
Gaspar
Olga
O
Sánchez-Rodríguez
Francisco
F
Aguilar
Inmaculada
I
Jurado
Rosario
R
D015670:Acupuncture Therapy; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy / Q000628:therapy*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac