title: Efficacy of periosteal stimulation therapy for the treatment of osteoarthritis-associated chronic knee pain: an initial controlled clinical trial.
abstract: OBJECTIVE
  To examine the efficacy of periosteal stimulation therapy (PST, osteopuncture) for the treatment of chronic pain associated with advanced knee osteoarthritis.
  
  
  METHODS
  Randomized, controlled clinical trial.
  
  
  METHODS
  Outpatient pain clinic.
  
  
  METHODS
  Eighty-eight community-dwelling older adults with moderate knee pain or greater for 3 months or longer and Kellgren-Lawrence (K-L) grade 2 through 4 radiographic severity (80% had K-L 4).
  
  
  METHODS
  Participants were randomized to receive PST or control PST once a week for 6 weeks.
  
  
  METHODS
  Pain severity and self-reported function (Western Ontario and McMasters University Osteoarthritis Index (WOMAC)) and physical performance (Short Physical Performance Battery (SPPB)) were assessed at baseline, after the last PST session (post), and 3 months later (follow-up). Pain severity was also assessed monthly using the multidimensional pain inventory short form.
  
  
  RESULTS
  Pain was reduced significantly more in the PST group than in the control PST group at post (P=.003; mean WOMAC pain subscale baseline 9.4 vs 6.4) and 1 month later (P<.001), but by 2 months, pain levels had regressed to pre-intervention levels. The group-by-time interaction for the WOMAC function scale was significant at post (P=.04) but not at follow-up (P=.63). No significant group differences were found for the SPPB. Neither analgesic use nor global improvement differed between groups. There were four treatment dropouts.
  
  
  CONCLUSIONS
  PST affords short-term modest pain reduction for older adults with advanced knee OA. Future research should test the effectiveness of booster treatments in sustaining analgesic benefits and of combining PST with therapeutic exercise in ameliorating disability risk.
authors: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15206, USA. dweiner@pitt.edu
authors: Debra K
authors: DK
authors: Weiner
authors: Thomas E
authors: TE
authors: Rudy
authors: Natalia
authors: N
authors: Morone
authors: Ronald
authors: R
authors: Glick
authors: C Kent
authors: CK
authors: Kwoh
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D020370:Osteoarthritis, Knee / Q000145:classification / Q000628:therapy*; D059408:Pain Management; D010147:Pain Measurement; D012720:Severity of Illness Index