Tuesday, October 07, 2014 Acupuncture No Better Than Sham for Chronic Knee Pain in Adults 50+ Regardless of whether it's delivered traditionally or through a more high-tech laser version, acupuncture doesn't appear to have any benefit over sham procedures when it comes to reducing moderate-to-severe knee pain in adults 50 and over, according to a new study in the October 1 issue of the Journal of the American Medical Association (JAMA) (abstract only available for free). Researchers in Australia studied treatments of 282 patients who were 50 or older and had been experiencing moderate to severe knee pain on most days for a period of time longer than 3 months. The patients were divided into 4 groups: a needle acupuncture group, a laser acupuncture group, a sham laser acupuncture group, and a control group. Acupuncture treatments were conducted 1 to 2 times weekly for 12 weeks. Both acupuncturists and patients did not know if they were involved in the sham or actual laser treatment, but there was no sham treatment used in the needle-based acupuncture group. When the researchers compared self-reported knee pain and function at baseline, 12 weeks, and after 1 year, they found "no significant differences in primary outcomes between active and sham acupuncture at 12 weeks … or 1 year." "Although needle and laser acupuncture improved pain after treatment compared with control, improvements were not sustained at 1 year and were of clinically unimportant magnitude," authors write. "Improvement in … physical function with needle acupuncture relative to control at 12 weeks was of a clinically irrelevant magnitude and did not persist at 1 year. Furthermore, this improvement was not different from sham laser." "Among patients older than 50 years with moderate to severe chronic knee pain, neither laser nor needle acupuncture conferred benefit over sham for pain or function," they conclude. "Our findings do not support acupuncture for these patients." Although researchers acknowledged that the study size suffered due to the numbers of patients declining treatment during the course of the study (ranging from 13% o 19%), they argue that the design of the study—patients didn't know they would be participating in an acupuncture study until after recruited to reduce drawing participants with positive attitudes about the intervention—strengthens the findings. Still, they write, the findings "likely only apply to patients with clinically diagnosed osteoarthritis and moderate or severe pain … and may not be generalizable to end-stage radiographic disease." Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.