Table 6.57Symptoms: pain

Pain outcomeReferenceInterventionAssessment timeOutcome/effect size
Knee osteoarthritis
Acupuncture vs sham/no treatment
WOMAC pain (outlier study removed to remove heterogeneity)1MA (White et al. 2007) 4 RCTs, N=1246Acupuncture vs sham acupunctureShort term (up to 25 weeks)WMD 0.87,% CI 0.40 to 1.34, p=0.0003
WOMAC pain1MA (White et al. 2007) 3 RCTs, N=1178Acupuncture vs sham acupunctureLong term (up to 52 weeks)WMD 0.54,% CI 0.05 to 1.04, p<0.05
WOMAC pain1MA (White et al. 2007) 2 RCTs, N=403Acupuncture vs true sham acupunctureShort term (up to 25 weeks)Significant heterogeneity
WOMAC pain1MA (White et al. 2007) 4 RCTs, N=927Acupuncture vs no additional treatmentShort term (up to 25 weeks)WMD 3.42,% CI 2.58 to 4.25, p<0.05
WOMAC pain1MA (White et al. 2007)Acupuncture vs other sham treatment (sham TENS)Short term (up to 25 weeks)Insufficient data
WOMAC pain1MA (White et al. 2007)Acupuncture vs other sham treatment (sham AL-TENS or education)Short term (up to 25 weeks)Insufficient data
Unilateral acupuncture vs bilateral acupuncture
Pain (VAS)1 RCT (Tillu et al. 2001 2207)Unilateral acupuncture vs bilateral acupuncture2 weeks and at 4.5 months post- intervention.NS
Electroacupuncture vs ice massage
Pain at rest, PPI scale of 1–51 RCT (Yurtkuran and Kocagil 1999)Electroacupuncture vs ice massage2 weeks (end of treatment)NS
Electroacupuncture vs AL-TENS
Pain at rest PPI scale of 1–51 RCT (Yurtkuran and Kocagil 1999)Electroacupuncture vs AL-TENS2 weeks (end of treatment)NS
Hip
Acupuncture vs sham acupuncture
Pain intensity (VAS)1 RCT (Fink et al. 2001) (N=67)Acupuncture vs placebo (sham acupuncture)1 week, 6 weeks and 6 months post- intervention.NS
Thumb
Acupuncture vs mock TNS
Pain reduction, VAS (change from baseline and change from end-of treatment scores)1 RCT (Dickens and Lewis 1989) (N=13)Acupuncture was better than placebo (mock TNS)2 weeks post- interventionAcupuncture better
Pain reduction, VAS (change from baseline)1 RCT (Dickens and Lewis 1989) (N=13)Acupuncture was better than placebo (mock TNS)2 weeks post- interventionNS
Pain reduction, VAS (change from baseline)1 RCT (Dickens and Lewis 1989) (N=13)Acupuncture was better than placebo (mock TNS)End of treatmentAcupuncture worse
Knee or hip
Acupuncture vs no acupuncture
WOMAC pain(change from baseline)1 RCT (Witt et al. 2006) (N=712)Acupuncture vs no acupuncture3 months, end of treatmentMean change 43.7% (acupuncture) and 6.2%(no acupuncture), p<0.001
Mixed (knee, hip, finger, lumbar, thoracic or cervical)
Acupuncture vs sham acupuncture
Pain (patient’s assessment, scale 1–4, change from baseline) and tenderness (physician’s evaluation, scale 1–4, change from baseline)1 RCT (Gaw et al. 1975) (N=40)Acupuncture vs placebo (sham acupuncture)End of treatment (8 weeks) and at 2 weeks and 6 weeks post-interventionNS

From: 6, Non-pharmacological management of osteoarthritis

Cover of Osteoarthritis
Osteoarthritis: National Clinical Guideline for Care and Management in Adults.
NICE Clinical Guidelines, No. 59.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2008, Royal College of Physicians of London.

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