Acupuncture for Rheumatoid Arthritis, A Review
For the estimated 1.3 million Americans who suffer with rheumatoid arthritis, treatment options typically include medications that can be associated with significant side effects. A natural complementary treatment is acupuncture, but how effective is this form of therapy for rheumatoid arthritis?
Should you consider acupuncture for rheumatoid arthritis?
Acupuncture is widely used as an alternative or complementary treatment for various types of pain, including osteoarthritis, back and neck pain, chronic headache, and shoulder pain. However, there is still some controversy regarding its effectiveness.
A systematic review of 31 randomized controlled trials of acupuncture for chronic pain, involving nearly 18,000 patients, was published in a recent issue of the Archives of Internal Medicine. In it the authors noted that overall, patients who received acupuncture for osteoarthritis, chronic headache, or back, neck, or shoulder pain had less pain than did patients who received sham or no acupuncture. The authors thus concluded that "acupuncture is effective for the treatment of chronic pain" and that the results indicated "acupuncture is more than a placebo."
But what about rheumatoid arthritis? The evidence supporting the use of acupuncture for rheumatoid arthritis is less clear, but that does not mean it cannot be effective for some patients. Here's what experts have to say in recent research.
Acupuncture for rheumatoid arthritis
At Baylor College of Medicine, investigators in the new issue of Current Rheumatology Reports reviewed the latest evidence on the treatment of rheumatoid arthritis, fibromyalgia, and other musculoskeletal conditions with acupuncture. They acknowledged acupuncture is "relatively safe," but that many of the studies "lack methodological rigor," indicating more, high-quality research is necessary to determine if acupuncture will prove useful in the treatment of rheumatoid arthritis and other chronic rheumatic conditions.
In Rheumatology (September 2012), researchers reviewed 11 trials of complementary therapies for rheumatoid arthritis, three of which compared acupuncture with sham acupuncture. Although none reported a significant improvement in pain reduction, one study did note improvement in patient global assessment.
Despite the less than stellar findings regarding acupuncture for rheumatoid arthritis, some research indicates the body responds to the treatment, or at least to electro-acupuncture. Electro-acupuncture involves sending a mild electrical pulse through the acupuncture needle as a different way to stimulate the treatment point (acupoint).
In a study published in the Chinese Journal of Integrative Medicine, researchers reported on 63 patients with rheumatoid arthritis who were randomly assigned to receive 30 treatments of either electro-acupuncture or regular acupuncture. Blood and synovial fluid were tested in all participants for two factors associated with rheumatoid arthritis: tumor necrosis factor-alpha (TNF-α) and vascular endothelial growth factor (VEGF).
Levels of both TNF-α and VEGF were reduced significantly after treatment in both patient groups. However, VEGF declined more in the electro-acupuncture group than in the regular acupuncture group. The authors concluded that electro-acupuncture could provide some benefit in the treatment of rheumatoid arthritis.
While the evidence for acupuncture as a complementary treatment of rheumatoid arthritis is not especially positive, some patients may respond. Individuals who want to try something along with medication and who have an opportunity and a desire to try acupuncture should consult their healthcare provider and seek out a qualified acupuncture therapist for treatment.
Amezaga UM, Suarez-Almazor ME. Acupuncture in the treatment of rheumatic diseases. Current Rheumatology Reports 2012 Dec; 14(6): 589-97
Macfarlane GJ et al. A systematic review of evidence for the effectiveness of practitioner-based complementary and alternative therapies in the management of rheumatic diseases: rheumatoid arthritis. Rheumatology (Oxford) 2012 Sep; 51(9): 1707-13
Ouyang BS et al. Effect of electro-acupuncture on tumor necrosis factor-a and vascular endothelial growth factor in peripheral blood and joint synovia of patients with rheumatoid arthritis. Chinese Journal of Integrative Medicine 2011 Jul; 17(7): 505-9
Vickers AJ et al. Acupuncture for chronic pain: individual patient data meta-analysis. Archives of Internal Medicine 2012 Sep 10; 1-10