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Meta-Analysis
. 2014 Aug 23:14:312.
doi: 10.1186/1472-6882-14-312.

Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis

Taru Manyanga  1 , Maria Froese, Ryan Zarychanski, Ahmed Abou-Setta, Carol Friesen, Michael Tennenhouse, Barbara L Shay
Affiliations
Meta-Analysis

Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis

Taru Manyanga et al. BMC Complement Altern Med. .

Abstract

Background: The utility of acupuncture in managing osteoarthritis symptoms is uncertain. Trial results are conflicting and previous systematic reviews may have overestimated the benefits of acupuncture.

Methods: Two reviewers independently identified randomized controlled trials (up to May 2014) from multiple electronic sources (including PubMed/Medline, EMBASE, and CENTRAL) and reference lists of relevant articles, extracted data and assessed risk of bias (Cochrane's Risk of Bias tool). Pooled data are expressed as mean differences (MD), with 95% confidence intervals (CI) (random-effects model).

Results: We included 12 trials (1763 participants) comparing acupuncture to sham acupuncture, no treatment or usual care. We adjudicated most trials to be unclear (64%) or high (9%) risk of bias. Acupuncture use was associated with significant reductions in pain intensity (MD -0.29, 95% CI -0.55 to -0.02, I2 0%, 10 trials, 1699 participants), functional mobility (standardized MD -0.34, 95% CI -0.55 to -0.14, I2 70%, 9 trials, 1543 participants), health-related quality of life (standardized MD -0.36, 95% CI -0.58 to -0.14, I2 50%, 3 trials, 958 participants). Subgroup analysis of pain intensity by intervention duration suggested greater pain intensity reduction with intervention periods greater than 4 weeks (MD -0.38, 95% CI -0.69 to -0.06, I2 0%, 6 trials, 1239 participants).

Conclusions: The use of acupuncture is associated with significant reductions in pain intensity, improvement in functional mobility and quality of life. While the differences are not as great as shown by other reviews, current evidence supports the use of acupuncture as an alternative for traditional analgesics in patients with osteoarthritis.

Systematic review registration: CRD42013005405.

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Figures

Figure 1
Figure 1
Study Flow diagram.
Figure 2
Figure 2
Summary risk of bias assessment.
Figure 3
Figure 3
Pain intensity (Visual Analog Scale).
Figure 4
Figure 4
Functional mobility (multiple scales).
Figure 5
Figure 5
Health-related quality of life (multiple scales).
See this image and copyright information in PMC

References

    1. Ezzo J, Hadhazy V, Birch S, Lao L, Kaplan G, Hochberg M, Berman B. Acupuncture for osteoarthritis of the knee: a systematic review. Arthritis Rheum. 2001;44(4):819–825. doi: 10.1002/1529-0131(200104)44:4<819::AID-ANR138>3.0.CO;2-P. - DOI - PubMed
    1. Manheimer E, Cheng K, Linde K, Lao L, Yoo J, Wieland S, van der Windt DA, Berman BM, Bouter LM. Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev. 2010;1:CD001977. - PMC - PubMed
    1. Balanescu AR, Feist E, Wolfram G, Davignon I, Smith MD, Brown MT, West CR. Efficacy and safety of tanezumab added on to diclofenac sustained release in patients with knee or hip osteoarthritis: a double-blind, placebo-controlled, parallel-group, multicentre phase III randomised clinical trial. Ann Rheum Dis. 2013;73(9):1665–1672. doi: 10.1136/annrheumdis-2012-203164. - DOI - PubMed
    1. Sovani S, Grogan SP. Osteoarthritis: detection, pathophysiology, and current/future treatment strategies. Orthop Nurs. 2013;32(1):25–36. doi: 10.1097/NOR.0b013e31827d96da. - DOI - PubMed
    1. Manheimer E, Linde K, Lao L, Bouter LM, Berman BM. Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med. 2007;146(12):868–877. doi: 10.7326/0003-4819-146-12-200706190-00008. - DOI - PubMed
Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6882/14/312/prepub