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. 2025 Apr;14(2):737-751.
doi: 10.1007/s40122-025-00713-x. Epub 2025 Feb 17.

Efficacy of Different Acupuncture Techniques for Pain and Dysfunction in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

Jing Sun #  1   2 , Yi Liang #  2 , Kai-Tao Luo  3 , Xiao-Mei Shao  2 , Ming-Qi Tu  2 , Xiao-Ting Wu  2 , Fang Liu  4 , Xin-Wei Li  5 , Yi-Dan Chen  6 , Qi-Fei Zhang  2 , Cong-Hua Ji  7 , Rong-Rong Li  1   2 , Xiao-Yu Li  2 , Fu Xu  8 , Jian-Qiao Fang  9   10
Affiliations

Efficacy of Different Acupuncture Techniques for Pain and Dysfunction in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

Jing Sun et al. Pain Ther. 2025 Apr.

Abstract

Introduction: Various acupuncture techniques are widely applied in clinics for pain control and dysfunction relief in patients with knee osteoarthritis (KOA). The purpose of this trial was to investigate whether the different acupuncture techniques were more effective in treating joint pain and dysfunction than were sham acupuncture or drug treatment in patients with KOA and to determine the differences in efficacy among them.

Methods: In this multi-center, single-blind, randomized, controlled trial, participants were randomly assigned to the manual acupuncture (MA), electroacupuncture (EA), warm-needling acupuncture (WA), mild moxibustion (MM), sham acupuncture (SA), or drug treatment (Celebrex) groups. Each participant in the above groups received individual treatments for 4 consecutive weeks. The primary outcome measures included the visual analog scale score (VAS) and the physical function score of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

Results: Compared with the SA group, the acupuncture technique groups (MA, EA, WA, and MM) had markedly lower patient VAS scores (- 0.61; 95% CI - 1.09 to - 0.13; P = 0.01) and lower WOMAC physical function scores (- 13.84; 95% CI - 21.14 to - 6.54; P < 0.01). Compared with Celebrex, EA had a significant advantage in reducing the VAS score (1.14; 95% CI 0.55 to 1.72; P < 0.01) and WOMAC physical function score (14.81; 95% CI 5.69 to 23.93; P < 0.01).

Conclusions: The observed acupuncture techniques effectively relieve pain and ameliorate knee joint dysfunction in patients with KOA. EA is the most effective method of alleviating pain intensity in treating KOA.

Trial registration: The trial was registered on ClinicalTrials.gov (NCT03563690).

Keywords: Acupuncture techniques; Electroacupuncture; Knee osteoarthritis; Pain control; Physical dysfunction; Randomized controlled trial.

Plain language summary

Chronic pain and joint functional disability are the main symptoms that occur in patients with knee osteoarthritis and decrease their quality of life. As a non-pharmacological treatment, acupuncture, a traditional complementary therapy originating in China, is an effective therapy for pain control and addressing knee-related disorders in the clinic. However, the efficiency of various acupuncture techniques in treating diseases is different. The purpose of this trial was to investigate whether acupuncture techniques were more effective at controlling pain and physical dysfunction than sham acupuncture or drug treatment and to determine the differences in efficacy among them. The participants experienced different acupuncture technique treatments, including manual acupuncture, electroacupuncture, warm-needling acupuncture, and mild moxibustion. The control treatments included sham acupuncture and drug treatment with Celebrex. We measured changes in pain perception via visual analog scale scores and physical dysfunction via physical function scores from the Western Ontario and McMaster Universities Osteoarthritis Index. Compared with sham acupuncture, the observed acupuncture techniques were effective for treating joint pain and dysfunction in patients with knee osteoarthritis. We compared the efficiency of different acupuncture techniques and reported that electroacupuncture was the most effective at alleviating pain intensity. Moreover, we compared the efficiency of electroacupuncture with that of Celebrex administration. The results revealed that electroacupuncture had an advantage over drug treatment. This finding could provide sufficient evidence that demonstrates the disparity in the efficacy of acupuncture techniques and could lead to proper acupuncture therapy for treating knee osteoarthritis.

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Conflict of interest statement

Declarations. Ethical Approval: The trial was approved by the Ethics Committees of the six hospitals. They are the Third Affiliated Hospital of Zhejiang Chinese Medical University (NO. ZSLL-KY-2017–030), Jiaxing TCM Hospital (NO. 2018-JZLS-001), Hangzhou Red Cross Hospital (NO. 2018 LS05), Tongde Hospital of Zhejiang Province (NO. 2018,019), Zhejiang Hospital (NO. 2018KA006) and Zhejiang Provincial Hospital of TCM (NO. 2018-KL-010–01). This study was performed in accordance with the Helsinki Declaration of 1964 and its later amendments. Participants provided their consent by signing a written informed consent form. Conflict of Interest: All the authors (Jing Sun, Yi Liang, Kai-Tao Luo, Xiao-Mei Shao, Ming-Qi Tu, Xiao-Ting Wu, Fang Liu, Xin-Wei Li, Yi-Dan Chen, Qi-Fei Zhang, Cong-Hua Ji, Rong-Rong Li, Xiao-Yu Li, Fu Xu, Jian-Qiao Fang) declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The trial flowchart
See this image and copyright information in PMC

References

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