Can Acupuncture Help Arthritis Pain?

From verywellhealth.com

Acupuncture is a form of traditional Chinese medicine that utilizes the insertion of thin needles into various parts of the body to reduce pain and inflammation. This practice is based on the concept of qi, an essential form of life energy that flows throughout the body along 20 different pathways called meridians. When the flow of qi through a meridian is blocked or disrupted, pain or illness is thought to result.

Acupuncturists use small needles to stimulate specific acupuncture points in an attempt to correct the flow of qi and alleviate bodily imbalances to relieve pain and illness. Acupuncture has been around for thousands of years. While Western medicine does not support the theories behind acupuncture, the medical community recognizes the potential benefits of using acupuncture to help relieve pain by directly stimulating problematic soft tissues through needle insertion. 

There is a lack of consistency and generalizability of clinical trials studying acupuncture, but emerging evidence suggests that acupuncture may provide symptom relief for patients suffering from joint pain, especially those with arthritis, specifically osteoarthritis and rheumatoid arthritis.

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How Acupuncture Benefits Arthritis

The actual method by which acupuncture reduces pain and inflammation remains unclear. Proposed theories include anti-inflammatory effects from needle insertion by suppressing inflammatory responses, improving blood flow, and relaxing muscles. While acupuncture cannot cure or reverse arthritis, it may be useful for managing pain and decreasing associated symptoms, especially in conjunction with other treatment options.

What the Research Shows

Research has shown that acupuncture has benefits for rheumatoid arthritis, osteoarthritis, and chronic pain. However, more evidence is needed in some of these areas to support the effectiveness of acupuncture for pain relief.

Rheumatoid Arthritis

While research is still preliminary and unstandardized, a systematic review of 43 different studies including human and animal subjects with rheumatoid arthritis demonstrates varied results, though many studies suggest improvement in symptoms and a decrease in biologic markers of rheumatoid arthritis following one to three sessions of acupuncture for four weeks or more.

Beneficial outcomes following acupuncture treatment for patients with rheumatoid arthritis include less pain and joint stiffness and improved physical functioning. The results of various human and animal studies also suggest that acupuncture has the potential to down-regulate levels of interleukins and tumour necrosis factor, specific cell signalling proteins collectively called cytokines that are involved in the inflammatory response and become elevated in autoimmune conditions like rheumatoid arthritis.

Most of the patients enrolled in these studies were also receiving other forms of treatment, especially medications, so it is difficult to conclude if acupuncture is beneficial alone or only as a supplemental option in addition to medical treatments.

Osteoarthritis

According to the 2019 American College of Rheumatology and Arthritis Foundation guidelines, acupuncture for osteoarthritis of the hand, hip, and knee is conditionally recommended, meaning that acupuncture may be worth trying although more research is needed to confirm how effective treatment is.

Efficacy of acupuncture for the treatment of osteoarthritis remains controversial as research study results are limited due to small sample sizes, variability of outcomes, and the possibility of the placebo effect. Because of these factors, it is difficult to conclude the true magnitude of the beneficial effects of acupuncture, but since the risk of harm is relatively minor, acupuncture for osteoarthritis can generally be considered a safe alternative treatment option for managing the symptoms of osteoarthritis.

Chronic Pain

Because clinical trials of acupuncture treatment suggest that acupuncture may be effective for providing pain relief, acupuncture may be an appropriate option to try for those who suffer from chronic pain. A recent systematic review that included data from 20,827 patients and 39 trials concluded that acupuncture is effective for the treatment of chronic musculoskeletal pain, headache, and osteoarthritis pain. Make sure to ask your doctor if acupuncture is safe for you to try based on your medical history.

Other possible benefits of acupuncture use include antioxidative effects by alleviating oxidative stress and inflammation, improving energy metabolism, and triggering the release of endorphins, hormones that help reduce pain. Inconsistency among clinical research about the exact therapeutic mechanisms and efficacy of acupuncture treatment requires further research.

Risks and Side Effects

Safety

Acupuncture is generally a safe procedure if performed by an appropriately licensed and credentialed professional. If you decide to get acupuncture done, make sure that your acupuncturist holds a current acupuncture license and underwent appropriate training.

To practice acupuncture in the United States, an acupuncturist needs a minimum of a master’s degree from a program accredited by the American Academy of Acupuncture and Oriental Medicine as well as a license in the state that you receive your acupuncture treatment. Doctors with an MD or DO degree who are licensed in the United States to practice medicine can also be licensed and credentialed by the American Academy of Medical Acupuncture after undergoing additional training.

Risks

The biggest risk associated with acupuncture treatment is bleeding and bruising from needle insertion, especially if you have a bleeding disorder like haemophilia or take a blood thinner like warfarin. Make sure to ask your doctor if acupuncture is a safe option for you to try.

Other potential risks include infection and damage to blood vessels or nerves if acupuncture is performed incorrectly or the needles are not clean. Because the lungs are very close to the skin, there is a possible risk of lung puncture if needles are inserted too deep into the upper back and shoulder blade area.

Side Effects

Most people do not experience any side effects from acupuncture treatment, although possible reactions may include: 

• Bruising
• Scarring
• Soreness 
• Needle shock

How a Typical Session Works

During your first acupuncture treatment, you will be taken into a private room to discuss your medical history and what joints and areas of your body are in pain with your acupuncturist. After a brief physical exam, you will then lie down on a treatment table so that your acupuncturist can insert needles into specific points. 

You may lie face up or face down depending on what areas of your body your acupuncturist needs to access. It is best to wear loose clothing that can be rolled up or moved out of the way so that the acupuncturist can easily access different areas of your body. Depending on what areas of your body need to be accessed, you may be asked to change into a gown. 

Your acupuncturist will use alcohol swabs to disinfect the skin before placing needles in various points throughout your body. The needles are made of stainless steel and are at least 10 times thinner than medical needles used for vaccines or drawing blood. Because of this, needle insertion is often painless, especially in thicker areas of the body. You may feel a slight pinch in more sensitive areas like the hands and feet where the skin is thin, but needle insertion should be comfortable and well tolerated without significant pain.

If you are going for electroacupuncture, your acupuncturist will pass a mild electric current through the needles, usually 40 to 80 volts.

Your acupuncturist will then leave the needles in place for 20 to 30 minutes while you relax. The lights in your private treatment room are often dimmed, and you acupuncturist will exit the room but stop in periodically to check on you during your treatment. Sometimes a heat lamp is placed over you during treatment.

After your treatment is finished, your acupuncturist will remove all of the needles and dispose of them.

Frequency

Your frequency of acupuncture visits will vary depending on the severity of your symptoms, and may also be dictated by whether your visits are approved and reimbursed by your health insurance company. Acupuncture visits are typically performed once or twice per week.

Finding a Practitioner 

To find an appropriately certified and credentialed acupuncturist near you, you can find a practitioner through your local state board to find one who is licensed in your state. You will have to call or visit each acupuncturist's website to find out more about visit costs and availability of appointments.

Cost and Insurance (US)

Costs for acupuncture can vary from $75 to $200 per session. Your first session, which involves an initial assessment and evaluation, may cost more than your follow-up visits. Whether your health insurance will cover some or all of the costs of acupuncture visits depends on your individual insurance company and condition for which you are seeking acupuncture treatment for. 

Medicare currently covers acupuncture services up to 12 visits within a 90-day period for chronic low back pain only. Acupuncture for any other condition will not be covered by Medicare.

A Word From Verywell

While acupuncture cannot cure arthritis, it may be a useful tool to use in conjunction with other medical treatments to help manage pain and other symptoms of arthritis. Further research is needed to determine the exact therapeutic mechanisms of how acupuncture works as well as the overall effectiveness of the treatment. Because the potential risks of trying acupuncture are relatively minor, acupuncture can be a safe, alternative treatment option for many.

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