Influence of aucpuncturists on treatment outcomes in osteoarthritis

There’s conflicting evidence on the value of Traditional Chinese Acupuncture (TCA).

Now, researchers at the University of Texas M.D. Anderson Cancer Center, in Houston report the influence of the acupuncturist on the response to treatment of osteoarthritis of the knee.

First, the details.

• Acupuncturists were trained to interact with their patients in 1 of 2 communication styles: ‘high’ or ‘neutral’ expectations.
• 527 patients were randomly assigned to a treatment group for 6 weeks.
  • Waiting list
  • ‘High’ expectation group with TCA or sham acupuncture
  • ‘Neutral’ expectation group with TCA or sham acupuncture
• Sham acupuncture was performed in non-meridian points, with shallow needles and minimal stimulation.
• The researchers measured joint pain using Joint-specific Multidimensional Assessment of Pain (J-MAP), Western Ontario McMaster Osteoarthritis Index (WOMAC), and patient satisfaction.

And, the results.

• Overall, there were no significant differences between TCA and sham acupuncture.
  • But both groups had significant reductions pain compared to the waiting group.
• But there were significant differences in pain reduction and satisfaction in the ‘high’ expectations group.
• The groups were not aware of the treatment given to them, according to the researchers’ assessment.

The bottom line?

TCA was not superior to sham acupuncture.

However, concluded the authors, “Acupuncturists’ style had significant effects on pain reduction and satisfaction, suggesting that the analgesic benefits of acupuncture can be partially mediated through placebo effects related to the acupuncturist’s behavior.”

Earlier this year, before publication of this study, a Cochrane review of acupuncture to treat peripheral joint osteoarthritis concluded that much of the reported benefit accorded to acupuncture “may be due to expectation or placebo effects.”

9/13/10 20:29 JR