Non-specific effects of traditional Chinese acupuncture in osteoarthritis of the hip

Fink, Matthias; Wipperman, B.; Gehrke, A.

doi:10.1054/ctim.2001.0442

Cited by 34 publications

(65 citation statements)

References 15 publications

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“…With regards specifically to Hip OA, the review identified three trials evaluating the use of acupuncture in management of hip OA, one of which was evaluating the use of electro acupuncture as opposed to the traditional needle methods [21][22][23]. However, the studies were deemed to be too heterogenous to be included in a meta-analysis.…”

Section: Acupuncturementioning

confidence: 99%

Modern Non-Pharmacological and Non-Surgical Treatments for Hip Pain

Lee¹,

Rozewicz²,

Chandrappa³

et al. 2018

J Arthritis

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Osteoarthritis of the hip describes a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life. Osteoarthritis may not be progressive and most patients will not need surgery, with their symptoms adequately controlled by non-surgical measures. The treatment of hip osteoarthritis is aimed at reducing pain and stiffness and improving joint mobility. Total hip replacement remains the most effective treatment option but it is a major surgery with potential serious complications. NICE guideline has suggested a holistic approach to management of hip osteoarthritis which includes both nonpharmacological and pharmacological treatments. The non-pharmacological treatments range from education ,physical therapy and behavioral changes ,walking aids .The ESCAPE( Enabling Self-Management and Coping of Arthritic Pain Through Exercise) rehabilitation programme for hip and knee osteoarthritis which integrates simple education, self-management and coping strategies, with an exercise regimen has shown to be more cost-effective than usual care. There is a choice of reviewed pharmacological treatments available, but there are few current reviews of possible nonpharmacological methods. This review will focus on the non-pharmacological and non-surgical methods.

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Section: Acupuncturementioning

confidence: 99%

Modern Non-Pharmacological and Non-Surgical Treatments for Hip Pain

Lee¹,

Rozewicz²,

Chandrappa³

et al. 2018

J Arthritis

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“…However, given that DN has been shown to improve pain in osteoarthritic joints using traditional acupoint and non-acupoint locations, [139] most researchers believe that the general effect of DN may be due to improved blood flow. Following EDN to the vastus medialis, Lazaro et al measured a significant increase in arteriolar diameter and a persistent increase in mean arterial pressure of arterioles supporting the knee joint [140].…”

Section: Electro-dry Needling For Joint Osteoarthritis: Underlying Mementioning

confidence: 99%

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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There are a number of biochemical, biomechanical, endocrinological and neurovascular mechanisms underpinning the anti-nociceptive and anti-inflammatory effects of dry needling (DN). While myofascial trigger points likely play a role in peripheral pain, a diagnostic tool for localizing them has not been validated, and DN studies that have targeted trigger points to elicit localized twitch responses have reported mixed results. Therefore, the mechanism responsible for DN-mediated analgesia may be more complicated. DN activates opioid-based pain reduction, mediated by endogenous cannabinoids and the sympathetic nervous system, and non-opioid pain relief via serotonin and norepinephrine from the brain stem. DN also triggers the hypothalamic-pituitary-adrenal axis centrally and the corticotropin releasing hormone-proopiomelanocortin-corticosteroid axis locally to inhibit cox-2, reducing inflammatory cytokines. Recent studies demonstrate that DN combined with mechanical and/or electrical stimulation may reverse PKC-mediated peripheral hyperalgesic priming by normalizing nociceptive channels, to include TRPV, ASIC, TTX and P2X/Y. Electrical DN (EDN) stimulates immune cells, fibroblasts and keratinocytes to release CGRP and substance-P, altering the stimulation of TTX receptors to reverse hyperalgesia. It also encourages the supraoptic nucleus to release oxytocin to quiet ASIC receptors peripherally and stimulate opioid interneurons spinally. Moreover, EDN inhibits ERK1/2 kinase pathways of inflammation in the spinal cord and stimulates Aδ fibers and N/OFQ to reverse C-fiber mediated central changes. Mechanotransduction of fibroblasts and peripheral nerves via TRPV1 and P2X/Y-mediated intracellular Ca 2+ wave propagation and subsequent activation of the nucleus accumbens inhibits spinal pain transmission via glycinergic and opioidergic interneurons. The increased ATP is metabolized to adenosine, which activates P1 purinergic receptors, events considered key to DN analgesia and rho kinase-based tissue remodeling. Mechanotransduction-mediated release of histamine further explains analgesia secondary to needling points distal to pain. DN-mediated analgesia is dependent on a number of synergistic physiologic events involving biochemical and mechanical processes in neural, connective and muscle tissue.

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“…Significant differences between the two groups could be detected for pain on motion and pain on exertion at the 1st follow-up (figs. 2,3). No other differences between groups were found for any outcome parameter at any followup.…”

Section: Resultsmentioning

confidence: 68%

“…This could either mean that sham needling has similar specific effects as acupuncture or that both methods are associated with considerable non-specific effects [1]. The conclusion of this systematic review is supported by our own investigation which compared invasive sham needling with real acupuncture in patients with osteoarthritis of the hip [2]. On the other hand, recent trials have indicated that acupuncture may have specific effects in tendomyotic and soft tissue disorders which are not caused by degenerative joint diseases, as is the case with osteoarthritis.…”

Section: Introductionmentioning

confidence: 58%

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Chronic Epicondylitis: Effects of Real and Sham Acupuncture Treatment: A Randomised ControlledPatient- and Examiner-Blinded Long-Term Trial

Fink

Wolkenstein²,

Luennemann

et al. 2002

Complement Med Res

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Objective: The clinical long-term effectiveness of real and sham acupuncture treatment on differentiated pain measurement was evaluated in chronic lateral epicondylitis, an example of a tendomyotic disorder. Methods: Randomised, examiner- and patient-blinded controlled clinical study. Outcome measurement: pain at rest, pain on movement, pain on exertion, frequency and duration of pain. Real acupuncture (n = 23) was tested versus invasive sham acupuncture (n = 22). Ten treatments were given (2 treatments/week). Patients were examined at baseline (E1) as well as 2 weeks (E2), 2 months (E3) and 1 year (E4) after the end of treatment. In the treatment with real acupuncture, acupuncture points were selected and mechanically stimulated while in the sham group non-acupuncture points were selected. Results: There was no significant difference between the groups at baseline for any outcome parameter. Two weeks, 2 months and 1 year after the end of treatment there were significant reductions in all pain variables compared to baseline. At the first follow-up, significant group differences were registered for pain on motion and pain on exertion in favour to the real acupuncture group. These differences in pain intensity between the groups were no longer significant at the 2 months and 12 months follow-ups. Conclusion: The results suggest that, in the treatment of chronic epicondylitis, the selection of so-called real acupuncture points gives better results than invasive sham acupuncture at early follow-up. This additional effect can be interpreted as a specific effect of real acupuncture.

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Non-specific effects of traditional Chinese acupuncture in osteoarthritis of the hip

Cited by 34 publications

References 15 publications

Modern Non-Pharmacological and Non-Surgical Treatments for Hip Pain

Modern Non-Pharmacological and Non-Surgical Treatments for Hip Pain

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Chronic Epicondylitis: Effects of Real and Sham Acupuncture Treatment: A Randomised ControlledPatient- and Examiner-Blinded Long-Term Trial

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