Natalie N. Matos

Acupuncture + Massage = Relief for People with Knee Osteoarthritis

I wrote this article based on the information from a 2022 research article titled “Systematic Review and Network Meta-analysis of Acupuncture Combined with Massage in Treating Knee Osteoarthritis,” of which I have provided a copy below the article.

New Study looks at types of acupuncture for the most effective treatment.

by Natalie Matos

In recent years, several studies have shown that acupuncture combined with massage can be an effective treatment for knee osteoarthritis with few or no side effects.

A recent study, the “Systematic Review and Network Meta-analysis of Acupuncture Combined with Massage in Treating Knee Osteoarthritis,” published by BioMed Research International, took this a step further and looked at which types of acupuncture combined with massage were the most effective in treating knee osteoarthritis. This is the first study to use analysis to compare the effectiveness of various types of acupuncture combined with massage against massage or acupuncture alone.

Knee osteoarthritis is a common joint disease often caused by wear and tear of cushioning of the knee joint. It is thought to impact as many as 30% to 40% of people 65 years and older.¹ The Osteoarthritis Research Society International (OARSI) recommends that less invasive treatments for knee osteoarthritis are tried before surgery. Doctors commonly use pain relievers, anti-inflammatories, and corticosteroid injections to treat osteoarthritis in the knee. However, these can also come with many side effects.

The study found that floating-needle acupuncture plus massage was best at reducing the overall symptoms of patients with knee osteoarthritis, needle knife acupuncture plus massage was the best for pain reduction, and silver needle acupuncture plus massage was best for improvement in the ability to do daily activities.   The table below shows the study results and an explanation of each acupuncture type. Common acupuncture is the type most people are familiar with in the United States and uses a very thin needle made of stainless steel inserted through the skin at strategic points in the body².

Study findings of what type of acupuncture, when combined with massage, works best

Best for

Type of Acupuncture

What is it?

Reducing overall symptoms

Floating needle therapy³

  • similar to common acupuncture,  
  • disposable floating and other needles are inserted into the skin at strategic points on the body
  • the placement points are different from the ones used in Traditional Chinese Medicine
  • only go into the layers of fat under the skin
  • combination of traditional acupuncture and modern medicine.

Pain Reduction

Needle knife⁴

  • uses needle tool made of metal material that resembles both a needle and a knife in shape
  •  The width of the needle knife is usually equal to the diameter of the needle body, and the edge is sharp
  • used to loosen and release scar tissue⁵

Improvement of Ability to do Daily Activities

Silver needle⁶

  • similar to common acupuncture,  
  • uses a needle made of 80% silver with good heat conduction
  • placement points are muscles, tendons, and other connective tissues⁷
  • a special machine to heat the needles

The study also looked at the side effects of acupuncture and massage to treat knee osteoarthritis and found only occasional mild side effects of bleeding or bruises at the site. No significant side effects were reported in the treatments.

The study analyzed a carefully selected group of completed research studies against each other. When selecting the studies to analyze, this group looked for studies written in English or Chinese, used diagnostic criteria from well-respected organizations, focused only on knee osteoarthritis, and were considered accurate and well-done by the medical community.  It reviewed 3076 research studies with 4458 patients with knee osteoarthritis.

The study compared the overall effective rates along with the visual analog scale (where the patient rates their pain from 1-10), the Lysholm index score (a scoring system often used by orthopedic doctors to rate a patient’s symptoms), and the WOMAC score (a list of questions answered by the patient about their pain, limitations, and symptoms) of various combinations of acupuncture and massage types.

The number of people with knee osteoarthritis is expected to rise based on increased rates of obesity and life expectancy.  The study noted that more specific studies with larger groups of patients are needed to find the best combination of acupuncture and massage in treating knee osteoarthritis.

Citations

¹Zhen Wang, Yongquan Wang, Congan Wang, Xujie Li, Ziyang Zhou, Lijuan Zhang, Miaoxiu Li, Yankun Pan, Tiyong Jiao, Xiaoyun Shi, Qing Liu, "Systematic Review and Network Meta-analysis of Acupuncture Combined with Massage in Treating Knee Osteoarthritis", BioMed Research International, vol. 2022, Article ID 4048550, 21 pages, 2022. https://doi.org/10.1155/2022/4048550

²Acupuncture – Mayo Clinic. (2022, April 30). Retrieved October 23, 2022, from https://www.mayoclinic.org/tests-procedures/acupuncture/about/pac-20392763

³Floating Acupuncture Therapy. (2018, July 22). Retrieved October 23, 2022, from https://goldenlinegroup.ca/floating-acupuncture/

⁴Lin, Munan et al. “Needle-knife therapy improves the clinical symptoms of knee osteoarthritis by inhibiting the expression of inflammatory cytokines.” Experimental and therapeutic medicine vol. 7,4 (2014): 835-842. doi:10.3892/etm.2014.1516

⁵Adhesion. (n.d.). Retrieved October 23, 2022, from https://medlineplus.gov/ency/article/001493.htm

⁶The efficacy and safety of silver needle in the treatment. . . : Medicine. (n.d.). LWW. Retrieved October 23, 2022, from https://journals.lww.com/md-journal/Fulltext/2021/05070/The_efficacy_and_safety_of_silver_needle_in_the.17.aspx

⁷What Is Fascia? (2021, June 25). WebMD. Retrieved October 23, 2022, from https://www.webmd.com/a-to-z-guides/what-is-fascia

Here is the original article along with its supplemental material.

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