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Osteoarthritis

Osteoarthritis involves damage to articular cartilage and other structures in and around joints, with variable levels of inflammation. The most commonly affected joints are the knee and the hip. About 10% of people aged over 55 years in the UK have painful knee osteoarthritis associated with mild to moderate disability. Many patients with osteoarthritis have significant pain and loss of function, often episodically, and will require treatment to control their symptoms. Every year, symptomatic knee osteoarthritis accounts for about 0.5% of all primary care consultations by those aged over 55 years, rising to 1% for those over 70 years. Disability due to osteoarthritis can limit quality of life and independent living, or the ability to care for a disabled spouse. 

Treatment options for osteoarthritis involve a combination of non-drug and drug interventions. The non-drug interventions include ongoing access to appropriate information; lifestyle measures (e.g. weight loss, exercise); walking aids; wedged insoles; local therapy involving heat or cold; physiotherapy; transcutaneous electrical nerve stimulation (TENS); cognitive behavioural therapy; and food supplements (e.g. glucosamine).

Drugs used include paracetamol, oral or topical non-steroidal anti-inflammatory drugs (NSAIDs), capsaicin, opioids and intra-articular corticosteroid injections. Joint replacement surgery is an option if pain relief and functional improvements are inadequate with other treatments, and there is a significant impact on quality of life.

Evidence from a systematic review suggests that moxibustion is more effective than conventional drug therapy for osteoarthritis of the knee, as well as in rheumatic conditions in general, and also that it improves benefits when added to conventional drugs. Several systematic reviews of acupuncture for osteoarthritis of peripheral joints/knee and hip/knee alone have concluded that it is statistically superior to sham acupuncture and to usual physician care, and similar in benefit to some other active interventions such as exercise regimes. All of these, together with the expert consensus guidelines of the Osteoarthritis Research Society International, recognise that it has clinically relevant benefits and a favourable safety profile, and they recommend acupuncture as a treatment option for osteoarthritis.
 

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic condition that can cause pain, stiffness, progressive joint destruction and deformity, and reduce physical function, quality of life and life expectancy. The condition involves synovial joint inflammation, and both T- and B-cells are implicated in the underlying immune pathology, as is the over-production of pro-inflammatory cytokines. The course of rheumatoid arthritis is variable, following a pattern of relapses and remissions. However, within about 2 years of diagnosis, patients usually have moderate disability and, after 10 years, around 30% are severely disabled. The cause of rheumatoid arthritis is unknown. Infection with a micro-organism in those genetically susceptible, hormonal influences, obesity, diet, and cigarette smoking have all been implicated as risk factors.

The aim of treatment is to control pain and inflammation, reduce joint damage, disability and loss of function, achieve low disease activity or remission, and improve quality of life. A variety of drugs are used, including NSAIDs, analgesics, corticosteroids and disease-modifying anti-rheumatic drugs (DMARDs). None-drug treatments such as physiotherapy may also be used.
 

How acupuncture may help

Arthritis Research UK gives support for acupuncture in treatment of arthritic and muscle pain. A recent study, published by Arthritis Research UK, into the efficacy of alternative medicine for conditions such as osteoarthritis, low back pain and fibromyalgia, found that acupuncture came out tops in treating these conditions. They concluded that there was good evidence for the use of acupuncture in alleviating these symptoms. Interestingly, evidence also backed the use of the Chinese health exercise, Tai Qi, in combating these conditions.

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body's homeostatic mechanisms, thus promoting physical and emotional well-being. Stimulation of certain acupuncture points has been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress.

knees rheumatoid arthritis osteoarthritis acupuncture

hands rheumatoid arthritis osteoarthritis acupuncture

 

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