Acupuncture versus Homeopathy as A Complementary Therapy in Patients with Knee Osteoarthritis

Document Type : Original Article

Authors

1 Department of Internal Medicine - Rheumatology Division, Ain Shams University; Egypt.

2 Department of Physical Medicine and Rehabilitation, Ain Shams University; Egypt.

3 Department of Complementary Medicine, National Research Center; Egypt

Abstract

Background: Osteoarthritis of the knee is a major cause of disability with treatment focused only on control of symptoms.
Despite the popularity of both acupuncture and homeopathy, evidence of their efficacy for treatment of osteoarthritis remains
controversy. Aim of the Work: To assess the efficacy of Acupuncture compared with Homeopathy and with the usual
conservative treatment (analgesics and physiotherapy) in patients with knee osteoarthritis. Patients and Methods: Seventy-five
patients who had had chronic pain for at least 6 months due to osteoarthritis of the knee (American College of Rheumatology
[ACR] criteria and Kellgren-Lawrence score of 2), all continue on their conservative therapy remained unchanged all-through
the study. They were divided into three groups; Group I (Acupuncture group): Included 25 patients who were subjected to
acupuncture at the standardized acu-point stimulation treatment without electrical stimulation. Sessions were done twice weekly
from base line visit to week six. Group II (Homeopathy group): Included 25 patients who were given oral doses of homeopathic
remedies that were commonly used for the treatment of osteoarthritis (Arnica Montana, Ruta graveolans and Rhus
toxicodendron). Group III (Control group): Included 25 patients who continued only on their pre-study medications .Pain
intensity on visual analog scale (VAS), the Health Assessment Questionnaire (HAQ) score and the Western Ontario and
McMaster Universities Osteoarthritis Index (WOMAC) score were recorded for each patient before the beginning of treatment,
during each visit and at the end of the sessions. The results were statistically analyzed. Results: Pain has improved statistically
on both VAS and pain subscale of the WOMAC in group I. Also, the number of tender points decreased significantly and there
was significant decrease in the number of patients receiving analgesics for pain control at the end of the study (p<0.05). In
addition, a statistically significant improvement in knee function was detected (p<0.05) on the total WOMAC score for knee
osteoarthritis and both the function and stiffness subscales of the WOMAC, in addition a statistically significant decrease in knee
swelling (knee circumference) was detected in this group, as well as the patient quality of life assessed by the HAQ score in
comparison to the control group. There was a statistically significant improvement in the total WOMAC score, both VAS and
pain subscale of the WOMAC, number of tender points in group II. Moreover, a significant decrease in the number of patients
receiving analgesics for pain control was reported in this group (p<0.05).However, the decrease in knee swelling assessed by the
knee circumference was statistically insignificant in this group. In addition, we found that the improvement of pain and function
was statistically significant (p<0.05) in comparison to the control group (group III). Conclusions: Both Acupuncture and
Homeopathy were effective in reducing pain and improving function of the knee but acupuncture was significantly more
effective than homeopathy. Moreover, Acupuncture significantly decreased the knee circumference while homeopathy did not
decrease it significantly.

Keywords

Egyptian Journal of Rheumatology and Clinical Immunology
Volume 2, Issue 1
January 2014
Pages 45-51

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