(Press-News.org) Among patients older than 50 years with moderate to severe chronic knee pain, neither laser nor needle acupuncture provided greater benefit on pain or function compared to sham laser acupuncture, according to a study in the October 1 issue of JAMA.
Chronic knee pain affects many people older than 50 years and is the most common pain concern among older people consulting family physicians. Nonpharmacological approaches are central to managing chronic knee pain, and patients with joint pain frequently use complementary and alternative medicine. Acupuncture is the most popular of alternative medical systems, with use increasing over time. Although traditionally administered with needles, laser acupuncture (low-intensity laser therapy to acupuncture points) is a noninvasive alternative with evidence of benefit in some pain conditions. There is debate about the benefit of acupuncture for knee pain, according to background information in the article.
Rana S. Hinman, Ph.D., of the University of Melbourne, Australia, and colleagues randomly assigned 282 patients (50 years or older) with chronic knee pain to no acupuncture (control group, n = 71) or needle (n = 70), laser (n = 71), or sham laser (n = 70) acupuncture. Treatments were delivered for 12 weeks. Participants and acupuncturists were blinded to laser and sham (inactive) laser acupuncture.
There were no significant differences in primary outcomes (measures of knee pain and physical function) between active and sham acupuncture at 12 weeks or 1 year. Both needle and laser acupuncture resulted in modest improvements in pain compared with control at 12 weeks that were not maintained at 1 year. Needle acupuncture improved physical function at 12 weeks compared with control but was not different from sham acupuncture and was not maintained at 1 year.
Most secondary outcomes (other pain and function measures, quality of life, global change, and 1-year follow-up) showed no difference. Needle acupuncture improved pain on walking at 12 weeks but was not maintained at 1 year.
The authors note that incidental factors such as treatment setting, patient expectations and attitudes (such as optimism), acupuncturist's confidence in treatment, and patient and acupuncturist interaction may influence outcomes. "In our study, benefits of acupuncture were exclusively attributed to incidental effects, given the lack of significant differences between active acupuncture and sham treatment. Continuous subjective measures, such as pain and self-reported physical function, as used in our study, are particularly subject to placebo responses."
"In patients older than 50 years with moderate or severe chronic knee pain, neither laser nor needle acupuncture conferred benefit over sham for pain or function. Our findings do not support acupuncture for these patients."
INFORMATION:
(doi:10.1001/jama.2014.12660; Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Study finds acupuncture does not improve chronic knee pain
2014-09-30
ELSE PRESS RELEASES FROM THIS DATE:
Use of a 'virtual ward' model of care does not reduce hospital readmissions, risk of death
2014-09-30
In a trial involving patients at high risk of hospital readmission or death, use of a virtual ward model of care (using some elements of hospital care in the community) after hospital discharge did not significantly reduce the rate of readmission or death up to a year following discharge, according to a study in the October 1 issue of JAMA.
Hospital readmissions are common and costly, and no single intervention or bundle of interventions has reliably reduced readmissions. The virtual ward model of care is a way of providing care to patients with complex needs who are ...
Study compares long-term outcomes for types of aortic valve replacements
2014-09-30
Among patients ages 50 to 69 years who underwent aortic valve replacement with bioprosthetic (made primarily with tissue) compared with mechanical prosthetic valves, there was no significant difference in 15-year survival or stroke, although patients in the bioprosthetic valve group had a greater likelihood of reoperation but a lower likelihood of major bleeding, according to a study in the October 1 issue of JAMA.
Approximately 50,000 patients undergo aortic valve replacement annually in the United States. In older patients, bioprosthetic valves pose a low lifetime ...
Medical professional liability claims and esophageal cancer screening
2014-09-30
An analysis of liability claims related to esophageal cancer screening finds that the risks of claims arising from acts of commission (complications from screening procedure) as well as acts of omission (failure to screen) are similarly low, according to a study in the October 1 issue of JAMA.
Endoscopic screening for esophageal cancer has been recommended for patients with chronic symptoms of gastroesophageal reflux disease, but only if they have additional risk factors. Surveys of gastroenterologists indicate that concern about litigation for missing a cancer may drive ...
Biodiversity in the Mediterranean is threatened by alien species
2014-09-30
Millions of tourists visit the Mediterranean each year, but its deep-blue waters host the largest invasion currently underway on Earth. Almost 1,000 alien species, including fish, crustaceans, and algae are now established from other seas through human activities. In the open-access journal Frontiers in Marine Science, a multinational team of researchers analyzed data from a new information system developed by the European Commission to show how the introduction of alien species has changed the native biodiversity within the Mediterranean.
A hotspot for marine biodiversity, ...
Clinical trial finds virtual ward does not reduce hospital readmissions
2014-09-30
TORONTO — A virtual ward, a new model of care that provides support to high-risk and complex patients in the community for a few weeks after discharge from hospital, did not prevent hospital readmissions as hoped in a clinical trial in Toronto.
Hospital readmissions are common and costly and no intervention has reliably reduced them. Virtual wards, pioneered in Britain 10 years ago, were thought to have the potential to reduce readmissions, but had not been rigorously evaluated by researchers.
Dr. Irfan Dhalla, a physician at St. Michael's Hospital, led a randomized trial ...
Researchers show EEG's potential to reveal depolarizations following TBI
2014-09-30
CINCINNATI—The potential for doctors to measure damaging "brain tsunamis" in injured patients without opening the skull has moved a step closer to reality, thanks to pioneering research at the University of Cincinnati (UC) Neuroscience Institute.
The research team, led by Jed Hartings, PhD, research associate professor in the department of neurosurgery at the UC College of Medicine, has shown that spreading depolarizations—electrical disturbances that spread through an injured brain like tsunami waves—can be measured by the placement of electroencephalograph (EEG) electrodes ...
NASA's Swift mission observes mega flares from a mini star
2014-09-30
On April 23, NASA's Swift satellite detected the strongest, hottest, and longest-lasting sequence of stellar flares ever seen from a nearby red dwarf star. The initial blast from this record-setting series of explosions was as much as 10,000 times more powerful than the largest solar flare ever recorded.
"We used to think major flaring episodes from red dwarfs lasted no more than a day, but Swift detected at least seven powerful eruptions over a period of about two weeks," said Stephen Drake, an astrophysicist at NASA's Goddard Space Flight Center in Greenbelt, Maryland, ...
NASA's HS3 looks Hurricane Edouard in the eye
2014-09-30
NASA and NOAA scientists participating in NASA's Hurricane and Severe Storms Sentinel (HS3) mission used their expert skills, combined with a bit of serendipity on Sept. 17, 2014, to guide the remotely piloted Global Hawk over the eye of Hurricane Edouard and release a sonde that rotated within the eye as it descended and fell into the eyewall of the storm at low levels.
NASA's HS3 mission has returned to NASA's Wallops Flight Facility on the Eastern Shore of Virginia for the third year to investigate the processes that underlie hurricane formation and intensity change ...
Study shows that tongue size and fat may predict sleep apnea risk in obese adults
2014-09-30
DARIEN, IL – A new study of obese adults is the first to show that those who have obstructive sleep apnea have a significantly larger tongue with a higher percentage of fat than obese controls. This may provide a mechanistic explanation for the relationship between obesity and sleep apnea.
Results show that obese participants with sleep apnea had significantly greater tongue volumes, tongue fat and percentage of tongue fat than obese controls without sleep apnea, after adjusting for potential confounders such as age, body mass index (BMI), gender and race. Further analysis ...
Ultrafast remote switching of light emission
2014-09-30
This news release is available in German.
The researchers etched a photonic crystal around several quantum dots in a semiconductor layer. Quantum dots are small structures that spontaneously emit light as a consequence of atomic processes. If a short laser pulse is fired at the photonic crystal, its refractive index is modified and the quantum dot experiences a change in the electromagnetic field around it. This change can speed up or slow down the emission of light by the dot. As soon as the refractive index recovers its usual value, the dot emits light again ...