Guideline for the management of knee and hip osteoarthritis

Recommendations

Acupuncture

Guideline for the management of knee and hip osteoarthritis
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  3. Figures and tables
  4. Provided under licence

Non-pharmacological interventions 

Acupuncture

The evidence for different forms of acupuncture (ie traditional, laser, electro) was considered separately (Appendix 5 of the Guideline for the management of knee and hip osteoarthritis: Technical document).

Acupuncture – Knee and/or hip

Recommendation

We suggest not offering acupuncture (ie traditional, laser, electro) for people with knee and/or hip osteoarthritis (OA).

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low (knee)
Very low (hip)

What is it? 

Acupuncture may be administered by a variety of health professionals. It is traditionally applied via the insertion of acupuncture needles into acupuncture points, with or without mechanical or electrical stimulation. Laser acupuncture involves the application of low intensity laser light to acupuncture points, instead of needles. Acupuncture is usually provided as a course of treatment over multiple sessions spread over a number of weeks. 

Rationale 

There is low-quality evidence that traditional, laser and electro acupuncture have statistically significant benefits on pain and function, compared with sham acupuncture in people with knee OA (Appendix 5 of the Guideline for the management of knee and hip osteoarthritis: Technical document). However, these benefits are small and not of a clinically relevant magnitude. There is very low-quality evidence suggesting no statistically significant effect of laser acupuncture on either pain or function in people with knee OA. There is very low-quality evidence that traditional acupuncture has no statistically significant effect on pain or function, compared with sham in people with hip OA (Appendix 5 of the Guideline for the management of knee and hip osteoarthritis: Technical document). Clinicians should not offer acupuncture to people with knee and/or hip OA because of its lack of clinical effectiveness and the necessity of multiple visits to a clinician for passive treatment that may come at a financial cost to the individual.

Harms 

There is a statistically significant increase in the risk of adverse events with acupuncture, compared with sham in people with knee OA, although most were unrelated to acupuncture treatment (Appendix 5 of the Guideline for the management of knee and hip osteoarthritis: Technical document).

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