Acupuncture for knee osteoarthritis and chronic low back pain
Acupuncture analgesia:its relationship with pain adaptability and endogenous pain control in chronic low back pain and knee osteoarthritis patients
RMIT university
90 participants
May 18, 2015
Interventional
Conditions
Summary
Chronic non-specific low back pain and knee osteoarthritis are among the most prevailing chronic pain conditions. Despite the a wide array of treatment options available, not everyone receives satisfactory pain relief. This may be because people respond differently to pain treatments. An optimal and safe treatment is necessary. This project aims to determine whether people with two forms of pain adaptability respond differently to local acupuncture needling. We test this aim in people with knee osteoarthritis or low back pain. The pain adaptability of the participants has previously been determined using a cold pressor test. The acupuncturist is blinded from participants’ pain adaptability and delivers an acupuncture treatment of 8 sessions. The response to acupuncture is measured by assessing the change in pain at the knee or lower back through a pain diary before and after the acupuncture treatment. This project will contribute to the development of individualised medicine by targeting those who respond better to acupuncture.
Eligibility
Inclusion Criteria17
- Chronic non-specific low back pain sufferers, meeting the following criteria:
- aged 20-65years
- Diagnosed with chronic non-specific low back pain by a general health practitioner or a registered health practitioner (eg: chiropractor, physiotherapist, osteopath) OR meeting the recommendations from the American College of Physicians and the American Pain Society (R. Chou et la, 'Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of physicians and the American Pain Society', Ann Intern Med, 147(2007),478-91)
- experienced ongoing pain at or above two out of 10 on a 10cm visual analogue scale (VAS) in the previous week
- adequate conversational English
- OR
- knee osteoarthritis sufferers meeting the following criteria:
- aged 40-80 years
- diagnosed with osteoarthritis (by a general practitioner or a registered health care practitioner) in one/ both knees for more than six months OR knee pain with at least three out of six of the following criteria as recommended by the American College of Rheumatology (R. Altman et al, The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the knee, Arthritis Rhuem 1986;29:1039-1049):
- Age more that 50 years
- stiffness for more than 30 minutes
- crepitus
- bony tenderness
- bony enlargement
- no palpable warmth
- Experienced ongoing pain at or above two out of 10 on a 10cm visual analogue scale (VAS) in the previous week
- adequate conversational English
Exclusion Criteria15
- For chronic non-specific low back pain suffers:
- Regular anti-convulsant, anti-depressant or opioid use for pain.
- People with Chronic non-specific low back pain who also have knee osteoarthritis
- Radicular pain, osteosporosis, surgery or previous fractures of the spine, history of acute trauma in the spine, low back pain caused by inflammatory, malignant, or autoimmune disease (or other low back pain from specific reasons)
- Pregnancy or intent to become pregnant, breast feeding, brain tumor, cancer, hemophilia or peripheral neuropathy.
- Frequent recreational drug or excessive alcohol use.
- Uncontrolled hypertension
- Injuries in areas to be tested
- For knee osteoarthritis sufferers:
- Regular anti-convulsant, anti-depressant or opioid use for pain.
- People with knee OA osteoarthritis who also have Chronic non-specific low back pain
- Pregnancy or intent to become pregnant, breast feeding, brain tumor, cancer, hemophilia or peripheral neuropathy.
- Frequent recreational drug or excessive alcohol use.
- Uncontrolled hypertension
- Injuries in areas to be tested
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Interventions
The participants will receive eight sessions of acupuncture twice a week over four weeks. A registered and experienced acupuncturist will deliver the acupuncture. At each session, participants will receive manual acupuncture for a duration of 20-30 minutes at tender points at or close to the site of pain condition. Four to eight points are needled. A record of each acupuncture session is kept. To monitor compliance and adherence participants are sent reminders for the acupuncture appointments. We also offer a flexible schedule to accommodate the participants who cannot come within working hours. The participants in this study were also part of a psychophysics research project determining their pain adaptability through a cold pressor test (the psychophysics research project is not a clinical trial so it does not have a registration number). At the end of the acupuncture treatment participants will undergo psychophysics tests. Please see information about secondary outcome measures.
Locations(1)
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ACTRN12615000944538