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By Alice Dembner, Globe Staff (December 21, 2004)

Treatment with acupuncture needles significantly reduced pain and eased movement for patients with arthritic knees who were taking pain medicine, according to the largest and most rigorous study to date of the ancient treatment.

The new findings offer hope to the 20 million Americans with osteoarthritis, many of whom have chronic pain despite taking medicine daily, and who are looking for safe alternatives to the popular pain drugs that have been linked to heart attacks and strokes.

The new results also mark the most significant proof yet that acupuncture, first practiced in China more than 2,000 years ago, is a useful and safe treatment for some illnesses. The study, sponsored by the National Institutes of Health and published today in the Annals of Internal Medicine, is part of the government's multimillion-dollar effort to test alternative medical therapies using scientific methods.

"We now have a new adjunct therapy for millions of patients with degenerative arthritis," said Dr. Stephen E. Straus, director of the National Center for Complementary and Alternative Medicine, which helped fund the study.

About 2 million Americans use acupuncture for various problems, according to a federal survey, and it is increasingly offered by hospitals and other mainstream health professionals. Several smaller, less rigorous studies have indicated that acupuncture is helpful in treating nausea after chemotheraphy or surgery, and can alleviate postoperative dental pain. Studies are also underway to test whether it can reduce high blood pressure or ease depression.

But researchers yesterday cautioned against extrapolating the new findings to other common arthritis symptoms, such as hip or back pain, without further study. Other studies on pain have yielded conflicting results, and a separate, smaller study published yesterday in the same medical journal found that acupuncture reduced chronic neck pain, but not enough to make a difference to patients.

"Just because acupuncture is 2,000 years old doesn't mean it's magic," said Straus. "Running to acupuncture is not going to cure you" of osteoarthritis.

The knee study involved 570 patients in Maryland and New York who had moderate to severe pain despite treatment with pain medicine. Researchers randomly assigned patients to get acupuncture, sham acupuncture, or education in addition to their pain pills.

The treatment involved insertion of nine thin needles into key points in the leg. In the sham treatment, acupuncturists tapped on the same points, but then taped needles to the skin without inserting them. All patients were blocked from seeing their legs during the treatment, so they would not know if they were truly getting acupuncture in the correct spots.

"The credible nature of the sham treatment adds to the credibility of the study," said Dr. David M. Eisenberg, director of the Osher Institute and Division for Research and Education in Complementary and Integrative Medicine at Harvard Medical School.

Patients in the acupuncture and sham acupuncture group each received two treatments a week for eight weeks, and then one treatment per month over the next 18 weeks. They reported few side effects and none that researchers believed were related to the acupuncture.

Those who got the acupuncture indicated a 40 percent reduction in pain and a nearly 40 percent improvement in function by the 14th week, which lasted through week 26, based on two specific tests of pain and movement, researchers reported. Significantly more patients getting the real treatment reported feeling better at 26 weeks, based on their own overall assessment. Both the placebo and real treatment were more effective than education about how to manage symptoms.

There was also a large placebo effect -- patients in the sham treatment group reported about a 30 percent reduction in pain -- but the effect of the real acupuncture was significantly greater.

"For patients who have chronic knee pain and aren't getting comprehensive relief, acupuncture should be a consideration," said Dr. John Klippel, medical director of the National Arthritis Foundation.

Neither Medicare nor most major insurers currently pay for acupuncture. However, in Massachusetts, all three major health plans -- Blue Cross-Blue Shield, Tufts, and Harvard Pilgrim -- offer members a discount on acupuncture costs if they choose from a list of approved providers.

© Copyright 2004 Globe Newspaper Company.