Acupressure for arthritis
Acupressure reduces osteoarthritis pain
ANN ARBOR. Patients with osteoarthritis of the knee can alleviate their symptoms using a self-applied acupressure technique, but the acupoints are not important, as Dr. Lydia Li and coworkers from Ann Arbor University.
The researchers opted for acupressure because pain sufferers can use it on themselves, unlike acupuncture. Acupressure could therefore be a simple and inexpensive method to relieve the pain of osteoarthritis as well, they write.
150 patients over 65 years of age took part in their randomized controlled study, who were randomly divided into three groups of equal size: One continued to receive only the usual treatment (control group), another was instructed to perform acupressure on himself, the the others received sham acupressure training (Arthritis Care & Research 2018; 70 (2): 221–229).
At the end of the study, the study doctors also offered the participants in the control group acupressure training.
Participants are 73 years old on average
In the acupressure group, the patients received a special massage stick with which they should stimulate nine different acupoints to reduce pain.
In a training session, therapists convinced themselves that at least 90 percent of them were able to do this. In addition, the patients were given information material and an instruction DVD to take home.
In the group with sham acupressure, the procedure was similar: Here, too, nine points were stimulated, but these did not match the acupoints and were clearly distant from them. Both acupressure and sham acupressure patients also received their usual pain therapy.
In the therapy groups, the participants were instructed to carry out the treatment themselves once a day, five days a week for two months.
The study doctors recorded the progression of pain and mobility restrictions through medical examinations after four and eight weeks and in weekly telephone calls.
The participants were on average 73 years old and about two-thirds women, the mean BMI was 29. The researchers chose the value on the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) pain scale (0-20) as the primary endpoint Points).
Starting from 6.5 points in the group with acupressure, this had fallen to 5.4 after four weeks and to 4.8 points (minus 1.7 points) after eight weeks.
In the group with sham acupressure there was a similar decrease from 6.8 to 5.5 points (minus 1.3 points) within two months, whereas the values in the control group only decreased slightly (minus 0.6 points).
Control group is a problem of the study
If the study authors took into account factors such as age, gender, ethnicity and BMI, the difference between acupressure and control and between sham acupressure and control turned out to be statistically highly significant, but not the difference between acupressure and sham treatment.
Acupressure and sham acupressure were able to significantly reduce the pain compared to the control group. The WOMAC subscale for physical limitations (0–68 points) produced a similar picture.
At the beginning the values were a little over 20 points, with acupressure and sham acupuncture they fell by around 6 points, in the control group only by 2 points. Here, too, the differences between the two intervention and control groups were significant, but not those between the two intervention groups.
Finally, the study doctors also checked the course of pain perception using a numerical 10-point analog scale. With acupressure the pain decreased significantly by 0.75 points, with sham acupuncture by 0.5 points more than in the control group.
One problem with the study, however, is the control group: Patients who hope for active therapy are usually disappointed when they are assigned to the waiting group; and this disappointment can distort the perception of pain. (courage)
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