Pain-reducing effects of auricular acupuncture in cold-damp-type knee osteoarthritis: A randomized controlled trial

Abstract

   Background: Effective, low-risk adjuncts for knee osteoarthritis (KOA) are needed. We evaluated whether adjunctive auricular acupuncture (AA) improves pain and function in patients with cold-damp-type KOA.
   Methods: In a single-center, randomized, single-blind, controlled trial, 124 adults (≥40 years) with radiographic primary KOA and baseline VAS ≥6 were randomized 1:1 to receive standard care (electroacupuncture, shortwave diathermy, and Duhuo Jisheng decoction tablets) with either weekly AA at Shenmen, Sympathetic, and Knee auricular points for 4 weeks (n=62) or sham auricular patches (n=62). Co-primary outcomes were change in VAS (0-10) and proportion achieving pain-free status (VAS ≤1) at week 4; secondary outcomes included WOMAC subscales and responder thresholds (≥30% and ≥50% WOMAC reduction).
   Results: Mean VAS reduction was greater in the AA group than control (-4.84 ±0.22 vs -3.43 ±0.16; between-group p=0.009). Mean total WOMAC change favored AA (-42.64 ±1.74 vs -26.39 ±1.28; p=0.009). Pain-free status at week 4 occurred in 15/62 (24.2%) AA versus 3/62 (4.8%) control (RR 4.8; 95% CI 1.4-16.2; p=0.002). Clinically meaningful functional response (≥50% WOMAC) was 37/62 (59.7%) versus 7/62 (11.3%) (RR 5.3; 95% CI 2.5-11.2; p<0.001). No intervention-related adverse events were reported.
   Conclusions: Weekly AA added to standard therapy produced greater short-term pain relief and functional gains with excellent safety. Confirmatory multicenter trials with longer follow-up are warranted.

DOI: 10.59715/pntjmp.5.2.14