Acupuncture: Can It Help My Rheumatoid Arthritis?

Summary of Dr. Meng’s Presentation at the Early RA Support and Education Workshop on May 16, 2012


Charis F. Meng, MD

Charis F. Meng, MD

Assistant Attending Rheumatologist, Hospital for Special Surgery
Assistant Professor of Medicine, Weill Cornell Medical College

Rheumatoid Arthritis (RA) is a chronic, inflammatory systemic illness that affects the whole body, especially the joints. It is also an autoimmune disease, which means that the immune system in the body, usually responsible for fighting off infections, also mistakenly begins to attack healthy tissue.

One of the most common symptoms of RA is joint pain. People suffering from pain conditions, such as RA-related joint pain, may be interested in trying acupuncture treatment. Acupuncture is not a cure for RA, but it may provide some temporary relief of RA-related joint pain.

Acupuncture - What It Is

Acupuncture treatment, which has been practiced for over 2,500 years, is rooted in traditional Chinese medicine and is based on the theory of “Qi.”

“Qi,” the body’s vital energy or life force, controls the workings of the body and is concentrated in 12 main meridians, corresponding to 12 major bodily functions. If one’s energy is in balance, the body is healthy; if not, the body experiences symptoms such as pain. A traditional Chinese medical evaluation is performed with an examination of the tongue and the pulse. The treatment is designed to restore the patient’s energy balance.

How It Works

Acupuncture technique stimulates specific acupoints, (sometimes, but not always, at the site of the symptom), using fine needles.

Studies show that most acupoints cluster near nerves. When a needle is placed, patients typically report soreness, tingling, and electrical sensations, which are associated with nerves being activated. Needle placement activates the nerve and sends a signal to the spinal cord and brain, the pain centers of the nervous system. These are then activated to produce endorphins, the body’s natural pain killers. The theory is that this is how acupuncture works to fight pain.

What It Can Do

Studies have shown some evidence that acupuncture can help patients with chronic pain (pain lasting longer than three months), and also may relieve back pain disability. Acupuncture has also been found to be helpful in treating low back pain, and pain from other conditions, such as osteoarthritis, fibromyalgia, carpal tunnel syndrome, and headaches.

Acupuncture Treatment and Rheumatoid Arthritis

Acupuncture has not been shown to prevent joint damage, and study data is conflicting as to whether acupuncture controls inflammation. Although there is no positive proof that acupuncture addresses inflammation, this has occasionally been seen.

Acupuncture can, however, help with RA-related pain, just as it does with other types of pain, through the stimulation of endorphin production. Acupuncture should not be used as the sole treatment for RA, but rather as an additional treatment, in conjunction with RA disease-modifying medications. It is a tool to fight pain with minimal side effects, which can be undertaken along with medication treatment.

What to Expect at an Acupuncture Appointment

An acupuncturist may be a medical doctor or not, but licensing is required to practice in New York state. A practitioner’s acupuncture certification and license should be displayed in his or her office.

The patient should expect:

  • to be positioned comfortably during treatment
  • have the skin cleansed with alcohol prior to the placement of needles
  • have the needles placed 1-2 centimeters deep
  • for the needles to be single-use, sterilized and disposed of after use

After the needles have been placed by the practitioner, they may be stimulated manually or electrically, and a warming lamp may be used. Acupuncture needles are thinner than injection hypodermic needles, so the insertion should feel akin to a mosquito bite. The patient may experience tingling, soreness, or an electrical sensation as the needles are being manipulated.

Everyone’s response is unique, but the patient is likely to feel a sense of relaxation and well-being during treatment.

It is important for a patient to communicate any concerns they may have prior to undergoing treatment and make note of any easily accessible ways to contact the practitioner should a need for assistance arise. In some instances, the practitioner may leave the room once the needles have been placed to give the patient time to relax.

Side Effects

Potential side effects include:

  • mild aching
  • bruising or redness at the needle placement site
  • light headedness right after treatment
  • occasionally nausea.

Uncommon side effects include infections and nerve injury; but these are extremely rare when the treatment is performed by a licensed acupuncturist.

Patients should always discuss acupuncture with their individual physicians, prior to undergoing treatment, since certain conditions may make it ill-advised. For example, if a patient is taking a blood-thinning medication, extra care would need to be taken. Also, if a patient has a seizure disorder or irregular heartbeat, electroacupuncture, where a small electric current is passed between pairs of acupuncture needles, should be avoided.

Is Acupuncture Treatment Covered by Insurance?

Unfortunately, Medicare does not cover acupuncture, and only some insurance plans do. Standard treatment for pain is 6-10 treatments spread over 3-5 weeks. Ask your acupuncturist how many treatments are needed to see an improvement in your pain.

Typically, after 6-10 treatments, the patient may continue treatment at a lower frequency, or stop the treatment and resume on an as-needed basis.

In Summary

Acupuncture may be a safe and effective treatment for RA related pain, but it is not a substitute for disease-modifying medication treatment. Always consult your physician before starting treatment, to discuss whether this might be an option for you.

Summary by Kathryn Klingenstein, L.M.S.W.

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