Osteoarthritis (OA), the most common form of arthritis, is commonly known as wear-and-tear arthritis. It is a growing epidemic as the world’s population ages. In Taiwan, nearly 40% of Taiwanese individuals over age 50 have OA of the knee; that number rises to 55% in women over age 80. OA is a known risk factor for falls in older adults, making OA management a public health goal. Researchers in Taiwan wanted to better understand the association between acupuncture therapy, which has been around for centuries, and the risk of fracture in Taiwanese patients with OA.
Using a 1:1 propensity score-matched cohort design, the multi-site team used the Taiwanese National Health Insurance Research Database (which covers about 97% of the population) to identify >3,400 patients between 1997 and 2010 with newly diagnosed OA. The 2 groups (1,708 individuals each) were equally matched in baseline characteristics for age, sex, comorbidities, drugs used, and surgical episodes. More than half the study population had hypertension, 40% had hyperlipidemia, 23% had diabetes, and 17% had depression. Alcoholism, tobacco dependence, and obesity were similar among both cohorts. In the final analysis, 292 patients in the acupuncture cohort and 431 in the no-acupuncture cohort developed fractures. Fracture incidence increased with age rising from 2.11 in those age 40 to 60 years, to 3.91 in those over age 65. Patients with depression had higher risk of fractures while the acupuncture cohort overall had a lower cumulative incidence of fracture (log-rank test, P<0.001).
In the acupuncture group, 87% underwent manual acupuncture, 2% electroacupuncture, and 11% used a combination of the 2 forms. The authors note the evidence for use of acupuncture as a fracture preventive is growing. In particular, they cite studies that found acupuncture increases bone mineral density and may stimulate and/or regulate pro-inflammatory and anti-inflammatory cytokines, which has the potential to improve osteoporosis and therefore fractures.
The authors concluded that acupuncture treatment relieves joint pain and improves muscle power, which benefits musculoskeletal disorders as well as degenerative disease and may help stroke patients preserve limb function and attain better quality of life. The results of this study, they write, shows the association between using acupuncture and the reduced incidence of fracture in an aging population.
Source: Huang CY, Wu MY, Huang MC, et al. The association between acupuncture therapies and reduced fracture risk in patients with osteoarthritis: a nationwide retrospective matched cohort study. J Integr Complement Med. 2022;28(5):418-426. doi: 10.1089/jicm.2021.0287.
