Acupuncture: Can It Help My Rheumatoid Arthritis?

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 treatment, which has been practiced for over 2,500 years, is rooted in traditional Chinese medicine (TCM) and is based on the theory of “qi” (sometimes spelled “chi,” “ch’i” or “ki”), the body’s vital energy or life force.

In TCM, qi controls the workings of the body and is concentrated in 12 main meridians (pathways in the body) that correspond to 12 major bodily functions. If one’s qi 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 acupuncture works

Acupuncture stimulates specific points located on the body mapped out (sometimes, but not always, located 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 reliever. 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. In addition to outpatient use, acupuncture is also being explored in perioperative settings. At HSS we have incorporated acupuncture techniques during surgery to support pain control and reduce opioid requirements, as part of a broader multimodal approach to anesthesia.

Acupuncture treatment and rheumatoid arthritis

Acupuncture has not been shown to prevent joint damage. However, growing evidence suggests it can influence inflammatory pathways, with studies demonstrating reductions in certain inflammatory markers. Additionally, acupuncture can 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 (DMARDs). 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

Whether the practitioner is a medical doctor with acupuncture certification, or a licensed nonphysician acupuncturist, his or her credentials should be displayed in the office.

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.

Possible side effects from acupuncture

Potential side effects for some people include:

• mild aching

• bruising or redness at the needle placement site

• light-headedness right after treatment

• 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, then the practice of electroacupuncture, (in which a small electric current is passed between pairs of acupuncture needles), should be avoided.

Is acupuncture for rheumatoid arthritis covered by insurance?

Medicare does not cover acupuncture for rheumatoid arthritis. Coverage by other insurance plans varies, so it’s important to check with your insurance provider before starting treatment. Standard treatment for pain is 6 to 10 treatments spread over 3 to 5 weeks. Ask your acupuncturist how many treatments are needed to see an improvement in your pain. Typically, after 6 to 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 treatments. Always consult your physician before starting treatment, to discuss whether this might be an option for you.

For more helpful information, visit the following websites:

• American Academy of Medical Acupuncture
• Memorial Sloan Kettering Cancer Center: Integrative Medicine

This article is based on a May 16, 2012, presentation by Charis F. Meng, MD, to the Early RA Support and Education Workshop.