role of acupuncture in arthritis of the knee joint in addition to local steroid injection

ABSTRACT

This study was conducted to know the effects of acupuncture on patients with osteoarthriiis [OA] of the knee joint and to identify the trigger points in these patients. This study was conducted on OA of knee joint at Pain and Plegia center Peshawar from 1999 to 2004. Patients with multiple small joints pain, rheumatoid arthritis, gout or in whom knee joint was distended with fluid were excluded. All patients were treated with acupuncture for pain relief. Trigger spots were identified by palpating the knee. These trigger spots were treated by local instillation of triamcinolone acetonide 40 mg. These patients were then treated with Transcutaneous Electro-Neuro Stimulator [TENS] to treat muscle weakness. Out of 250, 225 cases [90%] were symptoms free. Only 25 cases [10%] relapsed with in a month after completion of treatment. Pain knee was mainly due to tendonitis, in close proximity to the knee joint. Main trigger points were outside the knee joint at adductor tubercle possibly at the insertion of adductor magnus and on the lateral side at the origin of gastrocnemius lateral head. The third trigger spot was on the medial aspect probably in tibial collateral ligament. Pain knee joint attributed to OA Knee is in fact due to tendonitis and not due to osteoarthritic changes in the joint and it is very much amenable to complete recovery by using both acupuncture therapy and local steroid injections