May is Arthritis Awareness Month. Did you know researchers have studied several mind and body practices for osteoarthritis, the most common form of arthritis?
- Research studies have evaluated the effects of tai chi on osteoarthritis, with most studies focusing on osteoarthritis of the knee. In general, the results have been favorable. Guidelines issued by the American College of Rheumatology and the Arthritis Foundation in 2019 strongly recommend tai chi for knee or hip osteoarthritis.
- Acupuncture may help to relieve osteoarthritis pain. In some studies on knee osteoarthritis, the pain-relieving effect of acupuncture was comparable to that of nonsteroidal anti-inflammatory medicines such as ibuprofen.
- Not much research has been done on massage therapy for osteoarthritis. However, the small amount of available evidence suggests that massage therapy may provide short-term relief from pain associated with knee osteoarthritis.
What do we know about the effectiveness of complementary health approaches for osteoarthritis?
Psychological and Physical Approaches
- Acupuncture may help relieve osteoarthritis pain.
- A small amount of evidence suggests that massage therapy may be helpful.
- Participating in tai chi may improve pain, stiffness, and joint function in people with knee osteoarthritis. Qi gong may have similar benefits, but less research has been done on it.
- Despite extensive research, it’s still uncertain whether glucosamine and chondroitin have a meaningful impact on symptoms or joint structure in osteoarthritis.
- The evidence on other dietary supplements is too limited for any conclusions to be reached.
For more information about the effectiveness and safety of mind/body approaches to Arthritis self-care read more.
- Some dietary supplements can have side effects or interact with drugs.
- Psychological and/or physical approaches generally have good safety records when used correctly. However, some may need to be adapted to make them safe and comfortable for people with osteoarthritis.
- Magnetic therapies are not safe for people with some types of implantable medical devices.
Osteoarthritis (OA) is the most common type of arthritis. It occurs most often in the hands, knees, hips, and spine. OA affects cartilage—the slippery tissue that covers the ends of bones in a joint. Cartilage allows bones to glide over each other and absorbs the shock of movement. In OA, the top layer of cartilage breaks down and wears away, allowing the bones under it to rub against each other. This can cause pain, swelling, and difficulty in moving the joint. OA is most common in older people, but younger people can have it too, especially in joints that have been injured.
What the Science Says About Complementary Health Approaches for Osteoarthritis
Complementary approaches can be classified by their primary therapeutic input (how the therapy is taken in or delivered), which may be:
- Nutritional (e.g., special diets, dietary supplements, herbs, probiotics, and microbial-based therapies).
- Psychological (e.g., meditation, hypnosis, music therapies, relaxation therapies).
- Physical (e.g., acupuncture, massage, spinal manipulation).
- Combinations such as psychological and physical (e.g., yoga, tai chi, dance therapies, some forms of art therapy) or psychological and nutritional (e.g., mindful eating).
Nutritional approaches include what the National Center for Complementary and Integrative Health (NCCIH) previously categorized as natural products, whereas psychological and/or physical approaches include what was referred to as mind and body practices.
A variety of complementary approaches have been studied for osteoarthritis. The following sections summarize the evidence on the effectiveness and safety of specific approaches.
A 2012 combined analysis of data from several studies indicated that acupuncture can be helpful and a reasonable option to consider for OA pain. A 2013 analysis using different statistical methods also concluded that acupuncture may help relieve knee OA pain. After these analyses were completed, a 2014 Australian study showed that both needle and laser acupuncture were modestly better at relieving knee pain from OA than no treatment but not better than simulated (sham) laser acupuncture. These results are generally consistent with previous studies, which showed that acupuncture is consistently better than no treatment but not necessarily better than simulated acupuncture at relieving OA pain. A 2016 review of U.S. studies found evidence that acupuncture, as practiced in the United States, may help some patients with knee OA manage their pain.
How acupuncture works to relieve pain is unclear. Current evidence suggests that many factors—like expectation and belief—that are unrelated to acupuncture needling may play important roles in the beneficial effects of acupuncture on pain.
Acupuncture is generally considered safe when performed by an experienced practitioner using sterile needles. Improperly performed acupuncture can cause potentially serious side effects.
Tai Chi & Qigong
Tai chi and qi gong combine certain postures and gentle, dance-like body movements with mental focus, breathing, and relaxation.
Several studies have evaluated the effects of tai chi on knee OA. In general, they showed short-term improvements in pain, stiffness, and physical function. Some studies also showed other desirable changes, such as improved balance or reduced depression. In a 2016 study in which tai chi was compared with physical therapy for knee osteoarthritis and patients were encouraged to continue their exercises after the 12-week study period ended, patients in both the tai chi and physical therapy groups showed improvement in pain for a full year. Much less research has been done on qi gong, but the few studies that have been completed showed improvements in some OA symptoms.
Tai chi and qi gong are generally considered to be safe practices. However, side effects, such as temporarily increased knee pain, have been reported in some people with OA.
NCCIH thanks Partap Khalsa, D.C., Ph.D., NCCIH, for his contributions to the 2016 update of this publication.
This publication is not copyrighted and is in the public domain. Duplication is encouraged.
NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your healthcare provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.Last Updated: September 2016
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