respect to: pain relief, reduction of stiffness and increased physical function
during treatment; modifications in the consumption of diclofenac during
treatment; and changes in the patient’s quality of life.^101 Acupuncture plus
diclofenac was found to be more effective than placebo acupuncture plus
diclofenac for the symptomatic treatment of osteoarthritis of the knee.
A systematic review by Minns Lowe and colleagues assessed the effects of
physiotherapy exercise programmes given after total knee replacement
surgery in people with osteoarthritis.^102 The review found a small-to-
moderate effect of functional exercise on joint motion and quality of life at
3–4 months after surgery, but the effect was not sustained at one year.
Pregnancy
Among women in labour103,104and women at various stages of preg-
nancy,105–107 systematic reviews and randomised trials have shown acu-
puncture to be safe, although limited sample sizes preclude definitive
conclusions.
One hundred healthy women with singleton pregnancies took part in an
RCT.^108 The researchers were most interested in the impact of acupuncture
on the speed of delivery, the length of the active phase of labour, the need
for induction and the need for augmentation of labour with intravenous
oxytocin. This small and preliminary study suggests that acupuncture has
detectable beneficial effects on labour among women with spontaneous
rupture of membranes at term. But as there was no active control (such as
sham acupuncture), it is hard to say whether the benefits were due to the
acupuncture itself or to the 20 minutes of personal attention received during
treatment.
About 90% of all assisted reproductive treatment cycles result in the
transfer of at least one embryo, but only about 25% of all cycles end in
implantation of the embryo and live birth.^109 Some preliminary evidence
suggests that acupuncture given with embryo transfer may increase the odds
of clinical pregnancy compared with control groups,^110 although there is
other evidence to the contrary: Wang et al. carried our a trial to determine
if acupuncture performed during the follicular phase and luteal phase, but
not on the day of embryo transfer, could improve the outcome following in
vitro fertilisation pre-embryo transfer (VF-ET) compared with controls. The
pregnancy rate was not improved.^111
Shoulder injury
Trials investigating the effect of treating shoulder injuries with acupuncture
have yielded encouraging results.112,113
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