More than 40 million Americans suffer from some form of arthritis. Osteoarthritis, the most common variety, can make life miserable; it causes pain, limits movement, and is often treated with expensive drugs that don't always work and have bad side effects. So there is great interest in exploring alternative, nondrug treatment options ranging from magnets to massage and even acupuncture, which has been the subject of many small studies. You can imagine it's hard to do a so-called "blinded" study—in which patients don't know whether they're getting treatment or a placebo—to look at the effects of acupuncture. But researchers at the University of Maryland School of Medicine devised a way, and after a small pilot study, took on a large-scale, four-year examination of whether the ancient Chinese treatment can help arthritis sufferers.

What the researchers wanted to know: Is acupuncture an effective treatment for osteoarthritis of the knee?

What they did: Researchers recruited 570 patients, all of whom were at least 50 years old and had X-rays showing osteoarthritis of the knee. All said they had at least moderate pain most days of the month. The patients were divided into three groups; one had acupuncture treatments over 26 weeks (eight weeks of two treatments per week, then four weeks of one treatment every other week, and finally, 12 weeks of one treatment per month) administered by licensed practitioners, focusing on specific points of the body dictated by traditional Chinese medicine. Another group of people received so-called "sham treatments" over the same time period, but they were "treated" using fake needles that didn't pierce the skin. A third group had 12 sessions with a counselor who helped them learn more about how to manage their arthritis symptoms. Patients were permitted to keep using their previous remedies for arthritis. Researchers assessed patients' symptoms over the course of the study.

What they found: Eight weeks into the study, patients receiving acupuncture reported the same amount of pain, but their mobility and ability to function had improved compared with those receiving the sham treatment. But after the full 26 weeks, the acupuncture patients' pain was better than those getting sham treatment or educational counseling: those with acupuncture rated their pain 3.8 points (or 40 percent) lower on a standardized scale of 0-20 than when they began, compared with a 2.9 point drop (or 33 percent improvement) among the sham group and a 19 percent improvement in the education-only group. Ability to function was 40 percent better among the treated group compared with 32 percent for the sham group.

What the study means to you: Acupuncture has no side effects from treatment, according to this study. So if your current treatment isn't helping and you have the time for such an intensive schedule, you might consider adding acupuncture to the mix. It shouldn't be substituted for your current regimen, however.

Caveats: The treatment course was intensive, and a full 25 percent of both the acupuncture and sham groups dropped out, so data from the entire group wasn't used in calculating results. Because patients continued their previous treatments during the study, it's not possible to separate out the effects of acupuncture from those other treatments.

Find out more: Here's what the Arthritis Foundation has to say about acupuncture.

Read the article: Berman, B.M. et al. "Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee." Annals of Internal Medicine. Vol. 141, pp. 901-910.

Abstract online: www.annals.org