Electroacupuncture with different current intensities to treat knee osteoarthritis: a single-blinded controlled study

Background: To assess the efficacy of Electroacupuncture (EA) stimulation with high-intensity compared with low-intensity on knee osteoarthritis (KOA). Methods: Participants with KOA were randomized to either high-intensity EA group or low-intensity EA group. EA was applied unilaterally on the affected leg with the local points GB34, ST34, EX-LE4, EX-LE5, ST36, and SP9. The visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured before and after participation. Plasma TNF alpha, IL-1 beta, IL-6, and apelin levels were also assessed by enzyme immunoassay (ELA) before and after treatment. Results: Of 80 participants who consented to study participation, 77 completed the program. The patients showed a significant improvement in their pain, stiffness, and physical function on the VAS and WOMAC, accompanying with a significantly reduction in plasma levels of apelin and TNFa. Furthermore, high-intensity group exhibited statistically significant improvements in stiffness and physical function symptoms compared with low-intensity group. Plasma level of IL-6 was significantly decreased only after high-intensity EA treatment. Furthermore, apelin level was significantly inhibited in high-intensity EA group than in low-intensity EA group. Conclusions: Both high-and low-intensity EA treatments alleviate the clinical symptoms of KOA patients. High-intensity EA is more effective than low-intensity EA. Changes in plasma levels of TNF alpha, apelin and IL-6 may be involved in the therapeutic effect of EA on KOA.