Acupuncture for osteoarthritis of the knee

Once a week nurse Pam Richmond opens a room at Midway surgery.  A patient appears, sits down and rolls up his trousers.  Pam carefully places five acupuncture needles in his leg around the knee.  A few minutes later another patient appears and the process is repeated, until the room is filled with a relaxed chatting crowd, legs exposed, as if strangely displaced from a day at the seaside.

As Pam Richmond monitors their condition, patients chat about health, work and relatives, enjoying the opportunity to compare notes with others in a similar situation.

This simple but groundbreaking process is offered to people at selected surgeries around St Albans who suffer from osteoarthritis of the knee.  Most patients will be 50 - 80 years old; some would usually be given physiotherapy and lifestyle advice, others may be facing knee replacement surgery.  The pilot project is for people who prefer to have monthly acupuncture treatments to keep their knees supple and moving.

Valerie Lucien is typical of successful treatment.  She says: 'In 2003 I was diagnosed with severe osteo-arthritis in both knees and was told that the condition would deteriorate and my only recourse was painkillers and eventually  replacement knees.  Acupuncture on the NHS has transformed this prognosis.  It has eased the pain and discomfort to such an extent that I was able to take up regular exercise to strengthen my muscles.  Nowadays,  I rarely take painkillers and the flexibility in both knee joints has improved dramatically'.

At regular intervals patients give feedback to check that the acupuncture is working.  Those who don't respond well to simple acupuncture may receive electroacupuncture instead.  Surgery remains an option, but the majority seem happy to come in for monthly acupuncture top ups.  A preliminary audit in July 2008 showed 19 out of 48 patients with a good response or maintenance, 19 continuing treatment, with only four re-referred, and six not taking up the treatment.

The PCT is happy too.  Suzanne Novak, Assistant Director of commissioning says 'The business case for the service showed that it would provide a value for money and clinically effective alternative to traditional treatment.'

Midway partner Dr Michael Cannell hopes that the programme will move from a pilot to part of the standard offer of his surgery.  In the light of recent research, he's also interested in the possibility of exploring acupuncture for headache.  He says 'it's possible that this is just the beginning for us in piloting these well-founded interventions that are only rarely available on the NHS.'

St Albans and Harpenden Practice Based Commissioning group is winnner of our 2008 PCB award for its work in this area.