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Purpose 24 عو سنوت رجاس ع ند ‎a Crit‏ اه و ‎vowplewectary uttercaive therapy‏ جر

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wes بل م فك ام Review the ePPevts oP ‏حصا و نموه‎ (ePkacutory), urd yout (wetubolic); Ortercvice Whe od how to rePer ‏انوم وه‎ witht

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Osteoarthritis

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Osteoarthritis Over SO wilica people to the Detted Grates tive wits ‏مت‎ ‎fedtviduats oF age PG-OS, ocd‏ 90096 ,رومام له لاه ‎wore thot 00% over age “PO we‏ ‎Geoood wost people pver ne 0 ‎Oost cow ed! hee, Polowed by hips, spice, Peet, kod (cee OO ts var oP the ‏لها سنا‎ causes oF physicd disubiliy to the ‏الاو منم‎ ‎Qoit usudlly is the inital cod priavipd source oF ‏لطس‎ ‎oP perwourd Mupavily ooo‏ عومجم ‎ ‎

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Current Treatments لبيك 0085/1, ‏مس‎ ‎(Presortptirs pro crete رص لین جیوه تاج ره رید Chord herp, proper brace we, MEDS Der bos, aot) ‏سود السو‎ mpd heallookd, ‏جوسای موی بو سوب سیر‎ concn

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Why consider acupuncture? Oedicuivg side ePPevts @olypkanvapy io the eer 4eovoclusive ePPevis oP a lot oP wodediies otects ‏موه روصت لا‎ procedures oteotal beceP its oP acupuacture over other Oieieod ‏مامت حول مها ها مه مت‎ Oot ‏نان وا و چم طا لصتم نویه‎ Less ovsilpy thoo surqery

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Any research evidence for the effects of acupuncture in osteoarthritis?

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Acupuncture for knee and hip OA Oit at od. (COOO-COOWC) Remmuitreut Prow duly COO1 to dy COOP Ope > Ow (were [SO] 04.6 [A0.0]); ‏مرو تلو‎ evidewse oP ostevphyie; disease duraios > Ow; ot leust 19 dove wits pots tc the post OO days 5 1 ‏اي‎ ‏:((2966و) وه و ۵ الوم‎ nedowized ty ‏جح لجبواعل‎ )02000( Ker OP OP.0%; hip OB AP.S%; butts CO.F%

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Witt et al. (cont.) موه ‎sessives it O wows‏ 19) ۲ مد موه بلطم ‎(werage ID.7+9.0x, °O.O% SAO sessiow)‏ ‎voy‏ عصسجرجه سالج () ‎Oncud wooipuotica oot‏ نله ‎Bl three «cups vouticue to reveive wap‏ جلكجبك جما دسا نووم dd? study physiciccs it Cerro ]9(۳ weusures? OOOO indexes oP ‏یط له اه رم‎ GC-99 tod score ved ‏هه اوه لصوم‎ ®useiue, Pier O wouhs, wPter O wouths

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Witt et al. (cont.) - Results (Ot 9 work, there were siqePiccct iw OOOCC pur, siPPoess, Puortiva, ood GP 66 ‏سسوم‎ ‏ما للم و لت ام ۱ روموت‎ O ‏ایب‎ ‏رح جیوه جوا وتو وا وولو مور‎ ۶ vo wpored to pools ‏لجرواعل جرج و لو وب ارت‎ ‏ال سوه موه مت 0249 راو مس‎ ‏تحص سلاط بلاددص امود اد‎ ‎betwerd‏ موه اه و ماد موه من عون و ‎or‏ ولو ,مها وچ رو مانب عم موه ‎ ‎

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Witt et al. (cont.) - Results a ) 5 wwodtk, there were ‏امد اود جم‎ ‏كدص‎ ‎© Oo dPPereue to لهس توا اه همم 9 اه ۲ لا 55 5 وم هر >صتادج مجاه

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Witt et al. (cont.) - Results Ome ae; ‏وب‎ 0 higher busetice physicd or wecta qualiy oF ie, ood higher busetice DOOOC indexes Ckhysivicn poriripocts: 1% oP priecary more physicices i Cervo, ut eust IPO hours oP ‏جص مجح وه‎ ] peors oF clcicd experieure voted; tasutvect reyiwed voried — rePlevted well oP red word yeurrd ‏موی وا مه هداد اتمه ما ور‎ odin

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Witt et al. (cont.) - Cost analyses POS sbievts vowpleted ‏وراه ههور ناو وی‎ (qoupwrarture VECO; codirol aECPO) Orc overd ‏ام مه زا تچ وت‎ duntay the treated period were €0,COP.dS wits nhdiiogd posts oP ‏جه ,(وموومد/ © 69) جص اعصسحوجه‎ powpured ty €POR.8O ‏جوجقمم امت جز‎ ‏حصب (مجر حثلا لحاصيله رلسي) ج7ا )© ,سوب سيدناك‎ ‏تحص موه و لصوام‎ )8 ‏دمن اوم ونس‎ Por keer ostevorthriis ic Pewoles wos wore postePPenive thao woes; Oo yeuder ‏ناز‎ ic hip ostevorthritis

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Limitation of the study © Oetker physicicas wor ‏الما وب ام‎ © Oo ska treukvedt poutrol ۳ ‏سور‎ poled socple: age, oreo oP imoveweut

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SCEGM/Hartford Pilot Study (preliminary) — - Huang, Bliwise, Carvenale, Kutner Gupported by SCECO/MWarhord Coucdatiza cod 00 تا ارم (@cupuarture Por koee OO ‏اوه و‎ ‎protocol‏ موه لو موی ‎Skea ‏,اوه‎ double ‏اسلا‎ ‎Dreakved oF pod, sleep or bok ‎

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Huang et. al. (cont.) - baseline demographics 00-66 Qvennge ape PO po vera ‏وم ععو اه سل‎ 46.0 prs ®verage PGCO1 sore 9 4 ‏ولمم‎ yrvups: true sleep shaw pou, show pic tour sleep, tour poio tour sleep, shaw poio show sleep

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Huang et al. (cont.) - Results Gubjevts who neveived true asupwacture Por keer pata and/or Por poor sleep, cosppared to subjevis a aaa a kod wore it pois ratte (P=O.OQ) ceed 1 sovres (P=O.0F). Dro versus shaw ucupuarture Por koee pot wos ssvvidted wit improved GP-OO ratiogs ‏خام‎ ‎ceverdd heals (P=O.O9) ceed vitctiy (P = 0.0). True versus shaw ucupuarture Por poor sleep wos ‏کات سوه‎ improved GP-OO rates vP sovidt Puurtiocicy (P=O.O9).

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Acupuncture for severe knee OA Ty et al. 2002 OD potieats vo veto fist Por total koee replocewedt surgery Olocatice foto acupuerture your od coool yup wily sooiched age od yeuder ‏سل ولمم‎ acupuacture neqiced weehly Por O whe Outeowe weusures: ALospitd Por Gpevtal Gurgery svvres (po, Puortva, wuscke streanh, joie! ROO, Plexiva dePoreniy, kuee tostabiliy) SO weter why SO steps cheobicry ar sore (OW)

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Tillu et al. (cont.) - Results Ooupwacture yup siqeiPiccdly improved ia ull Duibowes) coud yup siqaiPiccdly worseced ia ull vuioo wes UPter CO woh 9 avbierts in wupwerture urvup (10%) requested susprusivd oF surgery due to the improveweuts oF their ‏مرو‎ Lixvitativa oP the study? aoe-rondowized, unt bide

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Acupuncture for OA (Summary) or keer OO), stroay neseuck evidewe suppers the use oP acupuucture Por ‏مرو‎ retieP ocd 9 ‏ی‎ واه ان جمجيدد كلابب ‎cued jot those‏ or kip OO, acupwarture vod be revowwewdted Por a trict oP poic netic; (Por other OO, the evideure is wt clear pet.

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Other types of arthritis

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Rheumatoid Arthritis ‎per ses for tis,‏ ار لاب عمجم موه نوات نجل (0<) دنه وه هه رت عنم ‎Outiple jvicts tevolvexredt tochudtagy sued‏ ارو ‎daoreused ESR, CORP‏ ‎

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Acupuncture for RA * Ooxbustion ‏کاس موی و‎ ۱ 1 ۷ © Cire weed

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Review by Wang et. al. (2008 Arthritis and Rheumatism) Gearck ia IC dotcbuses Prow (E09 ty Oak 00060 عسه ها اه مه حصنان) ‎®otk‏ Geteviioe criteria: noedowized ‏,علمض اوه‎ 600 hk criteria, clear puloowe weusures © studies (GOO subievts) fachided Prow couctries (Conrada, OK, Prez, Chia) (OPR-COOT

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Review on acupuncture for RA (cont.) & aqaivet show vootrol: plazebo order (9), superficidl uvupuartune agaiest utive podtrot OTX 10 ‏رو‎ ‎۲ 2-6 ۹ ۲ Ol wih pu usess weds, O dso wik CGR und 0006 - 9 skew und 9 ‏اوه هه‎ Orca study ‏عم اس 6 +10 :یت‎ P-COwks) Qeco cuber oP asupuccture sessives: PC + 0 (re 1-00.)

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Review on acupuncture for RA (Cont.) 9 ‏له‎ ) unive coil, C shaw cout!) showed ‏سكاميد‎ ‎reductive oP pot powpored to oooirols (derreuse oP trader joict vant by 1.S t7 0.9) studies (9 unive vocal, | shaw vow!) showed siquiPiccat ‏ممص اجر‎ oP worsicy siPPoess (“CO wicutes); however, ‏جم‎ ‏امه‎ diPRereuve Prow voutrols S shales (9 untive coil, C shaw cout!) showed siqaiPiccdt ‏دا مصتص اجر‎ EGR (-O.Owwlkr); 9 studies (C uiive ‏,اجه‎ ‎1 (- S.0w_dd); 1 study (anive coil) showed siqaiPicadt reductiog fa bots CGR aad ORP Guoolec jpict pouets — ww dP erreur beter iotervection ond ‏ی امود‎

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Acupuncture for RA (summary) Linvited studies sucgest the use oP ‏مجح‎ Por iproviey (RO suxwopiows und possible suwe Results ore ut ovachusive.

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Gouty Arthritis © Detabolic © One oid aystd deposition ta the jpici(s) لور ,حول ‎4doPecrctioa‏ © كمم تاه

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Acupuncture for gouty arthritis Ou SOO O=PC (FC experiwecta; OO vwatrvl) Rucdowized (how?), av bherciery Exp: Orupuactune daly x ID (cae course) — tora? Control: alopurtol IDO, bichtid; IhuproP ea COOwy tid P paicPul arthritis Outcowe weusures: cloicd issprovesveds oF supine wed siqes (detal?); sero uric utd, preutcice, BOO; CPkr urtcary protet votes Deve poids: buselive, coe ‏مدا واه کلمت‎

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Ma (cont.) Results: Cxceleut respouse (disuppearsare oP syxopiows ord sigue, wits ull lab tests wreuized): PSG.O% vs. CO%; CPR Revive respouse (improvewed oP ‏له مرو‎ sigue und lub tests): GO% vs. FO.9%; Caled respouse (aw vbvivus ipprovewed oF ‏مرو‎ ood siqes wits oo obvious chore fot bob tevts): F.O% ‏,ور‎ ۵ Potd ePPevive rote: O6.O% ve. 99.9%

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Ma (cont.) © ete amupuerture orcup, oll hob tests were iteproved (p<O.0); white Bt reticerttres 0 reoproved (p<O.O8) without charges ta BOD, Deuce or uric ۰

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Acupuncture for Gout (Summary) ‏وزرا‎ chic tras sugyest beoePicidl use oF ‏له ات رنب رید شم و جيجه‎ ‏م۳ امه اوه‎

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Summary (I) Acupuncture Effects in Arthriti Proves pot cootrol robuble cost ePPeviive Por isoprovieny Gob Cossible inoproveweuts ia cher related spwptows, roves io hoe ostevonthriis, esp. ‏وا شاه او‎ Pewoole potiects = (robuble ia hip vstevarthritis Qossible ta vier aneusippes oP arthritis

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What acupuncture has not be proven to do... = Vo reverse structucd dower | Do slow down diseuse ‏هماو وص جام‎ © Do reduce keultkowe vost

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When and how to refer patients for acupuncture

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Summary (II) Treatment Recommendation (When...) لبيك 0085/1, ‏مس‎ ‎(Presortptirs pro crete Over the counter wedicaivas Gonos, Physic heron, proper brace wee, MEDS Der bos, aot) ‏سود السو‎ mpd heallookd, ‏جوسای موی بو سوب سیر‎ concn

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How ... a (Keow the resvurves ‏ماه( هر و‎ a (Coow the credeutidiag process ut pour state ۴ ‏هل‎ nePerrd ‏جا یی‎

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Something your patients may ask you about ... a Gide ePPRevts proPite Por uvupwerture ۴ ‏تسه مضاو)‎

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Common adverse reactions Osudly wioort Loo bleed, bruise, uckicess/paict bout 0% wik sircay neurtives to ceecticny: AKU reaniod, moreused put Por OF- POkours

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Rare complications © ‏ویو‎ ‎© Derve ini a Olood vessel pevetratios سح SOCIETY oF AcufuNcTURISTS KOOO MLE ‏ل برو« وورون‎ HE ar 2) @orinaarist production nights obtainable For ‘aso Cancensck com

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Relative contraindications Ghic fePectiog (ut io the save oreo where wed wil be iuserted) leeday disorder/oa Oouadia wits high TOR 1 22-0090-0086 Qacewoker, carcdas orhyikeria, eplepsy (a7 تم هم وت تا وه ۳ص ۳ ما لا اما ‎GO1 witk tour‏ ‎derePenia)‏ reqecany (uot io certaict spots) On woderde tv forge aout oP ppivids

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Contact Information (or inPorevotion ubvut this specific presrotaivd please pvotact Det Ween, DO, PRO ot who @ewory.rdy or wy questivas ubput the woah BRECC Cudio CovPerewe Geries please ovotunt Tiew Polep ot fo. Potey@ve.qov or val (POP) CCC-FOCO ‎cooPereuce Por OC cred please vbtoia a‏ تا ارو و ‎‘(Pacuiy Gudtuatiod Por‏ ه ‎‘Gotellte Reysteaticd Porc aed‏ ‎Prov the Gutetite Ovordrrator of you Purity. She Pore oust‏ ‎be wuled 7 CEG wikia O weeks oP the broodcust.‏ ‎

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