People with osteoarthritis (OA) who seek symptom relief outside of mainstream medicine have many options, from exotic herbal preparations to hands-on treatments such as massage and chiropractic. However, just 1 or 2 percent of OA patients choose to try acupuncture, despite the popularity of this ancient therapy for treating other conditions. That’s unfortunate, say physicians who practice acupuncture or refer patients to specialists for treatments. While poking someone with a pin to cure pain may seem counterintuitive, they insist that acupuncture often provides modest symptom improvement and serves as a useful add-on therapy for people struggling with aching joints.

One barrier to greater acceptance may be that many studies have found acupuncture to offer minimal benefits for OA, at best. Yet researchers point out that designing clinical trials to test acupuncture – and interpreting their results – is tricky business, which may misrepresent the true value of pinprick therapy.

How Does Acupuncture Work and How Well?

Acupuncture has been practiced for thousands of years and plays an important role in traditional Chinese medicine (TCM). Acupuncturists treat medical conditions by inserting slender metal needles into the skin at specific points on the body. According to principles of TCM, health is governed by the flow of energy (known as qi) throughout the body along pathways called meridians. Illness occurs when this energy flow is disrupted or becomes unbalanced, the theory goes. Precise insertion of acupuncture needles is said to restore the flow of this essential energy and improve health.

Western medicine doesn’t recognize the concepts of qi and meridians. However, a solid body of scientific evidence suggests alternate explanations for why acupuncture might provide pain relief.

“There’s a lot of research that says when we put an acupuncture needle into the body, a number of physiological mechanisms occur,” says Brian Berman, MD, a professor of family and community medicine and director of the University of Maryland Center for Integrative Medicine.

A well-placed needle insertion sets off a cascade of events, Dr. Berman explains, producing a signal that travels along the spinal cord to the brain, triggering a release of neurotransmitters called endorphins and enkephalins, which scientists believe reduce the sensation of pain. Research also shows that the inserting an acupuncture needle induces production of cortisol, a hormone that helps to control inflammation. Acupuncture may stimulate activity of other pain-relieving chemicals in the body, as well.