In 2020, the U.S. Centers for Medicare and Medicaid Services agreed to cover acupuncture for Medicare patients with chronic lower back pain. This is the first time that acupuncture will be covered by insurance in the U.S. Some European countries have covered it before.
Dr. Wang discussed the results from a 2020 Current Rheumatology Reports review article focusing on acupuncture and chronic musculoskeletal pain that she co-authored.2 With an analysis of 16 updated review articles and 11 recent randomized controlled trials over the previous five years, researchers found that acupuncture provided short-term pain relief for symptomatic knee osteoarthritis (OA) and chronic low back pain. It also may have a beneficial role for fibromyalgia. The studies they examined did not show evidence to support acupuncture for hip OA or rheumatoid arthritis.2
Dr. Wang emphasized that acupuncture should not replace conventional care or be used to postpone seeking medical advice. When discussing acupuncture with patients, rheumatologists should emphasize the importance of finding an experienced practitioner who has previously treated the condition the patient has. An inexperienced practitioner may cause serious side effects, such as an infection, punctured organ or nervous system injuries. Most states require licenses to practice acupuncture, which is something else patients can check.
Patients should also ask acupuncture practitioners about the estimated number of treatments needed and the cost of each treatment. As a point of reference, under Medicare’s coverage for chronic low back pain, 12 visits within a 90-day period are covered, as well as eight additional visits if the treatment is working.3
Researchers found that acupuncture provided short-term pain relief for symptomatic knee osteoarthritis & chronic low back pain.
Tai Chi & Musculoskeletal Disorders
Another area researched by Dr. Wang is tai chi. She described tai chi as a multicomponent traditional Chinese mind-body practice that combines meditation with gentle graceful movement along with breathing and relaxation. In a broader sense, tai chi combines breathing techniques, awareness, mindfulness, balance, relaxation, social support and more, she said. Like acupuncture, tai chi has been part of Chinese culture and medicine for thousands of years.
By targeting physical, psychological and psychosocial symptoms, tai chi can reduce pain and lead to better patient results, according to those who practice it. Tai chi may be especially suited to tackle both the psychological and somatic symptoms associated with chronic pain.
Dr. Wang has led a series of studies on tai chi for chronic rheumatic conditions and found that the practice has short-term therapeutic benefits for pain relief and well-being.4-6 A trial published in 2016 included 204 participants and compared tai chi twice a week for 12 weeks with standard physical therapy twice weekly for six weeks for knee OA, followed by six weeks of home exercise.5