Efficacy of Electroacupuncture Compared to Topical Diclofenac Sodium Gel for Patients with Hand Osteoarthritis: A Randomized Controlled Trial

Background: Effects of electroacupuncture (EA) as compared to diclofenac sodium gel (DSG), a first-line pharmacological treatment, remain unknown for hand osteoarthritis (HOA). This randomized controlled trial aimed to evaluate the effectiveness and safety of 4-week EA compared to topical DSG for HOA.

Methods: Participants with symptomatic HOA for at least 3 months were randomly assigned to receive either 12 sessions of EA or topical DSG at a dose of 2 grams four times per day for 4 weeks followed by a 12-week follow-up. The primary outcome was the change in the average overall finger joint pain intensity in the dominant hand over the previous 48 h measured on the Visual Analogue Scale (VAS: 0 = no pain, 100 = maximal pain) from baseline at week 4.

Findings: A total of 120 (n = 60 in each group) participants were included. The change in the average overall finger joint pain intensity measured with VAS in the dominant hand over the previous 48h at week 4 was -32.80 (95% CI -37.29 to -28.30) in the EA group and -15.92 (95% CI -20.41 to -11.42) in the DSG group [between-group difference: -16.88 (95% CI, -23.24 to -10.52), P<0.001]. The decrease in the average overall finger joint pain intensity persisted through week 16 with a mean between-group difference of -18.35 [(95% CI, -25.79 to -10.92), P<0.001)] favoring the EA group. Treatment-related adverse events were rare, relatively mild, and transient in the trial.

Interpretation: Treatment of HOA with EA for 4 weeks had clinically meaningful effects on reducing pain compared with topical DSG, and the effects persisted through the 12-week follow-up. EA may be considered a promising non-pharmacological therapy for HOA.