Is there a role for acupuncture in basal thumb arthritis? A randomised controlled trial of real versus sham acupuncture.

INTERVENTION: Patients were allocated blind in order of recruitment according to a randomisation list (nQuery Advisor v6.01 software, mixed block‐size randomisation sequence) to either acupuncture (treatment arm, penetrating needle) or sham acupuncture (placebo, non‐penetrating needle). Both treatment and sham patients received six treatment sessions over 3 weeks with Gauge 8 solid Streitberger TM (asia‐med, Germany) acupuncture needles using standardised acupuncture needle locations and durations. CONDITION: Osteoarthritis of the thumb carpometacarpal joint ; Musculoskeletal Diseases ; Osteoarthritis PRIMARY OUTCOME: Pain relief was assessed using visual analogue pain scores (VAS) during an objective assessment of range of motion and strength, at pre‐treatment and 1 week post‐treatment. SECONDARY OUTCOME: 1. Measurements of motion were taken using a standardised protocol (Adams, Greene and Topoozian, 1992) and strength was measured using Jamar grip and pinch meters, both valid reliable and accurate assessment tools (Mathiowetz et al, 1984).; 2. Patient rated functional outcome was measured by the pre‐ and 1 week post‐treatment scores using the Nelson Hospital questionnaire (NHQ) (Citron et al, 2007).; 3. The duration of any improvement was assessed by patients completing the NHQ again by post or telephone at 2‐weekly intervals post treatment until either 12 weeks had passed or their score had returned to the pre‐treatment baseline. ; 4. Each patient’s perceived acupuncture experience was assessed by recording their pre‐treatment expectations, their needling sensations, and by recording their post‐treatment opinions of acupuncture. The Southampton Needling Questionnaire (White et al, 2008) is designed to assess the quality of needling by recording desirable and undesirable sensations and was used after first and last treatments. INCLUSION CRITERIA: 1. Acupuncture‐naïve 2. Newly referred to either surgical or therapist clinics at the Pulvertaft Hand Centre (PHC) with osteoarthritis of the basal thumb joint 3. Where both hands were affected, the worst affected hand according to the Nelson Hospital Questionnaire (NHQ) score was treated