Chin J Integr Med. 2013 Dec;19(12):900-4. doi: 10.1007/s11655-012-1218-4. Epub 2012 Dec 21.
Bi-meng Zhang 1, Li-wei Zhong, Si-wei Xu, Hui-ru Jiang, Jian Shen
PMID: 23263998 DOI: 10.1007/s11655-012-1218-4
Abstract
Objective: To examine whether acupuncture treatment would improve outcome in chronic Achilles tendinopathy.
Methods: A randomized, controlled trial at two centers of 64 randomized patients aged 18 to 70 years with chronic Achilles tendinopathy was conducted from July 2007 to April 2010, with follow-up until October, 2010. These patients were randomly allocated into an acupuncture treatment group (acupuncture group) and an eccentric exercises group (control group). The validated Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire was completed at baseline and 8, 16, and 24 weeks. The pain at rest and after activity was accessed at baseline and 8 weeks with Visual Analogue Scale (VAS).
Results: After randomization into the acupuncture group or control group, one patient was loss of follow-up. The mean VISA-A score improved significantly after 8 weeks in the acupuncture group to 67.1 points [95% confidence interval (CI), 64.1-70.2] and in the control group to 48.5 points (95% CI, 45.5-51.6) with an additional 18.6 points increase in acupuncture treatment patients (P=0.0000). Acupuncture treatment resulted in a significant increase from baseline in VISA-A of 25.8 after 16 weeks and 28.4 after 24 weeks. Whereas, in the control group the increase from baseline in VISA-A were 10.0 and 16.6 after 16 and 24 weeks, respectively (P=0.0000). The VAS diminished by 2.0 cm after activity, and by 1.5 cm at rest after 8 weeks in the control group. In the acupuncture group, the pain scores diminished significantly more than in the control group, with pain reduction of 3.7 cm after activity (P=0.0000) and 3.2 cm at rest (P =0.0000).
Conclusion: Acupuncture intervention could improve pain and activity in patients with chronic Achilles tendinopathy compared with eccentric exercises.
From the paper:
After the painful area of patients in the acupuncture group was cleaned with alcohol cotton, four stainless fi liform needles with diameter of 0.35 mm and in length of 40 mm were quickly inserted around the area for 20 mm at an angle of 15°between the needle and the skin. These needles were withdrawn after retained for 30 min. The treatment was done three times per week. All patients received 24 treatments in 8 weeks.
The patients in the control group were treated with eccentric exercises. They were instructed to stand with straight legs on a small step, lift up on the toes, hereafter put the weight on the injured leg and slowly lower the heel as far as possible until they felt a maximal stretch of the calf muscles and/or the Achilles tendon. The exercises were repeated 15 times. Then the patients were told to repeat the exercises with semi-flexed knee. If possible the series should be repeated twice increasing to three times at each session. If pain decreased they should increase the load on the Achilles tendons by wearing a rug sack and increasing the weight of the rug sack by adding weights (5 kg each). The patients were told that some pain was to be expected from the tendon during exercise, but that daily increasing pain or morning stiffness indicated that the exercises had been progressed too fast.