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Updated: Jan 16, 2026
Author Spotlight: Treating Knee Osteoarthritis with Tuina - A New Perspective
Published on: January 12, 2024
Acupuncture in Knee Osteoarthritis: A Narrative Review of Clinical Efficacy and Neuroimmune-Endocrine Mechanisms
Junru Jiao1, Baoqiang Dong1, Yiyan Han1
1College of Acupuncture and Massage, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, People's Republic of China.
Purpose:
Knee osteoarthritis (KOA) is a leading cause of global pain and disability and warrants complementary therapy. This review provides evidence of the clinical efficacy of acupuncture and the multisystem regulatory mechanisms of KOA.
Methods:
We analyzed clinical trials and mechanistic studies of acupuncture in the treatment of KOA.
Results:
Acupuncture-particularly electroacupuncture (EA) significantly reduced pain (VAS/WOMAC) compared with sham acupuncture and conventional care (P < 0.05). Clinical trials demonstrate that combining acupuncture with exercise significantly enhances functional outcomes. Mechanistically, acupuncture modulates neuroendocrine pathways through three key actions: (1) suppressing pro-inflammatory cytokines (eg, TNF-α, IL-1β); (2) activating the Melatonin/cAMP/PKA/CREB signaling cascade; (3) altering functional connectivity in central pain-processing regions. Controversies persist regarding the mechanisms, optimal techniques, and outcome standardization.
Conclusion:
Acupuncture is an effective complementary therapy for KOA. Future research should prioritize long-term efficacy, personalized protocols, technology integration, and multidisciplinary strategies.
