Efficacy of Fu's Subcutaneous Needling in Treating Soft Tissue Pain of Knee Osteoarthritis: A Randomized Clinical Trial

Author: Po-En Chiu1,2, Zhonghua Fu3,4, Jian Sun4,5,6, Guan-Wei Jian7,8, Te-Mao Li9, Li-Wei Chou10,11,12
Affiliation: <sup>1</sup> Department of Chinese Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua 505029, Taiwan. <sup>2</sup> Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan. <sup>3</sup> Institute of Fu&#x27;s Subcutaneous Needling, Beijing University of Chinese Medicine, Beijing 100029, China. <sup>4</sup> Clinical Medical College of Acupuncture &amp; Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510405, China. <sup>5</sup> Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510006, China. <sup>6</sup> Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510260, China. <sup>7</sup> Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan. <sup>8</sup> Department of Chinese Medicine, Sinying Hospital, Ministry of Health and Welfare, Tainan 730020, Taiwan. <sup>9</sup> School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan. <sup>10</sup> Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404332, Taiwan. <sup>11</sup> Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan. <sup>12</sup> Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung 413505, Taiwan.
Conference/Journal: J Clin Med
Date published: 2022 Dec 2
Other: Volume ID: 11 , Issue ID: 23 , Pages: 7184 , Special Notes: doi: 10.3390/jcm11237184. , Word Count: 316


Purpose:
Fu's subcutaneous needling (FSN) is a new acupuncture technique that produces a long-lasting effect in soft-tissue injuries. In patients with degenerative knee osteoarthritis (OA), myofascial trigger points (MTrPs) are common in the lower-limb muscles. In this randomized clinical trial, we evaluated the immediate, 1-week and 2-week effectiveness of FSN therapy in the treatment of degenerative knee OA.

Patients and methods:
We randomly divided 32 patients with knee OA into the FSN group (mean age: 65.73 ± 6.79 years) or the transcutaneous electrical nerve stimulation (TENS) group (mean age: 62.81 ± 5.72 years). The pressure pain threshold (PPT) and tissue hardness (TH) of the muscle and tendon attachment sites, knee range of motion, and physical ability (average walking speed) were measured. The subjective pain intensity index, Western Ontario and McMaster Universities OA Index (WOMAC), and Lequesne index were used to determine the efficacy of FSN on MTrP-induced soft-tissue pain compared with that of TENS.

Results:
A significantly greater improvement in pain qualities in the VAS (p &lt; 0.05) was found in the FSN group. Moreover, in muscle and tendon qualities (including PPT and TH), a significant difference in the PPT of the quadriceps muscle (p &lt; 0.05) was also observed among the immediate treatments in the FSN group. As for the functional index questionnaire assessment, the FSN group exhibited significant improvements among the immediate, 1-week and 2-week efficacies in terms of WOMAC (p &lt; 0.05) and Lequesne index scores (p &lt; 0.05).

Conclusion:
FSN was effective in treating soft-tissue pain in degenerative knee OA in terms of alleviating pain, strengthening walking ability, and improving overall functional performance. Pain relief was the primary benefit of FSN and a significant correlation between pain relief and knee joint mobility improvement was found.

Trial registration:
ClinicalTrials.gov Protocol Registration and Results System (registration number: NCT04356651).

Keywords: Fu’s subcutaneous needling; acupuncture; dry needling; knee osteoarthritis; muscle pain; myofascial pain; physiotherapy; tightened muscle; trigger point.

PMID: 36498758 DOI: 10.3390/jcm11237184