Comparison of Warm-Needling and Acupuncture for Knee Osteoarthritis: A Randomized Controlled Trial

퇴행성 슬관절염에서의 온침과 침의 효능 비교 연구

  • Received : 2013.02.08
  • Accepted : 2013.03.19
  • Published : 2013.03.27


Objectives : The aim of this study was to investigate whether warm-needling is more effective than acupuncture in relieving the pain and improving the symptoms of knee osteoarthritis(OA). Methods : 76 volunteers with knee OA participated in the study. The subjects were randomly assigned to one of two groups. One group received warm-needling(n=38), while the other group received acupuncture(n=38). Sixteen sessions of warm-needling or acupuncture were conducted on the pain region of each problematic knee over a period of 8 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) scores, physical health score based on the 36-Item Short-Form Health Survey(SF-36) and the Global Assessment(PGA) was measured. Results : Compared to the acupuncture group, the warm-needling group showed a significant decrease in pain, function, and total WOMAC scores according to the Mann-Whitney U-test. The PGA scores of the warm-needling group also showed a significant improvement compared to the acupuncture group. Conclusions : Warm-needling showed a greater pain relief effect on knee OA compared to the acupuncture group. These findings suggest that warm-needling may be a promising alternative therapy for treating knee OA.


warm-needling;acupuncture;arthritis;WOMAC;SF-36;patient global assessment


  1. Bae SC, Lee HS, Yun HR, Kim TH, Yoo DH, Kim SY. Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities(WOMAC) and Lequesne osteoarthritis indices for clinical research. Osteoarthritis Cartilage. 2001 ; 9 : 746-50.
  2. Han CW, Lee EJ, Iwaya T, Kataoka H, Kohzuki M. Development of the Korean version of Short-Form 36-Item Health Survey: Health related QOL of healthy elderly people and elderly patients in Korea. Tohoku J Exp Med. 2004 ; 203 : 189-94.
  3. Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN, et al. Acupuncture in patients with osteoarthritis of the knee: A randomised trial. Lancet. 2005 ; 366 : 136-43.
  4. Singh BB, Berman BM, Hadhazy V, Bareta J, Lao L, Zarow FM, et al. Clinical decisions in the use of acupuncture as an adjunctive therapy for osteoarthritis of the knee. Altern Ther Health Med. 2001 ; 7 : 58-65.
  5. Manheimer E, Lim B, Lao L, Berman B. Acupuncture for knee osteoarthritis: A randomised trial using a novel sham. Acupunct Med. 2006 ; 24 : S7-S14.
  6. Vas J, Mendez C, Perea-Milla E, Vega E, Panadero MD, Leon JM, et al. Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: Randomised controlled trial. BMJ. 2004 ; 329 : 1216.
  7. Scharf HP, Mansmann U, Streitberger K, Witte S, Kramer J, Maier C, et al. Acupuncture and knee osteoarthritis: A three-armed randomized trial. Ann Intern Med. 2006 ; 145 : 12-20.
  8. Foster NE, Thomas E, Barlas P, Hill JC, Young J, Mason E, et al. Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: Randomised controlled trial. BMJ. 2007 ; 335 : 436.
  9. Amin S, Niu J, Guermazi A, Grigoryan M, Hunter DJ, Clancy M, et al. Cigarette smoking and the risk for cartilage loss and knee pain in men with knee osteoarthritis. Ann Rheum Dis. 2007 ; 66 : 18-22.
  10. Gullahorn L, Lippiello L, Karpman R. Smoking and osteoarthritis: Differential effect of nicotine on human chondrocyte glycosaminoglycan and collagen synthesis. Osteoarthritis Cartilage. 2005 ; 13 : 942-3.
  11. Lansdown H, Howard K, Brealey S, MacPherson H. Acupuncture for pain and osteoarthritis of the knee: a pilot study for an open parallel-arm randomised controlled trial. BMC Musculoskeletal Disorders. 2009 ; 10 : 130.
  12. Kudriavtsev A, Vlasik T. Gentle and strong acupuncture: A short review of the two main approaches to treatment. Am J Chin Med. 1994 ; 22 : 221-33.
  13. Felson Felson DT, Lawrence RC, Hochberg MC, McAlindon T, Dieppe PA, Minor MA, et al. Osteoarthritis: new insights. Part 2: treatment approaches. Ann Intern Med. 2000 ; 133 : 726-37.
  14. World Health Organization. International Standard Terminologies on Traditional Medicine in the Western Pacific Region. 2007.
  15. Zhizhong W. Zhenjiuzishengjing(鍼灸資生經) - Classic of Nourishing Life with Acupuncture and Moxibustion. Seoul : Iljungsa. 1991.
  16. Moxibustion and meridian of oriental medical laboratory. Colleges of the whole university. Acupuncture & Moxibustion. Seoul : Jipmoondang. 2000 : 1048-9, 1335-8.
  17. Yoo SI, Ahn CB. The modern clinical acupuncture & moxibustion. Seoul : Euisungdang. 2000 : 707-9.
  18. Li CD, Huang XY, Yang XG, Wang QF, Huang SQ. Observation on therapeutic effect of warming needle moxibustion on knee osteoarthritis of deficiency-cold type. Chin Acupunct Moxibustion. 2006 ; 26 : 189-91.
  19. Chen N. Observation on therapeutic effects of bird-pecking needling and needle warming moxibustion on bulging of lumbar intervertebral disc. Chin Acupunct Moxibustion. 2006 ; 26 : 213-4.
  20. He XW, Huang JH, Zeng LY. Observation on the therapeutic effect of warming needle moxibustion on prolapse of lumbar intervertebral disc. Chin Acupunct Moxibustion. 2007 ; 27 : 264-6.
  21. Chen MR, Wang P, Cheng G, Guo X, Wei GW, Xu-hui C. Effect of warming needle moxibustion on pain threshold in the patient of sciatica. Chin Acupunct Moxibustion. 2005 ; 25 : 831-3.
  22. Xu FQ, Li HX, Huang T. Observation on therapeutic effect of warming needle moxibustion combined with medicine on 128 cases of myasthenia gravis. Chin Acupunct Moxibustion. 2006 ; 26 : 339-41.
  23. Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: A randomized, controlled trial. Ann Intern Med. 2004 ; 141 : 901-10.
  24. Berman BM, Singh BB, Lao L, Langenberg P, Li H, Hadhazy V, et al. A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the knee. Rheumatology. 1999 ; 38 : 346-54.
  25. Brinkhaus B, Witt CM, Jena S, Linde K, Streng A, Hummelsberger J, et al. Physician and treatment characteristics in a randomized multicentre trial of acupuncture in patients with osteoarthritis of the knee. Complement Ther Med. 2007 ; 15 : 180-9.
  26. Thomas M, Eriksson SV, Lundeberg T. A comparative study of diazepam and acupuncture in patients with osteoarthritis pain: A placebo controlled study. Am J Chin Med. 1991 ; 19 : 95-100.
  27. Ezzo J, Hadhazy V, Birch S. Acupuncture for osteoarthritis of the knee: A systematic review. Arthritis Rheum. 2001 ; 44 : 819-25.<819::AID-ANR138>3.0.CO;2-P
  28. MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R. Standards for reporting interventions in controlled trials of acupuncture : The STRICTA recommendati ons. J Altern Complement Med. 2002 ; 8 : 85-9.

Cited by

  1. Clinical Study for Eight Cases of Dysmenorrhea Treated by Sobokchukeo-tang-gagambang and Warm Needle Therapy vol.29, pp.3, 2016,
  2. Clinical Assessment of Warm Acupuncture Therapy System Using HF Time-varying Magnetic Field vol.33, pp.4, 2016,
  3. Efficacy and Safety of Miniscalpel Acupuncture in Knee Degenerative Osteoarthritis Patients: A Study Protocol for a Randomized Controlled Pilot Trial vol.33, pp.2, 2016,
  4. The Effects of Warm Needling at GB·GB on Complete Freund’s Adjuvant(CFA)-induced Rheumatoid Arthritis in Rats vol.32, pp.2, 2015,
  5. A Case Report of Cervical Myelopathy Caused by Ossification of Posterior Longitudinal Ligament: Focusing on Warm Needling Therapy vol.31, pp.3, 2014,
  6. Warm needle acupuncture for osteoarthritis: A systematic review protocol vol.8, pp.4, 2016,
  7. Trends of Studies in Korean Journal of Acupuncture vol.33, pp.1, 2015,


Supported by : Korea Research Foundation