Efficacy of Electroacupuncture Compared With Topical Diclofenac Sodium Gel for Patients With Hand Osteoarthritis: A Randomized Controlled Trial.

Abstract

To evaluate the effectiveness and safety of 4-week electroacupuncture (EA) compared with topical diclofenac sodium gel (DSG) for hand osteoarthritis (HOA). Participants with symptomatic HOA for at least 3 months were randomly assigned to receive either 12 sessions of EA or topical DSG at a dose of 2 g 4 times per day for 4 weeks followed by a 12-week follow-up. The primary outcome was the change in the average overall finger joint pain intensity in the dominant hand during the previous 48 hours measured on the visual analog scale (0, no pain; 100, maximal pain) from baseline at week 4. The research period was from September 1, 2020, to March 17, 2024, and the statistical analyses were completed by March 15, 2025. A total of 120 (n=60 in each group) participants were included. The overall finger joint pain intensity measured with the visual analog scale in the dominant hand during the previous 48 hours at week 4 was 28.72 (95% CI, 24.21 to 33.23) in the EA group and 42.82 (95% CI, 38.32 to 47.33) in the DSG group (between-group difference, -14.11; 95% CI, -20.49 to -7.73; P<.001). Similar between-group differences favoring EA were observed at week 8 and week 16. Treatment-related adverse events were rare, relatively mild, and transient in the trial. Treatment of HOA with EA for 4 weeks had clinically meaningful effects on reducing pain compared with topical DSG, and the effects persisted through the 12-week follow-up. Electroacupuncture may be considered a promising nonpharmacologic therapy for HOA. ClinicalTrials.gov identifier: NCT04402047.