A recent multicenter randomized controlled trial confirms that electroacupuncture (EA) is the most effective acupuncture modality for reducing pain and improving physical function in patients with knee osteoarthritis (KOA). Compared against manual acupuncture (MA), warm needling (WA), mild moxibustion (MM), sham acupuncture (SA), and oral Celebrex, electroacupuncture demonstrated the greatest therapeutic benefit in both pain relief and functional improvement, based on VAS and WOMAC scores [1].
The trial was conducted across six hospitals in China and included patients meeting standardized diagnostic criteria for KOA. Participants were randomly assigned to one of six groups: EA, MA, WA, MM, SA, or Celebrex. All interventions were delivered over four weeks. Acupuncture groups received treatment three times per week, totaling 12 sessions. Each session lasted 30 minutes [1].
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In the EA group, acupuncture needles were inserted at seven standardized points, followed by electrical stimulation using consistent current parameters across all centers. MA involved needle insertion without electrical stimulation. In the WA group, needles were heated after insertion. MM used moxa indirectly applied to the skin surface without needle insertion. The SA group received superficial needling at non-acupoint locations without stimulation. The drug group received standard doses of Celebrex for the same four-week period [1].
All acupuncture treatments used the following seven points bilaterally:
- ST34 (Liangqiu)
- ST35 (Dubi)
- EX-LE4 (Neixiyan)
- GB34 (Yanglingquan)
- SP9 (Yinlingquan)
- SP10 (Xuehai)
- ST36 (Zusanli)
These points were selected for their established use in managing knee pain and their inclusion in prior KOA research protocols [1]. HealthCMi acupuncturists confirm that electroacupuncture from medial to lateral Xiyan acupoints is highly efffective, often including manual application of Xi Xia along with the electroacupuncture pair. The HealthCMi team notes that additional points, including BL40 (Weizhong) and others mentioned in the research above are in common use in clinical practice by licensed acupuncturists with known efficacy, both historically and in modern research.
The publication reported that sterile, disposable needles were used but did not specify the gauge or brand. In the EA group, after manual insertion, electrode clips were attached to the needles and a regulated electric current was applied for 30 minutes. Manual stimulation was performed in the MA group without current. The WA group used thermal application directly to the needle shaft following insertion. No electrical or thermal stimulation was used in the MM or SA groups [1].
Electroacupuncture resulted in the largest reduction in pain and improvement in physical function. At the end of the treatment cycle, EA patients had significantly better scores on both the VAS and WOMAC scales compared with those in the SA and Celebrex groups (p < 0.05). EA also outperformed MA, WA, and MM, though those differences were smaller in magnitude [1].
Although the study did not measure changes in inflammatory biomarkers or conduct imaging, the authors hypothesized that EA’s enhanced effects may relate to segmental inhibition and central modulation of nociceptive processing, consistent with prior mechanistic literature. These biological explanations, while not directly tested, provide a plausible rationale for the superior outcomes observed with EA [1].
This large-scale randomized trial provides high-level evidence that electroacupuncture is more effective than other commonly used acupuncture and pharmacological interventions for treating knee osteoarthritis. Clinicians treating KOA are advised to consider EA using the standardized acupoint set and treatment schedule identified in this research. These findings support EA as a first-line acupuncture modality for KOA when delivered in a structured and consistent protocol [1].
Source:
1. Sun, J., Liang, Y., Luo, K.-T., et al. “Efficacy of Different Acupuncture Techniques for Pain and Dysfunction in Patients with Knee Osteoarthritis: A Randomized Controlled Trial.” Pain and Therapy, vol. 14, 2025, pp. 737–751.
