An ancient Chinese medical treatment that has been used by millions of Americans finally has a stamp of approval from western medicine. In what investigators are calling a landmark study of acupuncture was found to reduce pain and improve movement among patients with osteoarthritis of the knee when used with other treatments.

Investigators said osteoarthritis of the knee was logical choice for the large, government acupuncture study because so many people with the condition have already turned to alternative medicines.

Osteoarthritis is a big public health problem affecting many millions of people in the U.S. It is associated with a significant reduction in quality of life and is an area where traditional medicine does not have all the answers, adequate pain relief is often achieved and many drugs have undesirable effects, especially in the elderly.

The safety of the most widely used prescribed of the traditional medicines -- the pain relievers known as Cox-2 inhibitors -- has been much in the news lately. The arthritis drug Vioxx was voluntarily pulled from the market earlier after a large trial linked its use to an increase in heart attacks and strokes. In another, trial, Pfizer’s popular Cox-2 inhibitor Celebrex was also found to increase heart attack risk. The company says it has no plans to pull Celebrex from the market until it studies the data.

Just under a third of the patients in the acupuncture trial were also taking a Co-2 inhibitor. But other investigators claim that the Cox-2 inhibitors have not been shown to be superior to other pain relievers for the treatment of osteoarthritis.

The recent studies suggest side effects such as ulcers and bleeding that result from the prolonged use of nonsteriodal anti-inflammatory drugs such as proton-pum inhibitors or H2 blockers.

There was actually very little indication for the use of Cox-2 selective inhibitors in managing patients with symptomatic osteoarthritis, they said.

The newly reported study included 570 patients with knee osteoarthritis who were already taking anti-inflammatory drugs or other pain relievers. Ten patients continued on their pain relievers during the 26 week trial of them also got aggressive acupuncture treatments consisting of 23 total sessions. Another group of patients unknowingly got sham acupuncture, which involved the use of fake needles to mimic the real needless used for true acupuncture. A third group underwent an intensive 12-week education course on the management of osteoarthritis.

All the patients were assessed at weeks 4, 8, 12 and 26 for pain and knee function. By week 8, the patients who got the true acupuncture were showing significant increases in knee function, and by week 14 they showed significant decreases in pain compared with the sham acupuncture and the education groups.

The acupuncture group had a 40% decrease in pain as compared with their initial pain scores. They also experienced a 40% improvement in function at the end of the trial, and there were no major treatment-related side effects.

Research in animal studies suggests that acupuncture works by affecting genes, involved in the production of chemicals within the body that regulates pain. But it is not yet clear if the ancient practice can actually slow progression of the degenerative joint conditions. More than 20 million Americans have osteoarthritis, this disease is one of the most frequent causes of physical disability among adults, seeking an effective means of decreasing osteoarthritis pain and increasing function is of critical importance, they noted.