Brief summary, from the abstract
In this meta-analytic review of trials of nonpharmacological, nonsurgical treatments for knee osteoarthritis pain, a large share of the relief patients felt came from contextual effects rather than the treatment itself. For acupuncture about 61% of the total effect, and for topical energy modalities about 69%, was attributable to context such as placebo response, natural healing, and co-therapies.
- Acupuncture: proportion of contextual effect (PCE) 0.61 (95% CI 0.46-0.80), based on 13 studies and 1,653 subjects.
- Topical energy modalities (ultrasound, laser, TENS grouped together): PCE 0.69 (95% CI 0.54-0.88), based on 12 studies and 572 subjects.
- Contextual effects here lump together placebo response, natural history of symptoms, and effects of co-therapies, so they are not purely placebo.
- This is a pooled estimate across trials, not a single head-to-head trial, and results were reported only for these two grouped therapy types.
Clinically assessing this area? See the knee special tests.