If You Absolutely need a Knee Replacement Acupuncture May Help Reduce Narcotic Use

Knee replacement is often billed as a sure thing treatment for knee arthritis. However, what’s interesting is that numerous studies have found an alarmingly high number of patients who are still on narcotics long after the procedure. How can you reduce this risk if you really need a knee replacement? It may be as simple as finding a good acupuncturist!

Narcotics Are Bad News

Prescription opioids are narcotic painkillers and include oxycodone, hydrocodone, Demerol, morphine, and many more. The problem is that prescription opioids have become a national health crisis with severe addictions leading to accidental overdoses and thousands of deaths each year. A new petition to the FDA is requesting the ultra-high-dose opioids, such as OxyContin 80mg and oxycodone 30mg, be taken off the market. This follows on the heels of the FDA calling for the removal of the prescription opioid Opana ER from the market in June. The pharmaceutical manufacturer answered the call in July and removed it from pharmacy shelves. Prescription opioids, deservedly, are a hot topic in the bad-news headlines today, and will likely continue to be until the problem is under control. Why?

First, for some people, their NK1R protein receptor, which is stimulated by pain, can shield itself from the effects of certain opioids. This means that for those people, opioids don’t relieve their pain. In fact, narcotic drugs have been shown to actually make pain worse over time by messing up our pain signals, creating spinal cord inflammation and chronic pain. More pain can lead to more opioids, and, therefore, addiction. For every 5 people who receive just a 10-day opioid prescription, 1 person becomes addicted. The same study also found that even just a five-day prescription of opioids increased the chance that the patient would still be taking them at one year by 10%. And the higher the dosage or the longer the prescription, the higher the risk of addiction.

When you understand that knee replacement is the amputation of the knee joint and the insertion of a prosthesis, the need for pain medication is crucial. If a knee replacement is in your future, just one opioid prescription at any point during the two years before your surgery puts you at an increased risk for more pain following your surgery.  And patients who undergo knee surgery, in general, compared to many other common surgeries, are five times more likely to experience a narcotic addiction after surgery, making knee replacement opioid risk the risk you’ve likely unaware of.

So while a reduction in opioid use is certainly better than the alternative, eliminating opioid use altogether should be the bigger focus. Let’s review the new study.

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New Research on Opiods and Knee Replacement

The new study was a meta-analysis of 39 randomized trials consisting of a total of nearly 2,400 subjects. Researchers analyzed a variety of drug-free options to investigate ways to reduce opioid use following knee replacement. Some of the options explored were acupuncture, electrotherapy, cryotherapy, preoperative exercise, and so on. Only acupuncture and electrotherapy were found to reduce or delay opioid use following surgery.

While acupuncture is thought to relieve pain by inserting tiny needles through the skin into specific points and electrotherapy is thought to relieve pain using electrical-energy stimulation, researchers noted that there was very low certainty that the acupuncture or electrotherapy actually improved pain. So the reasons for the reduction in opioid use are unclear.

The upshot? If you have no other choice but to get a knee replacement, then acupuncture may well help you reduce the risk of becoming addicted to narcotics by reducing the amount you need to take. So first find a good surgeon and the second thing you do may be looking for a good acupuncturist!

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.