Electroacupuncture vs Topical Diclofenac Sodium Gel for Patients With Hand Osteoarthritis

Inclusion Criteria:

1. History of hand OA for at least 3 months before enrolment and use of a NASID for ≥ 1episode of pain;

2. Reported an average possible overall finger joints pain intensity in the dominant handover the past 48 hours of at least 40mm according to a 100-mm visual analog scale (VAS) after 1-week wash-out period of previous OA medications(Patients applying NSAIDsat the screening had to have an increase in pain in the dominant hand of ≥ 20 mmduring washout);

3. Posterior-anterior radiographs had to show Kellgren-Lawrence grade 1, 2, or 3 changesin symptomatic joints;

4. Rheumatoid factor and anticyclonic citrullinated peptide were negative in all eligibleparticipants to exclude inflammatory arthritis;

5. Ability to comply with the study protocol, understand the medical information forms aswell as having signed informed consent.

Exclusion Criteria:

1. History or current evidence of secondary OA(due to causes other than a solelydegenerative joint disease) or symptomatic OA at additional locations besides thehand(s) requiring treatment, or any painful syndrome of the upper limb which mayinterfere with evaluation of hand pain;

2. History of inflammatory arthritis(e.g., rheumatoid arthritis (RA), psoriaticarthritis), hemochromatosis, metabolic, or neuropathic arthropathies;

3. History of trauma, dislocation or operation to the hand or arm in the previous 3months;

4. Hand pain and stiffness due to tissue scarring or tendinitis;

5. Skin damage or serious skin disorders in the hands;

6. Intake of antidepressants, anticonvulsants, vascular or narcotics during the 10 daysprior to beginning the study;

7. Oral, intramuscular, intra-articular or intravenous corticosteroids, or hyaluronicacid injection within 3 months preceding enrollment;

8. Serious uncontrolled medical conditions such as cancer, uncontrolled cardiovasculardisorder, severe hepatic/renal insufficiency or coagulation disorder;

9. Known allergy, contraindication or intolerance to diclofenac, acetaminophen, or gelcomponents;

10. Known phobic to acupuncture or received acupuncture treatment within 4 weeks prior toenrollment.