Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

Clinical trial: Immediate Effects of Proximal and Distal Acupoints on the RPPW in Patients With KOA: a Randomized Controlled Trial

Eligibility criteria:
Inclusion Criteria:

        Patients meet at least three out of the following six conditions:

          -  Any gender aged 50 years or above;

          -  Have less than 30 mins of morning stiffness;

          -  Crepitus on active motion;

          -  Bony tenderness;

          -  Bony enlargement;

          -  No palpable warmth.

        Exclusion Criteria:

          -  Subjects who are unable to walk.

          -  Malignancy,

          -  Any acute medical condition,

          -  Poorly controlled diabetes or hypertension,

          -  A motor or sensory nerve defect,

          -  Blood clotting disease,

          -  Mental illness,

          -  Dementia,

          -  Mental retardation or other abnormal person on the organic mind.

          -  Subjects with intra-articular solid or hyaluronic acid injection in the past 3 months.

          -  Knee surgery,

          -  Knee trauma,

          -  Congenital knee deformation,

          -  Severe knee varus or valgus deformation,

          -  Endocrine,metabolic, infectious, inflammatory, secondary degenerative knee arthritis
             caused by problems with rheumatic immune diseases.

          -  Subjects who are hypersensitive to needles.

          -  Subjects who are unwilling to cooperate or sign the subject consent.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 20 Years old.


Eligibility (NLI label): Entailment