Systematic reviews have come up with conflicting conclusions regarding the effects of acupuncture treatment for rheumatoid arthritis. One found that the data suggest favourable effects of moxibustion (alone or combined with conventional drugs) on response rate compared with conventional drug therapy.(Choi 2011) The other two reviews found acupuncture to be as good as or better than drugs, but with no consistent advantage over sham acupuncture controls.(Wang 2008; Lee 2008)
More recent trials have been small and do not present a compelling case for upgrading the reviews' conclusions. It appears likely that some people may benefit from acupuncture treatment,(Lao 2010) but it is not known what proportion this may be, and to what degree and how acupuncture would compare to other possible interventions. More research is needed.
In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body's homeostatic mechanisms, thus promoting physical and emotional well-being. Stimulation of certain acupuncture points has been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress (Hui 2010) It has also be shown to reduce inflammation, by promoting release of vascular and immunomodulatory factors.(Zijlstra 2003; Kavoussi 2007)
Acupuncture treatment may help to relieve pain and improve function in patients with rheumatoid arthritis by:
decreasing the proinflammatory cytokines IL-1 and IL-6 and increasing the inhibitory cytokines IL-4 and IL-10 (Ouyang 2010);
inducing vasoactive intestinal peptide expression, an anti-inflammatory neuro-peptide (He 2011);
inhibiting the function of synovial mast cells (which are substantially involved in the initiation of inflammatory arthritis) (He 2010);
upregulating plasma adrenocorticotropic hormone, downregulating serum cortisol levels and synovial nuclear factor-kappa B p 65 immunoactivity, and restoring the hypothalamus-pituitary-adrenal axis (HPAA).(Gao 2010);
stimulating nerves located in muscles and other tissues, which leads to release of endorphins and other neurohumoral factors, and changes the processing of pain in the brain and spinal cord (Pomeranz 1987; Han 2004; Zhao 2008; Cheng 2009);
increasing local microcirculation (Komori 2009), which aids dispersal of swelling.
(Article from the British Acupuncture Council website)