The 2019 ‘Guideline for the Management of Osteoarthritis’ from the American College of Rheumatology (ACR) includes tai chi and acupuncture in its recommendations for clinicians and patients making treatment decisions for the management of osteoarthritis (OA). This evidence-based guideline was developed as a collaboration between the ACR and the Arthritis Foundation, updating 2012 ACR recommendations for the management of hand, hip and knee OA. Based on the available evidence, strong recommendations were made for tai chi, as well as exercise, weight loss self-management programs, cane use, hand orthoses, tibiofemoral bracing, topical and oral nonsteroidal antiinflammatory drugs (NSAIDs) and steroid injections. Conditional recommendations were made for acupuncture along with balance exercises, yoga, cognitive behavioral therapy, kinesiotaping, patellofemoral bracing, thermal modalities, radiofrequency ablation, chondroitin sulfate, topical capsaicin, acetaminophen, duloxetine and tramadol. The conditional recommendation for acupuncture was based on the voting panel’s assessment that while the ‘true’ magnitude of effect of acupuncture in OA is difficult to discern, its risk of harm is minor. The overall conclusion of the panel was that optimal management of OA requires a comprehensive, multimodal approach to treating patients.

2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020 Feb;72(2):220-233