A Smarter Way to Target Acupuncture for Knee Pain? Scientists Are Testing Heat-Guided Needles

Scientists in Beijing are testing whether thermal cameras can make acupuncture more effective for knee osteoarthritis by identifying the exact spots where needles should be placed. The innovative approach uses infrared thermography to detect temperature changes at acupuncture points, potentially solving a long-standing problem in acupuncture research: how to choose the best needle placement for each patient.

Why Does Acupuncture Point Selection Matter?

Traditional acupuncture for knee osteoarthritis (KOA) faces a significant challenge. More than 40 different acupuncture points have been used across various studies, but there's no clear standard for which ones work best. This inconsistency may explain why acupuncture research shows mixed results, particularly in studies conducted outside China. The lack of objective criteria for choosing acupuncture points has led medical organizations like the American College of Rheumatology to give acupuncture only limited recommendations for knee pain treatment.

The new study, conducted at Beijing University of Chinese Medicine, aims to change this by using science to guide needle placement. Researchers have discovered that patients with knee osteoarthritis show abnormal skin temperatures at specific acupuncture points on their lower limbs, creating what they call "thermal-sensitized acupoints."

How Does Heat-Guided Acupuncture Work?

The thermal-sensitized approach works by using infrared thermography (IRT) to detect temperature variations at acupuncture points. When inflammation occurs in knee joints, it affects the temperature of surrounding tissues, including areas near traditional acupuncture points. These temperature changes may be linked to autonomic nervous system function and metabolic activity, with certain acupoints showing more pronounced temperature variations than non-acupoint regions.

The research team's pilot study will compare two approaches with 60 knee osteoarthritis patients:

• Thermal-guided group: Acupuncture points selected based on abnormal skin temperatures identified by infrared cameras using real-time surface projection technology
• Conventional group: Traditional acupuncture point selection following established prescriptions from previous studies
• Treatment schedule: Both groups receive three acupuncture sessions per week for four weeks

Recent anatomical studies have shown that acupuncture points often overlap with perforating cutaneous blood vessels, which infrared thermography can detect through temperature changes. This scientific basis gives researchers confidence that heat-guided point selection could improve treatment outcomes.

What Could This Mean for Knee Pain Treatment?

Knee osteoarthritis affects millions of people worldwide and is the most common form of arthritis. Current treatment options remain limited, with long-term pharmaceutical use often constrained by cardiovascular and gastrointestinal risks. If the thermal-guided approach proves successful, it could provide a more personalized and potentially more effective non-drug treatment option.

The study began enrolling participants in February 2025, with 30 people already enrolled by January 2026. All enrollment and follow-up are expected to be completed by June 2026. The research will measure not only pain relief and functional improvement but also the feasibility of conducting larger studies using this technology.

The infrared thermography method offers several practical advantages: it's non-invasive, convenient to use, and allows for flexible acupoint selection based on individual differences while remaining easy to standardize. This could address one of acupuncture's biggest research challenges by providing objective criteria for needle placement rather than relying solely on traditional theory or practitioner preference.