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Health Behavior News Service
January 21, 2009
Two systematic reviews have found that acupuncture therapy can provide patients who
suffer from tension and migraine headache an alternative treatment for their pain.
Tension
headaches are the most common headaches, and generally cause infrequent mild to moderate
pain, but in a considerable number of patients, tension headaches are so frequent
that they require treatment. Migraine headaches, on the other hand, can be disabling
and severe. Accompanying symptoms can include nausea, vomiting and sensitivity to
light.
Treatment for tension-
The reviews appear in the current issue of The Cochrane Library, a publication
of The Cochrane Collaboration, an international organization that evaluates research
in all aspects of health care. Systematic reviews draw evidence-
Acupuncture involves penetrating the skin with thin, metallic needles
at specific points. It is one of the main medical treatments in traditional Chinese
medicine, where it came into being more than 2,000 years ago.
Lead reviewer Klaus
Linde of the Center for Complementary Medicine Research at the Technical University
of Munich said the therapy is popular in his country.
"In Germany, acupuncture is
frequently used for headache," he said. "Most private health insurances, in fact,
reimburse for acupuncture, although they cover only about 10 percent of the population."
The
practice has also gained popularity in the United States. A 2002 National Health
Interview Survey of complementary and alternative medicine use found that about 8.2
million U.S. adults had ever used acupuncture in their lives, and an estimated 2.1
million had used acupuncture the previous year.
Brian Berman, M.D., director of the
University of Maryland Center for Integrative Medicine in Baltimore, confirmed that
acupuncture is definitely becoming a more popular treatment option for Americans.
"There
is more evidence coming out showing acupuncture is safe and often effective and should
be considered as part of a multidisciplinary approach for chronic pain," he said.
The
first Cochrane review by Linde and his colleagues focused on acupuncture for tension
headaches. The researchers evaluated 11 studies that investigated 2,317 participants.
The studies compared participants who had undergone acupuncture therapy with those
who had no treatment except painkillers for acute headaches, or had a sham therapy,
which mimicked "true" acupuncture. Researchers followed the patients for at least
eight weeks.
Two large studies that investigated whether adding acupuncture to treatment
with painkillers found that those patients who received acupuncture had fewer headaches.
Forty-
Six studies compared true acupuncture to "fake” acupuncture in
which needles were either inserted at incorrect points or did not penetrate the skin.
Overall, these studies found slightly better effects in the patients receiving the
true acupuncture intervention.
"The response to acupuncture in general seems to be
large and clinically relevant," Linde said.
Berman agreed with the review findings
and said patients at his clinic seek acupuncture for the relief from tension headaches
and some experience good outcomes.
"I have seen some patients do very well, but not
everyone," he said. "Often, the intensity of the headaches and number of headaches
are reduced."
In a second review, Linde and colleagues examined acupuncture for migraine
treatment and reviewed 22 trials with 4,419 total participants who had received a
migraine pain diagnosis with or without aura.
Six studies compared acupuncture to
no treatment or routine care (with painkillers) only. After three to four months,
patients who received acupuncture had fewer headaches.
"The effect over no prophylactic
[preventive] treatment and also compared to prophylactic drug treatment proven to
be superior to placebo is clearly clinically important," said Linde.
The Cochrane
reviewers concluded that there is consistent evidence that acupuncture provides additional
benefit to treatment of acute migraine attacks only or to routine care. They also
concluded that for migraine patients, placing the needles in the correct points did
not seem as relevant, which is contrary to what most acupuncturists believe.
"On average,
the studies do not show an effect of acupuncture at correct points over acupuncture
at incorrect points," Linde said. There appeared to be some benefit of pain relief
regardless of the insertion points.
The reviews disclose that Linde has received travel
reimbursement and twice received fees from acupuncture societies for speaking about
research at conferences. Other review authors reported a variety of honoraria and
reimbursements related to acupuncture lectures and speaking engagements.
The Cochrane
Collaboration is an international nonprofit, independent organization that produces
and disseminates systematic reviews of health care interventions and promotes the
search for evidence in the form of clinical trials and other studies of interventions.
Visit http://www.cochrane.org for more information.
References:
Linde K, et al. Acupuncture for tension-
Linde K, et al. Acupuncture for migraine prophylaxis. Cochrane
Database of Systematic Reviews 2009, Issue 1.
Migraines and Tension Headaches Respond to Acupuncture
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