Recent studies show acupuncture is helpful in treating headaches

By DRS. REMY COEYTAUX and WUNIAN CHEN
UNC Health Care

Headache is a common symptom that affects most adults at some point in their lives. There are many different causes of headache, but the two most common headache diagnoses are migraine and tension-type headaches.


Another type of headache that appears to be becoming increasingly more common is chronic daily headache (CDH). CDH is currently defined as the occurrence of headache 15 or more days per month, largely irrespective of the cause of the headaches.

There are several medications that have been proven to be highly effective in treating migraine headaches, and there are some medications that can be useful in the treatment of tension-type headaches. Most of the medications commonly used for headache, however, have the potential to cause the “transformation” of episodic migraines to CDH. This paradoxical relationship between medications and CDH (in that the very medications used to treat some headaches are implicated in the development of difficult-to-treat CDH) has led many headache experts and headache sufferers to explore non-pharmacological ways of treating or preventing headaches.

The most effective way to prevent many types of headaches, including migraines, is to avoid headache triggers such as sleep deprivation, certain foods, changes in daily routine, allergens, or other activities, exposures or substances that seem to trigger a person’s headaches. When such avoidance of triggers is not possible or not sufficiently effective, the next best non-pharmacological option may be acupuncture.

Acupuncture is a healing technique that has been used in China and other eastern Asian cultures for more than 3,000 years. It involves placing fine, metal needles in specific bodily locations and leaving them in place for periods of a few seconds to one or more hours at a time. This therapeutic technique has been used to treat headache for thousands of years, but only recently has its efficacy in the treatment of headache been studied rigorously.

The results of at least four relatively large and well-designed, randomized, clinical trials were published in medical journals in 2004 and 2005. One study, published in the British Medical Journal (BMJ), demonstrated that patients in the United Kingdom who experienced frequent headaches and who were randomly assigned to receive acupuncture treatments over a period of three months reported fewer days with headache than the patients who did not receive acupuncture.

Another study, conducted at the University of North Carolina and published in the journal Headache, demonstrated that patients with CDH who were randomized to acupuncture reported significant improvements in quality of life and improvements in their headache conditions compared to patients who did not receive acupuncture.

Two studies conducted in Germany and published in the Journal of the American Medical Association (JAMA) and BMJ demonstrated that acupuncture was effective in the treatment of both migraine and tension-type headache when compared to no acupuncture, but not when compared to sham acupuncture (the shallow insertion of acupuncture needles in bodily locations not generally believed to be helpful in the treatment of headache). The lack of a statistically significant difference between “true” and “sham” acupuncture suggests either that the benefits associated with acupuncture are due to a placebo effect or that sham acupuncture confers some “real” clinical benefit, or a combination of the two.

These studies support the conclusion that acupuncture appears to be a safe and effective way of treating headaches without the use of medications, or along with medical therapy. Although it is not yet clear how much of acupuncture’s benefits can be explained by the “placebo effect,” there is very good evidence to suggest that many people who experience frequent or severe headaches may benefit from a series of acupuncture treatments.

Remy Coeytaux, MD, PhD, is an assistant professor and Wunian Chen, MD, LAc, is an instructor in the University of North Carolina at Chapel Hill School of Medicine.

This column was released for publication in January 2006.  www.boomingpractice.com