Headache & Migraine

2021 Cureus Journal of Medical Science

Acupuncture seems to be an effective method for the long-term reduction of the intensity of headache pain in patients with tension-type headaches.

In the long term, acupuncture demonstrated a statistical (p=0.009) and clinical benefit compared with placebo/sham. Statistical analyses between the two groups showed a reduction of 0.41 in the VAS scale at the acupuncture group (mean difference: -0.41[CI: -0.72, -0.10]) (Figure 6).The heterogeneity was zero (I2=0%, p=0.65). As a result, acupuncture seems to be an effective method for the long-term reduction of the intensity of headache pain in patients with TTH.

The Effectiveness of Acupuncture on Headache Intensity and Frequency in Patients With Tension-Type Headache: A Systematic Review and Meta-Analysis Spyridon Kolokotsios, Alexandra Stamouli, Ioannis Koukoulithras, Minas Plexousakis, Gianna Drousia

2021 Evidence-Based Complementary and Alternative Medicine

Cupping therapy has beneficial therapeutic effects and could be effective for the treatment of migraine.

We analyzed 6 RCTs with 510 migraine participants in this review and the results show that wet cupping and dry cupping could improve the migraine symptoms. No significant adverse events were identified in the studies included in this review.

This review is the first comprehensive systematic review and meta-analysis about cupping therapy for migraine. In addition, the levels of evidence were presented through assessment of the quality of the evidence. The quality of the level of evidence was low in the wet cupping versus drugs group and dry cupping plus acupuncture versus acupuncture group. Regardless of the potential bias and limitations, all the included studies concluded that cupping therapy had beneficial therapeutic effects in treating migraine.

Cupping therapy has potential therapeutic effects on treating migraine. Further larger and rigorously designed RCTs are needed to confirm the cupping therapy’s therapeutic effect. Additional economic studies might be considered for future studies to compare the cost-effectiveness of cupping therapy plus acupuncture or cupping therapy plus drugs.

Cupping Therapy for Migraine: A PRISMA-Compliant Systematic Review and Meta-Analysis of Randomized Controlled Trials Jihye Seo, Hongmin Chu, Cheol-Hyun Kim, Kang-Keyng Sung, Sangkwan Lee

2021 Complementary Therapies in Clinical Practice

Meta-analysis results showed that Tuina was superior to drugs for improving the effectiveness rate for tension-type headache.

Seven studies were included with a total sample of 1228 individuals. Meta-analysis results showed that Tuina was superior to drugs for improving the effectiveness rate. A visual analog scale (VAS) score of Tuina was significantly lower than that of drugs. The trial sequential analysis showed that the effectiveness of Tuina for tension-type headache was accurate. Adverse events were tolerable.

Tuina has a certain effect in treating tension headache. However, due to the low level of methodological quality included in the article, this conclusion should be considered cautiously.

The effectiveness and safety of Tuina for tension-type headache: A systematic review and meta-analysis Zhiyong Fan, Anqi Di, Fan Huang, Siyi Zhao, Mingwang Qiu, Cunshu Wu, Chuyu Huang, Rusong Guo, Qiang Tian, Shan Wu

2020 Neurology and Therapy

In many studies, acupuncture has been shown to be a safe, efficacious and readily available alternative therapy which may be beneficial to certain migraine patients.

Migraines are difficult to treat, and current treatment options have many unwanted side effects, such as exacerbating headache pain in those with chronic migraine. Therefore, while the primary treatment for migraines is drug therapy, acupuncture is gaining increasing attention as a viable addition to the treatment management of migraine patients due to its measurable effects on both the duration and frequency of migraine attacks. Many studies suggest that acupuncture is a safe, helpful and available alternative therapy that may be beneficial to certain migraine patients. Nevertheless, further large-scale RCTs are warranted to further consolidate these findings and provide further support for the clinical value of acupuncture.

Acupuncture and Its Role in the Treatment of Migraine Headaches Urits I, Patel M, Putz ME, Monteferrante NR, Nguyen D, An D, Cornett EM, Hasoon J, Kaye AD, Viswanath O.

2020 Frontiers in Neurology

Compared with the sham acupuncture group, the acupuncture group had greater improvements in the frequency of migraine attacks, VAS score, and treatment efficiency.

Meta-analysis of 28 articles showed that acupuncture treatment has higher treatment efficiency than sham acupuncture treatment, and acupuncture can reduce the frequency of migraine attacks and ameliorate the visual analog scale (VAS) score more significantly. Compared with the medication (medication group), acupuncture treatment is more effective and the incidence of adverse reactions is lower. In addition, the transcranial doppler (TCD) analysis results suggested that the acupuncture group has a better hemodynamic improvement effect than the medication group, but the results need to be further verified due to the existence of heterogeneity.

A Systematic Review and Meta-analysis of the Therapeutic Effect of Acupuncture on Migraine Ou MQ, Fan WH, Sun FR, Jie WX, Lin MJ, Cai YJ, Liang SY, Yu YS, Li MH, Cui LL, Zhou HH

2020 Pain Research & Management

Acupuncture reduced more headache days and the times of using painkiller and was more effective in reducing the frequency and degree of headache than western medicine and sham acupuncture.

Based on high quality of evidence, we conclude that acupuncture is more effective and safer than medication or sham acupuncture in the treatment of migraine. However, the methodological quality, risk of bias, and reporting quality of SRs in acupuncture for migraine still needs improvement in future.

Effectiveness and Safety of Acupuncture for Migraine: An Overview of Systematic Reviews Li YX, Xiao XL, Zhong DL, Luo LJ, Yang H, Zhou J, He MX, Shi LH, Li J, Zheng H, Jin RJ

2019 Neuropediatrics

Currently, acupuncture is considered to be a safe, helpful, and available alternative option for patients who have not responded to or complied with conventional pharmacotherapy.

In this article, the authors conduct a review of acupuncture in pediatric headache, including neurobiological mechanisms, adult headache studies, pediatric headache studies, safety, and use of acupuncture in other conditions in children. This article aims to summarize the currently available evidence with which to recommend acupuncture in children for the adjunctive treatment of headache. Acupuncture appears to be safe and effective for the treatment of migraine in children.

Acupuncture in Adult and Pediatric Headache: A Narrative Review Doll, E., Threlkeld, B., Graff, D., Clemons, R., Mittel, O., Sowell, M. K.

2019 Headache

There is growing evidence that acupuncture is just as effective and has fewer side effects than many of the standard pharmaceutical agents that are currently used.

Out of the 706 search results, 7 clinical trials, with a total of 1430 participants, met inclusion criteria for trials comparing the effectiveness of acupuncture to standard pharmacologic treatment. Several of the studies showed acupuncture to be more effective than standard pharmacological treatments for migraine prevention; however, methodological heterogeneity precluded aggregation of these data.

Systematic Review: Acupuncture vs Standard Pharmacological Therapy for Migraine Prevention Niushen Zhang, Tim Houle, Nada Hindiyeh, & Sheena K. Aurora

2019 World Journal of Acupuncture-Moxibustion

The results of this meta-analysis showed that acupuncture is more effective and safer than medication for migraine.

A total of 13 trails including 1218 participants met the selection criteria. The meta-analysis of 3 articles showed that acupuncture was more effective in reducing the frequency of migraine attacks than medication. The meta-analysis of three articles showed that acupuncture was more effective in reducing the number of migraine days than medication after treatment. The meta-analysis of six articles showed that acupuncture was more effective in reducing VAS after treatment. The meta-analysis of two articles showed that acupuncture was more effective in reducing VAS during follow-up. The meta-analysis of seven articles showed that the total effective rate of acupuncture was higher than that of medication. In addition, fewer adverse effects in acupuncture groups were reported than in medication groups. Overall the quality of the evidence was low.

The results of this meta-analysis showed that acupuncture is more effective and safer than medication for migraine. Acupuncture can be considered a treatment option for patients willing to undergo this treatment. But more high-quality studies, based on standardized, comprehensive and objective evaluation, are required to enhance the reliability of the conclusion.

Acupuncture for migraine: A systematic review and meta-analysis SHEN, Feng-jiao AU - XU, Jia AU - ZHAN, Yi-jun AU - FU, Qin-hui AU - PEI, Jian PY

2019 Pain Research & Management

Acupuncture has the advantage for acute and preventive treatment of migraine in pain improvement and safety.

This overview included a considerable number of systematic reviews/meta analyses (SR/MAs), illustrating that acupuncture has the advantage in pain improvement of VAS score, headache days/frequency, analgesic use and efficacy of response rate, and effective rate according to the present evidence.

In terms of conclusion, the results of all 15 (100%) SR/MAs were positive. For treatment, 6 SR/MAs reported acupuncture had superiority relative to drugs; 4 SR/MAs reported acupuncture had superiority relative to sham acupuncture, drugs; 3 SR/MAs reported acupuncture had superiority relative to sham acupuncture; 1 SR/MA reported acupuncture had superiority relative to drugs, other TCM treatments. 1 SR/MA reported that acupuncture had superiority in treating migraine, but did not mention the control group in the conclusions.

Based on previous evidence we reviewed, we supposed acupuncture might be a kind of available treatment for migraine in preventive or acute treatment, but in consideration of low methodological quality of present SR/MAs or RCTs of acupuncture for migraine, we need more high-quality evidence to demonstrate the effect of acupuncture for migraine.

An Overview of Systematic Reviews of Randomized Controlled Trials on Acupuncture Treating Migraine Xia-tian Zhang, Xin-yi Li, Chen Zhao, Ye-yin Hu, Yi-yi Lin, He-qing Chen, Zhao-feng Shi, Xiao-yu Zhang, Hong-cai Shang, Gui-hua Tian

2017 Evidence-Based Complementary and Alternative Medicine

Acupuncture was more effective than conventional medicine therapy in effectiveness, improvement rate of vertigo and headache, and increased average blood flow velocity of vertebral-basilar artery.

This systematic review and meta-analysis based on current evidence suggested that acupuncture may be more effective in effectiveness and improvement of clinical symptom and average blood flow velocity of vertebral-basilar artery compared with conventional medicine therapy for CV. However, the findings should be insufficient to make a firm conclusion due to a lack of studies with high methodological quality. Further rigorously designed studies and higher-quality trials with larger sample size are necessary to confirm the effectiveness and safety of acupuncture for CV.

The Efficacy of Acupuncture for the Treatment of Cervical Vertigo: A Systematic Review and Meta-Analysis Zhuanzhuan Hou, Shibing Xu, Qinglin Li, Libing Cai, Weigang Wu, Huida Yu, Huade Chen

2016 Cochrane Database of Systematic Reviews

The available evidence suggests that adding acupuncture to symptomatic treatment of attacks reduces the frequency of headaches.

Contrary to the previous findings, the updated evidence also suggests that there is an effect over sham, but this effect is small. The available trials also suggest that acupuncture may be at least similarly effective as treatment with prophylactic drugs. Acupuncture can be considered a treatment option for patients willing to undergo this treatment.

Acupuncture for the prevention of episodic migraine Linde K, Allais G, Brinkhaus B, et al.

2016 Cochrane Database of Systematic Reviews

The available evidence suggests that a course of acupuncture consisting of at least six treatment sessions can be a valuable option for people with frequent tension-type headache.

Acupuncture added to usual care or treatment of headaches only on onset (usually with pain-killers) in two large trials resulted in 48 in 100 participants having headache frequency at least halved, compared to 17 of 100 participants given usual care only.

Acupuncture was compared with ‘fake’ acupuncture, where needles are inserted at incorrect points or do not penetrate the skin, in six trials. Headache frequency halved in 52 of 100 participants receiving true acupuncture compared with 43 of 100 participants receiving ‘fake’ acupuncture. The results were dominated by one large, good quality trial (with about 400 participants), which showed that the effect of true acupuncture was still present after six months. There were no differences in the number of side effects of real and ‘fake’ acupuncture, or the numbers dropping out because of side effects.

Acupuncture for the prevention of tension‐type headache Klaus Linde,Gianni Allais,Benno Brinkhaus, Yutong Fei,Michael Mehring,Byung‐Cheul Shin,Andrew Vickers,Adrian R White

2016 Neural Regeneration Research

A 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo.

Acupuncture at Fengchi (GB20) in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi.

Of the 136 patients, 120 completed the study. There were no significant differences between pretreatment and posttreatment test results in any of the groups. Only five patients suffered from minor adverse events (needling pain, slight hematoma and transient chest tightness). No serious adverse events were found. Our results indicate that a 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo.

Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo Wen Y, Zhang C, Zhao Xf, Deng Sz, He S, Huang Lh, Tian G, Meng Zh

2015 BMC Complementary Medicine and Therapies

Acupuncture demonstrates a significant immediate effect in reducing discomforts and VAS of both dizziness and vertigo.

Acupuncture demonstrates a significant immediate effect in reducing discomforts and VAS of both dizziness and vertigo. This study provides clinical evidence on the efficacy and safety of acupuncture to treat dizziness and vertigo in the emergency department.

Efficacy and safety of acupuncture for dizziness and vertigo in emergency department: a pilot cohort study Chiu, CW., Lee, TC., Hsu, PC. et al.