Acupuncture Effective for Migraine Relief

2009, Issue 08, Share |. Acupuncture Effective for Migraine Relief. By Editorial Staff. …
Furthermore, almost half of those migraine cases are undiagnosed. …
www.acupuncturetoday.com/mpacms/at/article.php?id=31775 – 79k – 2008-08-01
Acupuncture Today
August, 2008, Vol. 09, Issue 08

Acupuncture Effective for Migraine Relief
By Editorial Staff

As any chronic sufferer will tell you, migraine headaches can be debilitating, affecting concentration and the ability
to perform daily tasks. In fact, the odds are high that a patient will come to see you with a complaint of migraines.

The latest epidemiologic data estimates 28 million Americans (approximately one in 10) suffer from migraines.
Furthermore, almost half of those migraine cases are undiagnosed.

Fortunately, as research suggests, Chinese medicine may help stop migraines in their tracks. In the March 2008 issue of
the journal Headache, Italian researchers published the results of a study that involved 160 migraine patients.
Researchers divided study participants into different groups, each of which received one of the following treatment
protocols: real acupuncture plus migraine medication, two different methods of mock acupuncture with migraine
medication, and medication alone. Patients were evaluated three and six months after starting treatment. Migraines were
classified according to the following TCM symptoms:

¦exogenous wind-cold attack;
¦exogenous wind-heat attack;
¦exogenous wind-dampness attack;
¦excess of liver yang;
¦obstruction of the middle jiao due to damp phlegm;
¦deficiency of kidney essence; or
¦stagnation of qi and blood.

For patients receiving true acupuncture, each syndrome was treated with a specific acupoint selection according to TCM.
Twice a week, patients submitted to two courses of 10 acupuncture applications each, with a one-week rest period
between the treatment courses. The sessions lasted 30 minutes.

In patients receiving ritualized mock acupuncture, the protocol was the same as in the actual acupuncture group, but
the needles were not inserted. A small cylinder of foam was applied to the skin by a double-adhesive plaster on each
acupoint. Needles with blunted tips were then inserted into the cylinder, touching but not penetrating the skin. This
allowed the patient to feel a superficial, light pricking-like sensation, thus simulating needle insertion. A slight
pressure was applied on the needle to simulate the arrival of qi. This procedure was used in order to check possible
placebo effects related to the use of the TCM approach.

In patients who received standard mock acupuncture, only the Western approach was used for diagnosis and the following
standard acupoint selection was used: tou wei (ST 8), xuan lu (GB 5), feng chi (GB 20), da zhui (GV 14), lie que (LU
7). The same method of needle insertion as for ritualized mock acupuncture was used.

All patients were allowed to take rizatriptan to treat migraine attacks, The rizatriptan wafer was administered at a
dose of 10 mg, and a second dose was allowed after two hours if the pain persisted.

The researchers found that of all the groups studied, only the group that received real acupuncture showed a
significant improvement both in terms of migraine disability and reduced medication use, both at the three- and six-
month follow-up. Mock acupuncture showed a slight placebo effect, but only at the three-month follow-up.

***Article 2

Migraine

Acupuncture Provides Significant Benefits for Migraine Patients
By Michael Devitt

Acupuncture Today
May, 2004, Vol. 05, Issue 05

A new report published in the online version of the British Medical Journal1 has found that acupuncture is a useful,
cost-effective treatment for chronic headaches, particularly migraines.

The report found that over a 12-month period, headache patients who received regular acupuncture sessions reported
fewer headaches, had a higher quality of life, missed fewer days from work, used less medication, and made fewer visits
to a general practitioner than patients given standard treatment for headaches.

The research was conducted at a series of single acupuncture practices and general practices in Wales and Great
Britain. In the study, the authors recruited 401 patients who suffered from chronic headaches, predominantly migraine
headaches. The patients were randomized to receive either acupuncture or “usual care” from a general practitioner. In
the acupuncture group, subjects standard care for headaches, and were also treated with acupuncture up to 12 times over
a three-month period. Treatment patterns were individualized to each patient, and different points were used based on
the discretion of the acupuncturist providing care. In the usual care group, patients received standard headache care
from their general practitioner, but were not referred out for acupuncture.

At various times throughout the study, patients used a daily diary to track the frequency and severity of headache
pain, and any related medication use. Headache severity was measured four times a day on a six-point scale, with the
total summed to give a headache score. In addition, the patients completed the SF 36 Health Status Questionnaire at the
start of the study, and at three months and 12 months after treatment. Patients also completed a series of
questionnaires every three months that monitored use of different headache treatments, days missed from work due to
illness, and other usual activities.

Initially, there was not much difference between patients in either group. By the 12-month interval, however, striking
differences were noted in terms of frequency of headache, doctor visits and medication use:

¦Patients given acupuncture had an average of 1.8 less days with headaches over the first four weeks of the study
compared to the control group. When projected over 52 weeks, the authors estimated that acupuncture would result in an
average 22 fewer days of headaches per year.

¦The effects of acupuncture appeared to be long-lasting. At the start of treatment, the average weekly headache score
among acupuncture patients was 24.6. Three months after the start of the study, the average score had dropped to 18.0;
at 12 months, it had dropped by more than 34 percent, to 16.2. In the standard care patients, weekly headaches scores
dropped only 16 percent over the course of the year.

¦Results from the SF-36 questionnaire showed significant benefits for acupuncture patients in terms of physical role
functioning, energy levels and changes in health. Over the course of a year, physical role functioning, energy and
health change scores increased an average of 9.6, 7.4 and 10.3 points, respectively, for those in the acupuncture
group. These scores also increased in usual care patients, but at much lower levels.

¦Acupuncture patients used an average of 15 percent less medication to treat headaches than patients receiving only
usual care. They also made 26 percent fewer visits to a general practitioner, and missed fewer days from work due to
sickness.

“Acupuncture in addition to standard care results in persisting, clinically relevant benefits for primary care
patients with chronic headache, particularly migraine, compared with controls,” the researchers commented. “We also
found improvements in quality of life, decreases in use of medication and visits to general practitioners, and
reductions in days off sick.”

In their conclusion, the researchers admitted they could not rule out the occurrence of a placebo effect, as the study
did not include a sham acupuncture group. In addition, since the patients knew which treatment group they were assigned
to, there remained the possibility that patients could give somewhat biased assessments of their treatments. However,
the authors noted that the results of their study were similar to results seen in blinded, placebo-controlled trials,
which “provides further evidence that bias does not completely explain the apparent effects of acupuncture.”

The authors recommended that their findings should be taken into account by policymakers when assessing the most cost-
effective ways of treating patients. They also called for an expansion of acupuncture services for the treatment of
chronic headaches in the National Health Service, which provides health care to millions of Britons each year.

In an interview with the BBC, Dr. Mike Cummings, the medical director for the British Medical Acupuncture Society,
called the study “innovative” and agreed with the authors’ assertions.2

“It is very positive for us,” he said of the research. “This should help to lift acupuncture out of what is seen to be
alternative to mainstream medicine … It should be made available in primary care to treat pain and to prevent costly
referrals to hospitals.”

References

1.Vickers AJ, Rees RW, Zollman CE, et al. Acupuncture for chronic headache in primary care: large, pragmatic,
randomized trial. British Medical Journal Online First; doi:10.1136/bmj.38029.421863.EB. Published March 15, 2004.
Available at www.bmj.com.
2.Acupuncture beats headache pain. BBC News, March 15, 2004.

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