Fewer headache days with acupuncture

Acupuncture helped reduce the frequency of chronic tension headaches (CTTH), according to a randomized controlled trial in China.

More than two-thirds (68.2%) of people with CTTH who received true acupuncture reported a reduction of at least 50% in the number of monthly headache days at week 16, compared to 48.1% who received superficial acupuncture (OR 2.65, 95% CI 1.5-4.77), reported Ying Li, MD, PhD, of Chengdu University of Traditional Chinese Medicine in China, and colleagues from Neurology.

At week 16, those with true acupuncture had 13.1 fewer headache days per month, while those with superficial acupuncture had 8.8 fewer headache days per month (mean difference 4.5 days , 95% CI 2.1-6.8, P<0.001).

Despite the effect seen in the superficial acupuncture group, the trial was “rigorous” and had a “really strong design,” said Peter Wayne, PhD, of Harvard Medical School in Boston, who did not participate. in the study.

“Any encounter with a healthcare provider, whether it’s a doctor or a surgeon, has therapeutic effects,” Wayne said. MedPage today.

“People are inherently wired to want to get better,” he added, noting that participants in both groups received “the ritual of acupuncture and mild stimulation.”

Some headache patients steer clear of pharmaceuticals, Wayne observed. “I think many pain centers are already using acupuncture for headaches,” he pointed out. “I think that will only add to the evidence supporting this.”

Tension-type headaches, which cause pressure and tightening on both sides of the head, are usually treated with over-the-counter medications. Previous studies suggested that acupuncture may reduce the overall burden of tension headaches.

“Tension-type headaches are one of the most common types of headaches and sufferers may seek alternatives to medication,” Li said in a statement. “Our study found that acupuncture reduced the average number of headache days per month for people experiencing these painful and disruptive headache attacks.”

The test included 218 CTTH patients with a mean age of 43.1 years, recruited from Chengdu Traditional Chinese Medicine University Teaching Hospital from June 2017 to September 2020. Participants had undergone CTTH for 130 months and had 21.5 episodes per month initially, on average.

Chronic headaches were defined as 15 or more headaches per month. People who took prophylactic drugs in the 3 months before the study were not included. A third of the participants took medication for the treatment of acute headaches at baseline.

Each participant was assigned to either true acupuncture (n = 110) or superficial acupuncture (n = 108). Participants in the real acupuncture group were brought to experience feeling of deqi, resulting in a feeling of tingling, numbness or heaviness. The superficial acupuncture group was needled to avoid deqi.

“We found that the sensation of deqi made [a] difference in clinical effect even when acupuncture points were the same in both groups, which may indicate that deqi sensation may be an independent contributor to acupuncture effect,” Li and colleagues wrote. “The mechanism of how the feeling of deqi affects the effect of acupuncture is unclear.”

Both cohorts received 20 sessions over 8 weeks and each treatment session lasted 30 minutes. The primary outcome was responder rate – defined as a reduction of at least 50% in the monthly number of headache days – at week 16, with follow-up through week 32. headaches were self-reported.

The overall effect lasted at least 8 months. At week 32, the responder rate was 68.2% in the true acupuncture group and 50% in the superficial acupuncture group (OR 2.4, 95% CI 1.36-4.3 , P<0.001).

From week 4 to week 32, the percentage of participants who reported no headache intensity on a Visual analog scale increased from 0.91% to 30.91% in the true acupuncture group and from 0% to 10.2% in the superficial acupuncture group.

Four mild adverse events were reported which did not require treatment. One participant in each group had a subcutaneous hematoma and two patients in the real acupuncture group had pain at the needle site.

Li and his co-authors noted that all of the participants came from one hospital and the findings might not be generalizable to other communities.

Disclosures

The study was funded by a grant from the Department of Science and Technology of Sichuan Province and the National Natural Science Foundation of China.

Li and his co-authors have reported no conflicts of interest.

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