Jim Galbiati, M.Ac.
Vincent CA (1989)
A controlled trial of the treatment of migraine
Clin J Pain 5: 305-312.
Type of Study: Acupuncture was compared to control needling ("minimal acupuncture") for reducing the frequency and severity of chronic migraine headaches.
Research Design: Thirty patients were randomly assigned to receive a course of correct acupuncture treatment or a course of "minimal" control needling. Treatment was administered weekly in six sessions. Correct acupuncture involved inserting eight needles with appropriate manipulation at four bilateral relevant points. "Minimal" acupuncture involved inserting eight needles superficially at four bilateral irrelevant loci. Headache frequency and intensity, and pain medication consumption were assessed from headache diary entries covering a 4 week period before treatment began, the 6-week treatment period, the 6 weeks immediately after treatment, and 2 weeks each at 4 month and 12 month follow-ups. Estimates of anxiety and pain-related behavior were also recorded at the beginning of the 4 week pre-treatment period, immediately before treatment, immediately after treatment and 6 weeks post-treatment. Patients were asked to assess the credibility of each treatment during the study.
Results: After treatment there was a significant reduction in pain scores and medication intake in the correct acupuncture treatment group but not in the "minimal" acupuncture treatment group. At the end of treatment, and at the 4 and 12 month follow- ups, the acupuncture group showed greater reduction in weekly pain scores (compared to baseline) than the control needling group, 43% vs 14%, 58% vs 21% and 71% vs 8%, respectively. The true acupuncture group also showed greater reduction, compared to baseline, in consumption of pain medication than the "minimal" acupuncture group, at the same periods of assessment: 38% vs 28%, 65% vs 23%, 71% vs 21%, respectively.
Conclusion: Chronic migraine pain was alleviated to a significantly greater extent with acupuncture than with "minimal" needling. It is of particular interest that the statistically significant post-treatment reductions in pain scores and medication recorded in the correct acupuncture group were maintained at 1-year follow-up.
Vincent CA (1990) The treatment of tension headache by acupuncture: A controlled single case design with time series analysis, J Psychosomatic Res 34:553-561.
Type of Study: Acupuncture was compared to control needling for treatment of tension headache.
Research Design: In a single-case design, each of 14 patients suffering from chronic tension headaches (3.8 years mean duration) received 4 weekly treatments of acupuncture and 4 weekly treatments of control needling. Acupuncture was administered at 4 bilateral points; the control treatment was also at 4 bilateral loci, but at non-points and using minimal or shallow insertion with no manipulation of the needles. The order of administering the 8 treatments was randomized. Pain intensity was recorded in head ache diaries 4 times per day on a 6 point scale for 4 weeks before treatment, during the 8 weeks of the treatment, for 6 weeks after the treatment, and for 2 weeks at 4 months after the treatment had finished. Intake of pain medications was recorded in the diary during the same time periods.
Results: At 6 weeks follow-up, pain scores relative to baseline indicated improvement of more than 50% in 9 of the 14 patients. Ml patients showed improvements, with an overall mean reduction of 52%. At the 4-month follow-up, mean reduction was 42%. Use of pain medications in the 8 subjects that were taking significant amounts of medication was reduced by 54% at 6 weeks and by 74% at 4 months. Week by week "timeseries" comparisons of pain scores and medication consumption for the two groups revealed that acupuncture produced better results than control needling in all 13 patients that could be analyzed by this method, with statistical significance achieved in 4 of these patients.
Conclusion: Acupuncture Treatment is effective for chronic tension headache.
Loh L, Nathan PW, Schott GD and Zilkha KJ (1984). Acupuncture versus medical treatment for migraine and muscle tension headaches, J Neurol Neurosurg Psychiat 47:333-337
Type of Study: Acupuncture was compared to standard drug therapy for treatment of migraine and muscle tension headaches.
Research Design: Forty-eight patients with chronic migraine and muscle tension headaches (mean duration 19 years), were randomly assigned to receive either acupuncture or standard drug therapy. After 3 months of treatment, each was asked to cross-over to the other therapy for an additional 3-month period, but only 29 agreed. Acupuncture was administered at a minimum of 6 needle sites per treatment session, with variation of treatment point selection based on examination of the patients. Patients in the drug therapy group were asked to continue taking the medications they had been using prior to entering the study. Patients assessed their headaches at the end of each 3-month treatment phase according to whether there was no, slight, moderate, or great benefit from their treatment. Patients kept a log of medications consumed throughout the study. At the end of the study, they were asked which treatment they preferred.
Results: Twenty-four of 41 patients (59%) who received acupuncture reported benefits from treatment, with 16 (39%) reporting moderate or great improvement. Nine of 36 patients (25%) who received drug therapy benefited from treatment, with 4 (11%) re porting moderate or great improvement. Of the 29 patients that received both treatments, there was a greater preference for the acupuncture treatment. A greater decrease in use of pain medication was reported by the acupuncture group.
Conclusion: These findings indicate that a relatively simple course of acupuncture can produce better relief than standard drug therapy in patients with long-term histories of chronic headaches.
Ahonen E, Hakumaki M, Mahiamaki S, Partanenj, Riekkinen P and Siveniusj (1983) Acupuncture and physiotherapy in the treatment of myogenic head-ache patients: Pain relief and EMG activity, Adv Pain Res Ther 5: 571-576
Type of Study: Acupuncture was compared to standard physiotherapy for the treatment of tension headaches.
Research Design Twenty-two patients with chronic tension headaches of various etiologies (mean duration 5.9 years) were randomly assigned to receive acupuncture or physiotherapy. Acupuncture was administered in 4 sessions at 16 loci on the neck and shoulders. Physiotherapy, consisting of a combination of ultrasound, massage and parafango (a mixture of paraffin and mud) was administered in 8 sessions. Pain was assessed using a 10 cm visual analogue scale. Pain medication usage, duration of treatment effects and frequency of headaches were also assessed. Surface electromyographic (EMG) activity was recorded from muscles of the forehead. Each endpoint was assessed during a 2 week pre-treatment phase, during the 3 weeks of treatment and at 3 and 6 month follow-ups.
Patients were comparable at baseline except that pain levels and
EMG activity were slightly higher in the physiotherapy group.
By the end of treatment, both groups had shown significant improvements
in pain levels. These improvements, that were maintained
at the 3 and 6 month follow-ups, were statistically significant for acupuncture at both time points and significant for physiotherapy at the 6 month follow-up. Use of medication, duration of treatment effects and frequency of headaches were comparable in both groups after treatment. EMG reading levels improved during and after treatment, being significant for acupuncture at both the 3 and 6 month follow-ups and significant for physiotherapy at the 6 month follow-up.
Four acupuncture sessions produced roughly the same levels of improvement
in the tension headaches as 8 sessions of physiotherapy.
This suggests that acupuncture provided therapy that was as
treatment-effective and more cost-effective than physiotherapy.