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Acupuncture: An effective treatment for chronic headaches

The Bottom Line

  • Acupuncture may help reduce the frequency of headaches and migraines, at least in the short-term, and is safe and well tolerated.
  • Many people don’t respond well to drugs prescribed to prevent headaches or migraines, so acupuncture is a good alternative.
  • More research is needed to determine whether acupuncture provides a lasting benefit, but emerging evidence shows some promise.  

If you are someone who often gets headaches or migraines, you understand how seriously they can impact your quality of life. It can often be difficult to think beyond the pounding in your head! When a headache strikes, finding treatments that bring relief becomes a top priority.


Treatment with painkillers at the first sign of pain is usually enough to curb many mild or infrequent headaches or migraines. However, when headache pain occurs more often or does not respond well to standard pain treatments, doctors will often prescribe preventative drugs. Unfortunately, many of these drugs produce unwanted side effects and are not well tolerated (1-3).


Many adults suffering from chronic headaches or migraines are increasingly turning to alternative therapies for pain relief, such as acupuncture (4;5). Despite acupuncture’s popularity, its effectiveness in preventing headache pain has been controversial.


Two systematic reviews aimed to find out more about whether acupuncture can actually help reduce how often people get headaches or migraines. One review included 12 randomized controlled trials with over 2300 adults suffering from frequent tension-type headaches for at least 6 months (6). The other review included 22 randomized controlled trials with just under 5000 adults suffering from 'episodic migraine': all participants reported having migraines for more than one year, less than 15 days per month (7).


The reviews compared the number of headaches experienced by people who used acupuncture to people in control groups who had routine care (treatment of their symptoms only), ‘fake’ acupuncture (needles placed in the wrong places, or not into the skin), and other treatments such as preventative drugs (7), or physiotherapy, massage and exercise (6). Only trials in which the participants had acupuncture every week for at least six weeks were included.


What the research tells us

Can acupuncture reduce the frequency of headaches or migraines? The available evidence suggests that it can, at least in the short-term.


Three months after starting acupuncture treatment, frequent headache or migraine sufferers experienced significantly fewer headache days than those receiving routine care, treatment with 'fake' acupuncture, or treatment with preventative drugs. Both systematic reviews also found that acupuncture was safe and well tolerated. Overall, people receiving acupuncture reported fewer side effects and were less likely to drop out of the studies than those receiving drugs (6;7).


Two, more recent, reviews looking at chronic pain further support the use of acupuncture for the treatment of headaches, as well as other forms of pain such as musculoskeletal and osteoarthritis (8;9). In terms of whether acupuncture is effective both in the short-and long-term, the evidence is more mixed. For instance, older research shows only short-term benefits—at six months—(7), while newer research shows the potential for sustained pain relief—over at least one year (9).


Future research will be useful to determine whether the number of needles or number of sessions impacts the benefits of acupuncture. Long-term studies comparing acupuncture to other non-drug treatments – such as physiotherapy, massage or exercise – are also needed.


Regular acupuncture appears to be a good choice to help prevent chronic headaches and migraines. This alternative therapy may be particularly useful for people who don’t respond well to preventative drug treatment options or get adequate relief from this approach. As for the long-term benefits of acupuncture—the jury is still out, but there may be promise.


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Author Details

References

  1. Linde M, Mulleners W, Chronicle E, et al. Valproate (valproic acid or sodium valproate or a combination of the two) for the prophylaxis of episodic migraine in adults. Cochrane Database Syst Rev. 2013; 6:CD010611. doi: 10.1002/14651858.CD010611.
  2. Linde M, Mulleners W, Chronical E, et al. Topiramate for the prophylaxis of episodic migraine in adults. Cochrane Database Syst Rev. 2013; 6:CD010610. doi: 10.1002/14651858.CD010610.
  3. Vécsei L, Majláth Z, Szok D, et al. Drug safety and tolerability in prophylactic migraine treatment. Expert Opin Drug Saf. 2015; 14(5): 667-681.
  4. Park J. Use of alternative health care. Health Rep. 2005; 16(2):39-42.
  5. Zhang Y, Lao L, Chen H, et al. Acupuncture use among American adults: What acupuncture practitioners can learn from National Health Interview Survey 2007. Evid Based Complement Alternat Med. 2012; doi: 10.1155/2012/710750.
  6. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016; 4:CD007587. doi: 10.1002/14651858.CD007587.pub2.
  7. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016; 6:CD001218. doi: 10.1002/14651858.CD001218.pub3. 
  8. Giannitrapani K, Holliday J, Miake-Lye I, et al. Synthesizing the strength of the evidence of complementary and integrative health therapies for pain. PainMed. 2019. doi: 10.1093/pm/pnz068. 
  9. Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for chronic pain: Update of an individual patient data meta-analysis. Pain. 2018; 19(5):455-474. doi: 10.1016/j.jpain.2017.11.005. 

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