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Headache

07 April 2020

Could acupuncture help prevent migraines?

Is there sufficient evidence to show that acupuncture could be an effective treatment for episodic migraines?

A new clinical trial supports acupuncture as an option for reducing migraine headaches, and researchers believe doctors should inform patients it is a possible treatment.

The Chinese study "helps to move acupuncture from having an unproven status in complementary medicine to an acceptable evidence-based treatment," said Dr Heather Angus-Leppan, a neurologist who wrote an editorial that was published with the study in the BMJ on 25 March.

"We now have good evidence that acupuncture is an effective treatment for episodic migraine," said Angus-Leppan, a consultant neurologist at the Royal Free London NHS Foundation Trust in the United Kingdom.

The new study was led by Wei Wang, a neurologist at Tongji Hospital and the Huazhong University of Science and Technology in Wuhan, China. Wang's team noted that there are preventive medicines to help people with frequent migraines, but not all patients respond well to drugs and many don't want to use them.

Significantly higher reduction 

Acupuncture has been investigated as a method of reducing migraine frequency, but the results have been mixed. So Wang's group decided to compare real acupuncture against either fake (sham) acupuncture or usual migraine care.

The study included 147 patients (average age 37) with a history of migraine without aura. None of them had received acupuncture before, and all were told not to take any painkillers or start any other treatments during the study.

For eight weeks, the participants received either: 20 sessions of real (manual) acupuncture at true acupuncture points; 20 sessions of non-penetrating sham acupuncture at non-acupuncture points; or usual care, including advice on lifestyle and self-management.

Over the following 12 weeks, those in the manual acupuncture group had 1.4 fewer migraine days in weeks 13 to 16 of the study, and about two fewer migraine days at weeks 17 to 20, compared to people in the sham acupuncture group.

Compared to those in the usual care group (non-acupuncture), those in the sham acupuncture group still had fewer migraine days (1.6 vs. 0.4) in weeks 17 to 20, according to the study.

Even though it was a short study, the results showed that acupuncture "resulted in a significantly higher reduction in the frequency of migraine days and migraine attacks," Wang's team wrote. Longer-term studies are needed to determine how long the preventive effects of acupuncture last in migraine patients, the study authors said.

Results highly variable

Still, the Chinese team believes that acupuncture "can be recommended as a [preventive] treatment" and doctors "should provide patients with information about acupuncture as an option when discussing [preventive] treatment strategies".

One US headache specialist said he already sees patients who are using acupuncture to help ease migraines.

"However, what people actually receive is highly variable depending upon the practitioner – this can be different techniques, different placement or number of needles and different course of therapy," said Dr Noah Rosen, who directs Northwell Health's Headache Center in Great Neck, New York.

Rosen said that, in many cases, the beneficial effects of acupuncture are gradual, and patients may "need to commit to a full course of care – not assuming that they will see benefit right away".

Image credit: iStock

 

Ask the Expert

Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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