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Acupuncture Helps Chronic Headache

In a randomized trial, acupuncture was associated with lower headache scores, less use of medication, fewer office visits, and fewer sick days.

About 10% of U.K. practitioners either refer patients for acupuncture or administer it themselves for various painful conditions, including headache. In a recent Cochrane review, data supported the value of acupuncture for headache, but the analysts questioned the quality and the amount of evidence, which prompted this randomized, controlled trial.

The researchers recruited 401 adult patients with at least two headaches per month. Patients were assigned to receive either usual care alone or usual care plus as many as 12 acupuncture treatments during 3 months; participants were followed for 12 months. At 12 months, headache scores on a Likert scale were reduced by 34% in the acupuncture group versus 16% in the control group -- a significant difference. Acupuncture patients experienced the equivalent of 22 fewer days of headache yearly than did control patients; they also used 15% less medication, made 25% fewer general-practitioner visits, and took 15% fewer sick days. Finally, several measures on health-status questionnaires were significantly better in the acupuncture group than in the placebo group.

Comment: This is a pretty impressive result, although the benefit that is attributable to acupuncture itself (as opposed to a placebo effect) might have been exaggerated because of inability to blind patients to treatment. What is also impressive is the duration of the effect. At the very least, acupuncture should be considered as one therapeutic option for chronic headache. At the time of publication, the full text of the original article was available free of charge.

— Keith I. Marton, MD

Published in Journal Watch General Medicine May 4, 2004

Citation(s):

Vickers AJ et al. Acupuncture for chronic headache in primary care: Large, pragmatic, randomised trial. BMJ 2004 Mar 27; 328:744.

• Original article (Subscription may be required)
• Medline abstract (Free)