Acupuncture For Tension-type Headache Research Articles

Acupuncture for the Treatment of Tension-Type Headache: An Overview of Systematic Reviews.

Objectives Because current evidence regarding the effectiveness of acupuncture for a tension-type headache (TTH) is controversial, we evaluated the reliability of the methodological quality and outcome measures of systematic reviews/meta-analyses (SRs/MAs) on acupuncture for TTH. Methods We conducted a comprehensive literature search for SRs/MAs in major databases from the database's inception to September 2019. The Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessments were used to assess the methodological quality of the included reviews and the quality of evidence, respectively. Results Eight reviews were included in the analysis. The AMSTAR-2 assessment results showed that the methodological quality of all included reviews was critically low. Thirty-six outcome measures were included in these reviews. The GRADE results showed that 25 (25/36, 69.4%) outcomes provided low- or very low-quality evidence, four (4/36, 11.1%) provided moderate-quality evidence, and seven (7/36, 19.4%) provided high-quality evidence. Descriptive analysis results showed that acupuncture treatment for TTH reduced headache frequency and severity. Conclusions Acupuncture appears to be an effective treatment modality for TTH, but the credibility of the results is limited owing to the generally low methodological quality and evidence quality in the included SRs/MAs.

Acupuncture for migraine prophylaxis.

BACKGROUND: Acupuncture is often used for migraine prophylaxis but its effectiveness is still controversial. This review (along with a companion review on 'Acupuncture for tension-type headache') represents an updated version of a Cochrane review originally published in Issue 1, 2001, of The Cochrane Library. OBJECTIVES: To investigate whether acupuncture is a) more effective than no prophylactic treatment/routine care only; b) more effective than 'sham' (placebo) acupuncture; and c) as effective as other interventions in reducing headache frequency in patients with migraine. METHODS: Search methods: The Cochrane Pain, Palliative & Supportive Care Trials Register, CENTRAL, MEDLINE, EMBASE and the Cochrane Complementary Medicine Field Trials Register were searched to January 2008. Selection criteria: We included randomized trials with a post-randomization observation period of at least 8 weeks that compared the clinical effects of an acupuncture intervention with a control (no prophylactic treatment or routine care only), a sham acupuncture intervention or another intervention in patients with migraine. Data collection and analysis: Two reviewers checked eligibility; extracted information on patients, interventions, methods and results; and assessed risk of bias and quality of the acupuncture intervention. Outcomes extracted included response (outcome of primary interest), migraine attacks, migraine days, headache days and analgesic use. Pooled effect size estimates were calculated using a random-effects model. MAIN RESULTS: Twenty-two trials with 4419 participants (mean 201, median 42, range 27 to 1715) met the inclusion criteria. Six trials (including two large trials with 401 and 1715 patients) compared acupuncture to no prophylactic treatment or routine care only. After 3 to 4 months patients receiving acupuncture had higher response rates and fewer headaches. The only study with long-term follow up saw no evidence that effects dissipated up to 9 months after cessation of treatment. Fourteen trials compared a 'true' acupuncture intervention with a variety of sham interventions. Pooled analyses did not show a statistically significant superiority for true acupuncture for any outcome in any of the time windows, but the results of single trials varied considerably. Four trials compared acupuncture to proven prophylactic drug treatment. Overall in these trials acupuncture was associated with slightly better outcomes and fewer adverse effects than prophylactic drug treatment. Two small low-quality trials comparing acupuncture with relaxation (alone or in combination with massage) could not be interpreted reliably. Authors' conclusions: In the previous version of this review, evidence in support of acupuncture for migraine prophylaxis was considered promising but insufficient. Now, with 12 additional trials, there is consistent evidence that acupuncture provides additional benefit to treatment of acute migraine attacks only or to routine care. There is no evidence for an effect of 'true' acupuncture over sham interventions, though this is difficult to interpret, as exact point location could be of limited importance. Available studies suggest that acupuncture is at least as effective as, or possibly more effective than, prophylactic drug treatment, and has fewer adverse effects. Acupuncture should be considered a treatment option for patients willing to undergo this treatment.

Acupuncture for tension-type headache in pregnancy: A prospective, randomized, controlled study

Acupuncture for tension-type headache in pregnancy: a prospective, randomized, controlled study. AimThis study was undertaken to test, under real-life conditions, the effects of acupuncture on headaches during pregnancy and compare this with a group of patients undergoing conventional treatment alone. MethodologyForty-three conventionally treated (lifestyle modifications and stretching) pregnant women were randomly allocated into two groups to routine care or acupuncture. The severity and disability caused by this pain and its affect on mood, sleep and work were assessed using a Numerical Rating Scale (NRS). The main end-point was the mean difference between the first and the last interview after eight weeks of treatment. Secondary end points were the changes over time in the NRS assessments of pain intensity, disturbances in mood, sleep and working and the use of medications.Differences between initial and final sessions were analyzed by a two-sample test. Changes over time in the NRS assessment were analyzed by the Fisher exact test. Mood's test for medians was used and a p-value<0.05 indicated a significant difference. ResultsAll women completed the treatment. No important adverse effects related to acupuncture treatment or to pregnancy's outcome were reported. Significant improvements were demonstrated for pain at the end of the trial in the study group, 3.9 vs 1.7 difference in favor to acupuncture group (p<0.05). This group also used less medication and had a greater improvement in mood and sleep when compared with the control group. ConclusionsThis study suggests acupuncture alleviates tension-type headaches during pregnancy.

Acupuncture for tension-type headache: a subject-blind, multi-centre, RCT

Acupuncture for tension-type headache: a subject-blind, multi-centre, RCT

Commentary on the Cochrane Review of Acupuncture for Tension-Type Headache

information on patients, interventions, methods and results; and assessed risk of bias and quality of the acupuncture intervention. Outcomes extracted included response (at least 50% reduction of headache frequency; outcome of primary interest), headache days, pain intensity and analgesic use. Main Results: Eleven trials with 2317 participants (median 62, range 10 to 1265) met the inclusion criteria. Two large trials compared acupuncture to treatment of acuteheadachesorroutinecareonly.Both found statistically significant and clinically relevant short-term (up to three months) benefits of acupuncture over control for response, number of headache days and pain intensity. Long-term effects (beyond three months) were not investigated. Six trials compared acupuncture with a sham acupuncture intervention, and five of the six provided data for metaanalyses. Small but statistically significant benefits of acupuncture over sham were found for response as well as for several other outcomes. Three of the four trials comparing acupuncture with physiotherapy, massage or relaxation had important methodological or reporting shortcomings. Their findings are difficult to interpret,butcollectivelysuggestslightlybetter results for some outcomes in the control groups. Conclusions: In the previous version of this review, evidence in support of acupuncture for tension-type headache was considered insufficient. Now, with six additional trials, the authors conclude that acupuncture could be a valuable nonpharmacological tool in patients with frequent episodic or chronic tension-type headaches.