Can the ancient Chinese treatment of acupuncture help patients with migraine, tension-type or sinus headaches?

Alexander Mauskop, M.D., Professor of Clinical Neurology SUNY Downstate Medical Center, and Director, New York Headache Center, New York, New York weighs in on it’s usefulness as an option to drug therapy.

Acupuncture has been studied in hundreds of animal investigations, and it is believed that it allows the release of natural pain-relieving substances such as endorphins (endogenous morphine). Other animal studies suggest that acupuncture works with the brain’s serotonin, histamine, and GABA systems.

There have been several studies over the years involving patients with migraine and tension-type headaches. One study, led by Vickers in Great Britain evaluated 401 patients with chronic headache. Patients in the acupuncture group received 12 weekly treatments and the control group received their usual headache treatment. After one year, the headache number dropped by 34% in the acupuncture group versus a 16% drop in the control group. The acupuncture group reported better quality of life measures and less visits to their doctor.  Several studies indicate that acupuncture may not work better than placebo; it has been difficult proving that acupuncture is truly an effective therapy for pain or headache.

Are there any downsides to acupuncture? The cost can be a large factor, as most American insurance companies don’t cover it. Prices can range from $25 to $150 a session, and a typical treatment course is at least 10 sessions. Dr. Mauskop points out that typically, if a patient does not feel some effect after 4 or 5 sessions, continued sessions may not help. One possible hint of effectiveness may be seen in the first session – if the patient experiences a sense of deep relaxation.

Most methods of administering acupuncture involve the placement of needles in various parts of the body and head. The needles are then twirled at times during the session. Some acupuncturists attach electrodes to the needles and pass electric current through them with the use of a battery-operated device. Dr.Mauskop says research has not indicated whether or not electro-acupuncture is more effective than traditional acupuncture.

Some common side effects to acupuncture include fainting, most often during the first session due to patient anxiety, and “needle fear.” For some people, acupuncture has worsened patients headaches or other pains, often during the first session. Most people though don’t feel pain during the application of the needles – the needles are very thin.

If your headache specialist does not do acupuncture you can ask for a referral. Forty-three states (including Illinois) require licensure for acupuncture therapists. You can check on line to make sure your therapist is licensed.

Arthur H. Elkind, MD (President of the National Headache Foundation) said, “Acupuncture is difficult to establish with a definite scientific proof as to its effectiveness. The placebo effect is noticeable. In patients who are not helped by standard therapies, it is worth a try. I would emphasize it is an invasive procedure. The subject/patient must be sure disposable needles are used and one should seek licensed qualified physicians to administer the injections with the long needles. Although fortunately, serious complications are very rare, these adverse effects have been encountered. The use of contaminated needles could expose the patient to Hepatitis B and C, as well as HIV.”

Headwise    Volume 3,  Issue 3  2013

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