Acupuncture for the Management of Chronic Headache :  A systematic review

1.  Yanxia Sun, MD and

     2.  Tong J. Gan, MB, FRCA

1.  From the Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.

Address correspondence and reprint requests to Tong J. Gan, Duke University Medical Center, Department of Anesthesiology, Box 3094, Durham, NC 27710. Address e-mail to Gan00001@mc.duke.edu. 

Abstract

OBJECTIVE: The objective of this review was to evaluate the efficacy of acupuncture for treatment of chronic headache.

METHODS: We searched the databases of Medline (1966–2007), CINAHL, The Cochrane Central Register of Controlled Trials (2006), and Scopus for randomized controlled trials investigating the use of acupuncture for chronic headache. Studies were included in which adults with chronic headache, including migraine, tension-type headache or both, were randomized to receive needling acupuncture treatment or control consisting of sham acupuncture, medication therapy, and other nonpharmacological treatments. We extracted the data on headache intensity, headache frequency, and response rate assessed at early and late follow-up periods.

RESULTS: Thirty-one studies were included in this review. The majority of included trials comparing true acupuncture and sham acupuncture showed a trend in favor of acupuncture. The combined response rate in the acupuncture group was significantly higher compared with sham acupuncture either at the early follow-up period (risk ratio [RR]: 1.19, 95% confidence interval [CI]: 1.08, 1.30) or late follow-up period (RR: 1.22, 95% CI: 1.04, 1.43). Combined data also showed acupuncture was superior to medication therapy for headache intensity (weighted mean difference: −8.54 mm, 95% CI: −15.52, −1.57), headache frequency (standard mean difference: −0.70, 95% CI: −1.38, −0.02), physical function (weighted mean difference: 4.16, 95% CI: 1.33, 6.98), and response rate (RR: 1.49, 95% CI: 1.02, 2.17).

CONCLUSION: Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate.

IMPLICATIONS: This systematic review demonstrated that traditional needling acupuncture is superior to sham acupuncture and pharmacological therapy for chronic headache treatment by improving headache intensity and frequency and increasing the response rate.

Footnotes
 Accepted for publication July 22, 2008.