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Acupuncture Can Ease Headaches

But researchers say sham procedure also works as well

FRIDAY, July 29, 2005 (HealthDay News) -- Acupuncture treatments cut the frequency of tension headaches in half in individuals prone to the ailment, a new study found.

But the researchers also point out that minimal acupuncture -- defined as "superficial needling at non-acupuncture points" and considered a sham treatment -- was just as effective, according to a German study appearing in this week's issue of the British Medical Journal.

"Based on the results of our trial, as well as of yet-unpublished observational data from a larger number of patients in routine care, it seems that many (German) patients benefit definitively, so I see no reason to discourage patients from trying it," said Dr. Klaus Linde, senior author of the study and an epidemiologist with the Institute of Medical Statistics and Epidemiology at the Technical University of Munich.

But he added, "As there was no relevant effect over an inadequate acupuncture intervention, I would be a bit cautious to actively recommend it widely."

According to the study authors, in a given year, 38 percent of Americans have episodic tension-type headaches and 2 percent have chronic, tension-type headaches. In 1997, a consensus statement issued by an expert panel at the U.S. National Institutes of Health, included headache as one of a number of conditions that might be helped by acupuncture.

While acupuncture is widely used for different types of headaches, experts remain conflicted over how effective it really is.

In traditional Chinese medicine, acupuncture is practiced to restore the flow of energy in the body. The technique most widely studied by scientists involves penetrating the skin with thin, solid, metallic needles that are manipulated by hand or electrical stimulation.

For the randomized, controlled trial at 28 outpatient centers in Germany, 270 mostly female patients experiencing tension headaches were divided into three groups.

One group was treated with traditional acupuncture and another with minimal acupuncture, while the control group received no acupuncture at all. Those in the two acupuncture groups received 12 sessions each spread over eight weeks.

Headache rates among those in the traditional acupuncture group fell by almost half: The number of days with headache decreased by 7.2, compared with 6.6 in the minimal acupuncture group. Those in the control group experienced only 1.5 fewer days with headaches. Improvements in the traditional acupuncture group were similar to improvement seen with accepted treatments.

About a fifth of those in the traditional acupuncture group reported side effects, such as dizziness, other headaches and bruising.

Interestingly, the improvements continued for months after the intervention, rising slightly as time progressed.

After the main study segment had ended, individuals in the control group were given acupuncture for eight weeks and also experienced improvements, albeit less than the original study participants.

The fact that traditional and minimal acupuncture had such similar results may indicate that the location of needles don't have a huge impact on how effective the treatment is, the study authors wrote.

Even though apparent sham acupuncture and real acupuncture have similar effects, Dr. Charles Kim, a pain medicine specialist at Mount Sinai Medical Center in New York City who also practices acupuncture, thinks something must be happening.

"The research to date has somehow shown that acupuncture does stimulate the release of endorphins, but, more specifically, I do treatments with electrostimulation and a lot of the research has shown that certain frequencies of stimulation with acupuncture induces beta-endorphins at certain frequencies," he said.

It's also possible that both acupuncture and the sham treatment are associated with strong placebo effects. A similar phenomenon was seen in a trial on acupuncture and migraines, which Linde was also involved with and which was published in May.

"As the large response to minimal acupuncture was so impressive, it would be extremely interesting to see whether similar results are obtained in other countries, and if so, what the reasons are," Linde said. "There is some evidence that any repetitive needling might influence pain perception and memory, and also that the whole ritual and setting of acupuncture is powerful. Research in this direction could be extremely interesting."

More information

The National Center for Complementary and Alternative Medicine has more on acupuncture.

SOURCES: Klaus Linde, M.D., epidemiologist, Institute of Medical Statistics and Epidemiology, Technical University of Munich, Germany; Charles Kim, M.D., pain medicine specialist, department of anesthesiology, Mount Sinai Medical Center, and assistant professor of anesthesiology and rehabilitation medicine, Mount Sinai School of Medicine, New York City; July 30, 2005, British Medical Journal
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