Study Questions Value of Acupuncture for Migraines

It found the treatment no more effective than a sham procedure

Karen Pallarito

Karen Pallarito

Updated on May 03, 2005

TUESDAY, May 3, 2005 (HealthDay News) -- Migraine headache sufferers who use acupuncture get no more pain relief than those who undergo a sham treatment.

But they do get relief.

That is the result of a randomized, multi-center trial, one of the largest and most rigorous studies yet to examine acupuncture's effectiveness for migraine, the study's German authors report.

Both treatments reduced the number of days that patients experienced moderate to severe pain, with more than half of each treatment group reporting at least a 50 percent reduction in migraine attacks.

Whether patients received real acupuncture or a mock procedure, however, their outcomes were better than those receiving no treatment at all.

The findings, published in the May 4 issue of the Journal of the American Medical Association, seem to leave acupuncture's usefulness for migraine relief open to interpretation.

"If a patient is open to acupuncture [and] has access to a trained provider who can ensure that he treats safely, I would see no reason to discourage [that patient], although I am not certain how the effect is caused," said lead author Dr. Klaus Linde of the Center for Complementary Medicine Research at the Technical University of Munich.

Dr. Brian M. Berman, professor of family medicine and director of the Center for Integrative Medicine at the University of Maryland School of Medicine in Baltimore, said the results are comparable with the relief given by medications proven effective for migraines.

"These results are a good enough reason for migraine suffers to try acupuncture," he concluded.

But having observed inconsistent results among patients who have used acupuncture, Dr. Seymour Diamond, director of the Diamond Headache Clinic in Chicago, offered a less optimistic view.

"I no longer use it in my practice and do know that some patients use it as a last resort after all other forms of treatment have failed," he said. "I would never consider acupuncture as first-line treatment."

Migraine, a debilitating type of headache often accompanied by nausea and sensitivity to sound and light, is quite common. Twenty-eight million Americans suffer from migraines each year, according to the National Headache Foundation. Seventy percent of migraine sufferers are women.

While studies have shown that acupuncture may be useful for some migraine sufferers, its effectiveness has not been definitively established.

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 new study, Linde and his colleagues randomly assigned 302 migraine patients to receive acupuncture, sham acupuncture or placement on a "waiting list" for acupuncture.

The real and bogus acupuncture treatments consisted of 12 30-minute sessions administered over an eight-week period by specially trained physicians. In the sham procedure, needles were placed at non-acupuncture points. Patients on the waiting list served as the control group.

Nine to 12 weeks after a baseline assessment, patients in the acupuncture and sham treatment groups experienced a similar reduction in the average number of days that they suffered moderate or severe headaches.

Fifty-one percent of patients who had true acupuncture and 53 percent of those who underwent a sham procedure experienced at least a 50 percent reduction in the number of headache days they reported, the study found.

"In other words, acupuncture was quite effective. However, almost the same effect was achieved also with minimal [or sham] acupuncture," Linde noted.

The similar outcomes for real and fake acupuncture could be the result of a strong placebo effect, a physiological effect from needles, or a combination of both, the authors suggested.

While the German researchers did not formally test the sham procedure prior to the study's launch, Linde said investigators were quite aware that any intervention involving needles would have effects. That's one reason why they added a waiting-list control group, he explained.

More information

For more on treating the pain of migraines, visit the American Academy of Family Physicians.

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