Traditional acupuncture for migraine

How does it work?

Traditional acupuncture is a part of Traditional East Asian Medicine (TEAM) - which has a sophisticated system of theory, diagnosis and treatment based on the principles of "qi" (pronounced "CHEE"). The Chinese word Qi does not have a direct translation in English, but roughly correlates with an idea of your body's vital energy. Qi circulates around the body, and problems arise if it is blocked, depleted or over abundant.

There are several key signs which the practitioner will always look for, namely changes in complexion, body shape and movement, changes in the tongue and information gained from palpation of the pulse. TEAM uses a very patient-centered approach, and once the formal diagnosis has been made, the principles of it's theory can be used to devise a treatment plan which will be unique to each patient.

The actual treatment is carried out by inserting fine sterile needles into selected acupuncture points mainly on the arms and legs, but sometimes also using body points. Traditionally trained practitioners can also employ a form of heat treatment known as moxabustion, or cupping.

Is it Safe?

The safety record of traditional acupuncture has been examined rigorously and this includes an extensive study carried out by York university in 2000, the results of which provide important evidence for public health, considering that over 2 million treatments are given each year by practitioners in the UK.

The study looked at the safety of acupuncture treatments administered over a 4 week period, and encompassed a total of 574 practitioners. It was published by the BMJ in 2001. Each practitioner involved was professional trained and practising in the UK. In addition two thirds had been in practice for more than 5 years. They were all asked to report details of any adverse events, which they considered significant, including any which were unusual or dangerous.

A total of 34000 treatments were reported on and from these no serious adverse events were recorded. Given the possibility of biasses from self reporting, these results are impressive, especially when compared with some of the adverse events reported from the use of painkillers such as NSAID's.

Evidence for Effectiveness for treating Migraine

The research available for the use of acupuncture to address migraine includes some large high quality studies which have been carried out quite recently. The studies include systematic reviews, including one by the respected Cochrane database, and clinical studies. The conclusion from these reviews and studies show that acupuncture is at least as effective as or possibly more effective than drug treatment, and with fewer adverse effects.

To illustrate the scope and high quality nature of the research, three of the more significant pieces of research are discussed here. First, the systematic review carried out by the Cochrane database was carried out in 2009, and looked at 22 trials which examined the effectiveness of acupuncture in the prevention of migraine attacks. Overall this showed that patients benefited from acupuncture, and it was shown to be at least as effective as or possibly more effective than drug treatment and, significantly with fewer adverse effects.

The research also includes 2 good quality clinical trials. One a randomised controlled trial which looked at acupuncture for acute migraine attacks. 175 patients were randomly chosen to a sham group and a 'true' acupuncture group. The 'true' acupuncture group was shown to be more effective than the sham group for acute migraine and significantly in preventing relapses. The second trial was also an RCT that assessed effectiveness of acupuncture compared to routine care in 3182 patients with migraine and/or tension headaches. After 3 months the number of days with a headache had decreased more in the acupuncture group.

Conclusion

Understanding the theory, safety considerations and available research, together shows not just the effectiveness of acupuncture in being able to offer relief for patients with migraine, but also offers healthcare providers with a safe form of treatment with very significant benefits in terms of no long term side effects, which can be a possibility for long term use of pain relief medication.

References

Clinical Guideline - http://www.nice.org.uk/nicemedia/live/13901/60853/60853.pdf.

Hugh Macpherson, et al. The York Acupuncture Safety Study: Prospective Survey of 34000 Tx's by Traditional Acupuncturists. BMJ. Sept. 1, 2001; 323(7311): 486-487.

Tranmer MR, Moore RA, et al. Quantitative Estimation of rare adverse events which follow a biological progression: a new model applied to chronic NSAID use. Pain. 2000; 85: 169-182 - on PubMed

Linde K et al. Acupuncture for migraine prophylaxis. Cochrane Database of systematic review 2009 issue 1. Art. No.:CD001218. DOI: 10.1002/14651858. C.D001218. pub2.

Sun Y, Gan TJ. Acupuncture for management of chronic headache - a Systematic review. Anesh Analg. 2008; 1007:2038-47.

Li Y, Liang F, Yang X, Tian X, et al. Acupuncture for treating acute attacks of migraine: a RCT. Headache. 2009; 49(6) (pp 805-816).

Jena S et al. Acupuncture in patients with headache. Ceph

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