Research Review by Dr. Shawn Thistle©

Date:

Sept. 2005

Study Title:

Acupuncture for patients with migraine - A randomized controlled trial

Authors:

Linde K et al.

Publication Information:

JAMA 2005; 293: 2118-2125

Summary:

Acupuncture has been widely utilized to treat and prevent migraine headaches. However to date, little quality research has been done to properly investigate this.

Migraine headaches are common and disabling for many people. Migraine headaches typically manifest as one-sided, pulsating, severe headaches that may or may not be associated with sensitivity to light or sound, or other symptoms such as nausea or vomiting. Common pharmaceutical treatment options for migraine headaches have demonstrated some benefit, but the effect is often modest and tolerability is suboptimal.

This study investigated the effectiveness of acupuncture for the treatment of migraine headaches. A total of 302 patients participated in this study - 88% were women, and the average age of patients was 43 years of age. Patients were randomized into three groups:
  1. acupuncture - 12 sessions lasting 30 minutes were administered over a period of 12 weeks. Standard traditional Chinese points were utilized and practitioners had the flexibility to utilize additional points based on patient symptoms. Total number of needles was limited to 25 per treatment. Manual stimulation of the needles was performed throughout the treatment.
  2. sham acupuncture - 12 session lasting 30 minutes were administered over a period of 12 weeks. At least 5/10 predetermined "non-acupuncture" points were needled bilaterally and superficially. No manual stimulation of the needles was performed.
  3. waiting list control group - did not receive any prophylactic treatment for their headaches for 12 weeks, after which they received 12 weeks of acupuncture treatments as described above.
The authors state that even though the sham acupuncture technique does not follow traditional Chinese methods or principles, it "…has been associated with positive outcomes in clinical trials."

The main outcome measure used in this study was the difference in the number of days with headache of moderate to severe intensity as measured by a headache diary completed by the patients. Diaries were completed 4 weeks before the trial, during the intervention, and for 3 weeks after the trial.

Conclusions & Practical Application:

The most significant result of this study was that patients in both the acupuncture and sham acupuncture group faired significantly better than the waiting list group, however there was no difference between the two acupuncture groups.

The authors concluded that acupuncture was no better than sham acupuncture in treating migraine headaches, without mentioning the fact that both groups improved. The results of this study were publicized as such in the news and print media, which in my opinion misses a striking finding of this study - that acupuncture seems to have a NON-SPECIFIC, beneficial effect on migraine headaches, regardless of adherence to traditional Chinese principles and specific points.

Attempting a "sham" form of acupuncture proves problematic in most studies, but this common problem in clinical research in this instance resulted in a finding that many of us who practice acupuncture in a medical model have known for some time.

That is simply that acupuncture produces a physiological response in the tissue in which the needles are inserted, independent of specific and traditional Chinese locations. The fact that both acupuncture groups improved to similar degrees in my opinion lends support to this theory, and adds evidence suggesting at least some effectiveness of acupuncture for the treatment of migraine headaches.