Patients who suffered migraines without aura, and who received five
true acupuncture treatments per week for four consecutive weeks had
about one less headache per month than similar patients who got the
same number of sham acupuncture treatments, researchers report.
“Acupuncture should be considered as one option for migraine
prophylaxis in light of our findings,” the authors write in JAMA
About 18 percent of women and 6 percent of men in the U.S. suffer
from migraine headaches in a given year, according to a 2001 study,
making the condition a leading cause of disability.
Acupuncture is commonly used to treat migraines in China, however,
studies of whether it works for migraine prevention have been
inconsistent, the study team notes.
Ling Zhao of Chengdu University of Traditional Chinese Medicine in
Sichuan, China, and colleagues recruited 249 adults who had an
average of two to eight migraines without aura per month from three
clinical centers in China.
For the study, participants kept track of their migraine headache
frequency and severity for four weeks before being randomly assigned
to receive true acupuncture treatment, sham acupuncture treatment or
to be put on a waiting list for treatment.
People in both the true and sham acupuncture groups received 20
treatments with acupuncture needles and electrical stimulation, each
lasting thirty minutes.
The true acupuncture group was treated at four acupuncture points
thought to affect headaches and with enough electrical stimulation
to elicit a “Deqi" sensation, which includes “soreness, numbness,
distention or radiation that indicated effective needling,”
according to the authors.
For the sham treatment, the needles were placed in areas not known
to be acupuncture points and the deqi sensation wasn’t induced.
At 16 weeks, the number of migraines reported in the true
acupuncture group fell by about three attacks per month, while
people in the sham acupuncture group had two fewer attacks per
Among the study’s limitations, about 20 percent of the participants
had previous experience with acupuncture, and it’s not known how
many may have been able to guess whether their treatments were real
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“Placebo response is strong in migraine treatment studies, and it is
possible that the Deqi sensation . . . that was elicited in the true
acupuncture group could have led to a higher degree of placebo
response because there was no attempt made to elicit the Deqi
sensation in the sham acupuncture group,” Dr. Amy Gelfand writes in
an accompanying editorial.
Gelfand, a neurologist at the University of California, San
Francisco, told Reuters Health that the placebo effect is
interesting and important, especially in migraine studies, but she
thinks about it differently as a researcher and as a clinician.
“When I'm a researcher, placebo response is kind of a troublesome
thing, because it makes it difficult to separate signal from noise,”
she said. But when she’s thinking as a doctor about the patient in
front of her, placebo response is welcome, Gelfand said.
“You know, what I really want is my patient to feel better, and to
be improved and not be in pain. So, as long as something is safe,
even if it's working through a placebo mechanism, it may still be
something that some patients might want to use,” she said.
When a patient is interested in a treatment that may have a strong
placebo effect, Gelfand added, “There's a real checklist in my head,
with safety being the first thing; and if it seems like it's safe
then I think about things like cost, because often these things are
not going to be covered by insurance, but to a certain extent that's
the patient's decision; and I think about time, because these
treatments can be time-consuming.”
It’s a good idea to keep your doctor informed of any treatments that
you're using, be they over-the-counter supplements or
non-pharmacologic behavioral treatments, she said.
“I think that that's part of the picture, and as a provider, I like
to know about all of those things. If for no other reason than it
just helps me understand what kind of treatments my patient values
and is looking for,” Gelfand said.
SOURCE: http://bit.ly/2kWY8q4 and http://bit.ly/2m7OmU9 JAMA
Internal Medicine, online February 20, 2017.
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