Scientific proof of the benefit of acupuncture to fight against migraine

Acupuncture can reduce migraines compared to a placebo (placebo) and usual care, according to a new Chinese trial published in the renowned British Medical Journal.

More than one billion people worldwide are affected by migraine. It has a considerable impact on the quality of life and imposes a considerable burden on society.

For people with frequent migraines, preventative treatments aimed at reducing headache frequency are available, but not all patients respond well to drug therapy and many prefer to avoid it. Until now, the evidence for the benefit of acupuncture in migraine prevention has been mixed.

Real acupuncture versus sham acupuncture (placebo)

A team of researchers based in China therefore set out to compare the effectiveness of “real” acupuncture with sham acupuncture (placebo) or usual care.

Their findings are based on 147 patients (mean age 37) with a history of migraine without aura, who were recruited from seven hospitals in China between June 2016 and November 2018.

None of the patients had received acupuncture before, and all were instructed not to take painkillers or start other treatments during the trial.

After four weeks of baseline evaluation, patients were randomly assigned to receive either 20 sessions of manual acupuncture at actual acupuncture points or 20 sessions of non-penetrating sham acupuncture at non-acupuncture points. or usual care (including lifestyle counselling) over a period of eight weeks.

Fewer migraine attacks, shorter duration

Over the next 12 weeks, researchers compared changes in migraine days and migraine attacks per four-week period from baseline.

Compared to sham acupuncture, real acupuncture resulted in a greater reduction in migraine days (3.9 v 2.2) from weeks 13 to 20 and migraine attacks (2.3 v 1, 6) from the 17th to the 20th week.

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The adjusted difference between real acupuncture and sham acupuncture was 1.4 fewer migraine days at weeks 13-16, and 2.1 fewer migraine days and at weeks 17-20.

Sham acupuncture resulted in a small reduction in migraine attacks compared with usual care (1.6 v 0.4) during weeks 17-20, with a slightly decreasing trend over this period.

No serious adverse effects were reported.

Physicians should recommend acupuncture to their migraine patients

The researchers point out some limitations, such as the relatively short study period (20 weeks). Highlights are the use of a non-penetrating needle for sham acupuncture.

These results show that acupuncture treatment, compared to sham acupuncture or usual care, “produced a significantly greater reduction in the frequency of migraine days and migraine attacks,” the authors write.

According to them, acupuncture “may be recommended as a prophylactic treatment” and clinicians “should provide patients with information about acupuncture as an option when discussing prophylactic treatment strategies.”

Since nearly 90% of people with frequent migraines have no effective preventive treatment, “acupuncture is a useful additional tool in the preventive and therapeutic arsenal,” she says.

This study “helps move acupuncture from an unproven status in complementary medicine to an acceptable evidence-based treatment,” the researchers conclude.

Manual acupuncture versus sham acupuncture and usual care for the prophylaxis of episodic migraine without aura: randomised, multicentre, clinical trial, BMJ (2020). DOI: 10.1136/bmj.m697


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