2022 Expert Review of Neurotherapeutics

A 6-week course of acupuncture proves as effective as 6-month drug prophylaxis for migraines, with specific Chinese point selection and stimulation appearing less important.

The study began by revisiting previous research on acupuncture as a treatment for headache, finding shortcomings in many of these studies. It explored the influence of acupuncture on migraine and how it potentially functions. The methodology involved running several large, randomized trials comparing the use of acupuncture to conventional prophylactic drug treatments, spanning a time frame of six weeks to six months, respectively.

In the discussion of the results, it was found that the 6-week acupuncture treatment was just as effective in treating migraines as the 6-month drug treatment. Specific attributes of the acupuncture treatment, such as the selection and stimulation of Chinese points and the depth of the needles, were found to have lower significance than traditionally believed. The paper therefore suggested the integration of acupuncture into existing migraine therapy protocols.

Role of acupuncture in the treatment of migraine Endres HG, Diener HC, Molsberger A

2021 Journal of Clinical Pharmacy and Therapeutics

Acupuncture appears to have an effect on diabetic peripheral neuropathy, effectively improving nerve conduction and clinical symptoms.

Acupuncture appears to have an effect on DPN, effectively improving nerve conduction and clinical symptoms. Although the methodological quality of the included studies was generally very low and defects were frequent, our study highlights areas where improvement in methodology is required. There is a need for further study of the pathogenesis of DPN, and for developing a unified standard for methods of acupuncture treatment, acupoint selection, and adverse reactions reporting. Traditional Chinese medical practices such as acupuncture should adopt an evidence-based approach to provide greater confidence in their use.

Acupuncture treatment of diabetic peripheral neuropathy: An overview of systematic reviews Yu B, Li M, Huang H, Ma S, Huang K, Zhong Z, Yu S, Zhang L.

2020 Pain Research & Management

Acupuncture reduced more headache days and the times of using painkiller and was more effective in reducing the frequency and degree of headache than western medicine and sham acupuncture.

Based on high quality of evidence, we conclude that acupuncture is more effective and safer than medication or sham acupuncture in the treatment of migraine. However, the methodological quality, risk of bias, and reporting quality of SRs in acupuncture for migraine still needs improvement in future.

Effectiveness and Safety of Acupuncture for Migraine: An Overview of Systematic Reviews Li YX, Xiao XL, Zhong DL, Luo LJ, Yang H, Zhou J, He MX, Shi LH, Li J, Zheng H, Jin RJ

2020 Phytotherapy Research

Ginger, through various methods, exhibits promising pain reduction effects for conditions such as dysmenorrhea, muscle soreness, osteoarthritis, low back pain, and migraines.

The review incorporates a vast range of randomized controlled trials conducted over the past decade, where ginger was mainly used for pain relief in distinct conditions. The conditions included dysmenorrhea, delayed onset muscle soreness, osteoarthritis, chronic low back pain, and migraines. The variety of methods used included oral administration, topical application, and aromatic oil massages.

In the analysed trials, for dysmenorrhea and muscle soreness, the considered studies suggested a promising effect after both oral and topical administration of ginger. As for osteoarthritis, most trials demonstrated pain reduction following topical and oral use of ginger, one focused on the beneficial effects of ginger in relieving migraine pain. Last but not least, a trial involving massages with aromatic ginger oil highlighted its potential in reducing chronic low back pain.

Clinical trials on pain lowering effect of ginger: A narrative review Rondanelli M, Fossari F, Vecchio V, Gasparri C, Peroni G, Spadaccini D, Riva A, Petrangolini G, Iannello G, Nichetti M, Infantino V, Perna S

2019 Neuropediatrics

Currently, acupuncture is considered to be a safe, helpful, and available alternative option for patients who have not responded to or complied with conventional pharmacotherapy.

The authors conducted an exhaustive review of existing literature exploring the use of acupuncture to address migraine headaches in children. This review encompassed understanding the neurobiological mechanisms of acupuncture, studies on adult headaches, pediatric headache studies, consideration of acupuncture's safety, and its application in other health conditions present in children.

The findings of this review suggested that acupuncture emerges as a safe and effective treatment option for migraine in children. Evidence proposes that it can be effectively integrated into the primary treatment regime to reduce the child's discomfort and pain. The effectiveness of acupuncture comes with the added advantage of being safe, with negligible risks, especially important when dealing with young patients. These insights support acupuncture to be seriously considered as an auxiliary treatment strategy for migraines in children.

Acupuncture in Adult and Pediatric Headache: A Narrative Review Doll, E., Threlkeld, B., Graff, D., Clemons, R., Mittel, O., Sowell, M. K.

2019 Headache

There is growing evidence that acupuncture is just as effective and has fewer side effects than many of the standard pharmaceutical agents that are currently used.

Out of the 706 search results, 7 clinical trials, with a total of 1430 participants, met inclusion criteria for trials comparing the effectiveness of acupuncture to standard pharmacologic treatment. Several of the studies showed acupuncture to be more effective than standard pharmacological treatments for migraine prevention; however, methodological heterogeneity precluded aggregation of these data.

Systematic Review: Acupuncture vs Standard Pharmacological Therapy for Migraine Prevention Niushen Zhang, Tim Houle, Nada Hindiyeh, & Sheena K. Aurora

2019 Acupuncture in Medicine

Acupuncture, regardless of the trial design, showed a positive effect on pain-related outcome measures for participants with diabetic peripheral neuropathy.

Acupuncture, regardless of the trial design, showed a positive effect on pain-related outcome measures for participants with DPN. However, a meta-analysis could not be performed owing to the highly heterogeneous outcome measures and limited number of high-quality RCTs available. Findings from this review showed that acupuncture improves symptoms despite the variations in acupuncture dosage, and provides beneficial effects in comparison with vitamin B therapies and no treatment. However, owing to problems with control group suitability and blinding, strong non-specific effects cannot be ruled out.

Acupuncture for the treatment of lower limb diabetic peripheral neuropathy: a systematic review Nash J, Armour M, Penkala S

2019 Arthritis Research & Therapy

Strong electroacupuncture for at least two weeks improves chronic pain management in knee osteoarthritis patients better than weak or sham electroacupuncture.

In this investigation, a multicenter, three-arm parallel, single-blind randomized controlled trial was conducted in which 301 patients suffering from knee osteoarthritis were randomly divided into three groups based on the electroacupuncture current intensity: strong, weak, and sham. Treatments were carried out in five sessions per week over a two-week period. The impact of these treatments was primarily measured by assessing the Visual Analog Scale, conditioned pain modulation function, and the Western Ontario and McMaster Universities Osteoarthritis Index.

After a week of electroacupuncture, a clinically significant improvement was observed in Visual Analog Scale scores and Western Ontario and McMaster Universities Osteoarthritis Index scores, but not in conditioned pain modulation function. However, after two weeks of treatment, improvements were seen in all three primary outcomes when compared to baseline. In terms of enhancing conditioned pain modulation function specifically, both weak and strong electroacupuncture outperformed the sham option, with strong electroacupuncture showing superiority to weak, and resulted in better pain management.

Effects of intensity of electroacupuncture on chronic pain in patients with knee osteoarthritis: a randomized controlled trial Lv, Z., Shen, L., Zhu, B. et al.

2018 Evidence-Based Complementary and Alternative Medicine

There is potential of acupuncture combined with conventional treatment for treating female chronic pelvic pain.

This review suggests the potential of acupuncture combined with conventional treatment compared to conventional treatment alone for treating female chronic pelvic pain. However, there is insufficient evidence to conclude that acupuncture can be recommended as a complementary and alternative (CAM) treatment for women with CPP. To draw a firm conclusion, future studies should require not only lager, more rigorously designed RCTs but also research on different acupuncture treatment types.

Acupuncture Treatment for Chronic Pelvic Pain in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Sung SH, Sung ADM, Sung HK, An TEB, Kim KH, Park JK

2018 Acupuncture in Medicine

Acupuncture for cluster headache may be more effective if treated in the same way as has been shown effective for trigeminal neuralgia.

Acupuncture has not generally been successful for cluster headache. This may be due to acupuncturists approaching the problem as one of severe migraine. In fact, cluster headache is classed as a trigeminal autonomic cephalgia.

In this case report, episodic cluster headache is treated in the same way as has been shown effective for trigeminal neuralgia. Acupuncture is applied to the contralateral side at points appropriate for stimulating branches of the trigeminal nerve. Thus, ST2 is used for the infraorbital nerve, BL2 and Yuyao for the supratrochlear and supraorbital nerves, and Taiyang for the temporal branch of the zygomatic nerve.

Acupuncture for Episodic Cluster Headache: A Trigeminal Approach Simon Hayhoe

2017 The Journal of Pain

Acupuncture has a clinically relevant effect on chronic pain that persists over time. Referral for acupuncture treatment is a reasonable option for chronic pain patients.

We included randomized trials of acupuncture needling versus either sham acupuncture or no acupuncture control for nonspecific musculoskeletal pain, osteoarthritis, chronic headache, or shoulder pain. Trials were only included if allocation concealment was unambiguously determined to be adequate. Raw data were obtained from study authors and entered into an individual patient data meta-analysis. The main outcome measures were pain and function. An additional 13 trials were identified, with data received for a total of 20,827 patients from 39 trials. Acupuncture was superior to sham as well as no acupuncture control for each pain condition (all P < .001) with differences between groups close to .5 SDs compared with no acupuncture control and close to .2 SDs compared with sham. We also found clear evidence that the effects of acupuncture persist over time with only a small decrease, approximately 15%, in treatment effect at 1 year.

Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain.

Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis Vickers, Andrew J. et al.

2017 Pain

Patients with chronic pain can generally be reassured that treatment effects persist after a course of treatment with acupuncture.

The available individual patient data set included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck, and shoulder), osteoarthritis of the knee, and headache/migraine. We used meta-analytic techniques to determine the trajectory of posttreatment pain scores. Data on longer term follow-up were available for 20 trials, including 6376 patients. In trials comparing acupuncture to no acupuncture control (wait-list, usual care, etc), effect sizes diminished by a nonsignificant 0.011 SD per 3 months after treatment ended. The central estimate suggests that approximately 90% of the benefit of acupuncture relative to controls would be sustained at 12 months. For trials comparing acupuncture to sham, we observed a reduction in effect size of 0.025 SD per 3 months, suggesting approximately a 50% diminution at 12 months.

The effects of a course of acupuncture treatment for patients with chronic pain do not seem to decrease importantly over 12 months. Patients can generally be reassured that treatment effects persist. Studies of the cost-effectiveness of acupuncture should take our findings into account when considering the time horizon of acupuncture effects. Further research should measure longer term outcomes of acupuncture.

The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain MacPherson, H; Vertosick, E.A; Foster, N.E; Lewith, G; Linde, K; Sherman, K.J; Witt, C.M; Vickers, A.J

2017 Pain Physician

The existing evidence suggests that most acupuncture therapies, including acupuncture combined with other therapies, are effective in decreasing pain and in improving physical function.

Thirty-three trials with 1,692 patients were included. Patients were allocated to 22 kinds of interventions, of which dry needling and manual acupuncture was the most frequently investigated intervention. Compared with placebo-sham acupuncture, scraping combined with warming acupuncture and moxibustion was found to be more effective for decreasing pain intensity; miniscalpel-needle was more effective for increasing the PPT; trigger points injection with bupivacaine was associated with the highest risk of adverse event; and only EA showed a significant difference in the ROM.

Acupuncture for Myofascial Pain Syndrome: A Network Meta-Analysis of 33 Randomized Controlled Trials Li X, Wang R, Xing X, Shi X, Tian J, Zhang J, Ge L, Zhang J, Li L, Yang K.

2016 Neural Regeneration Research

A 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo.

Acupuncture at Fengchi (GB20) in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi.

Of the 136 patients, 120 completed the study. There were no significant differences between pretreatment and posttreatment test results in any of the groups. Only five patients suffered from minor adverse events (needling pain, slight hematoma and transient chest tightness). No serious adverse events were found. Our results indicate that a 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo.

Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo Wen Y, Zhang C, Zhao Xf, Deng Sz, He S, Huang Lh, Tian G, Meng Zh

2015 Neurology

The majority of trials demonstrate a positive effect of acupuncture over control condition in the treatment of neuropathy.

The majority of RCTs reviewed showed clear benefit for acupuncture over control in the treatment of diabetic neuropathy, Bell’s palsy and carpal tunnel syndrome. Acupuncture is probably effective in the treatment of HIV-related neuropathy and there is insufficient evidence for its benefits in idiopathic neuropathy. Meta-analyses of all diabetic neuropathy and bell’s palsy data using a summary estimate random effects model showed combined Odds Ratio (OR) of 4.23, p<0.001 favoring acupuncture over control for pain outcomes. The majority of trials demonstrate a positive effect of acupuncture over control condition in the treatment of neuropathy. Further more rigorously designed studies are needed to better characterize this effect.

Effects of Acupuncture on Neuropathic Pain: A Systematic Review and Meta-analysis Alexandra Dimitrova, Charles Murchison, Barry Oken

2015 Neurology

The majority of trials demonstrate a positive effect of acupuncture over control condition in the treatment of neuropathy.

The majority of RCTs reviewed showed clear benefit for acupuncture over control in the treatment of diabetic neuropathy, Bell’s palsy and carpal tunnel syndrome. Acupuncture is probably effective in the treatment of HIV-related neuropathy and there is insufficient evidence for its benefits in idiopathic neuropathy. Meta-analyses of all diabetic neuropathy and bell’s palsy data using a summary estimate random effects model showed combined Odds Ratio (OR) of 4.23, p<0.001 favoring acupuncture over control for pain outcomes. The majority of trials demonstrate a positive effect of acupuncture over control condition in the treatment of neuropathy. Further more rigorously designed studies are needed to better characterize this effect.

Effects of Acupuncture on Neuropathic Pain: A Systematic Review and Meta-analysis Alexandra Dimitrova, Charles Murchison, Barry Oken