1/18/2013 10:42:00 AM Dr. K for January 18, 2013 Acupuncture is promising remedy for chronic headache pain
DEAR DOCTOR K: I suffer from chronic tension headaches. Do you think acupuncture might help?
DEAR READER: Acupuncture is a form of complementary or alternative medicine, and many of my patients ask about it. It first gained recognition in the United States in 1971 when a well-known New York Times columnist, James Reston, developed appendicitis on a trip to China. His pain following surgery was treated not with conventional pain medicines but with acupuncture. Reston reported that his pain had been completely relieved by acupuncture. His standing and credibility caused many people to take acupuncture seriously.
Acupuncture has long been used to treat headaches. But until recently, there hadn't been strong evidence to support its use for headache pain. Two large scientific reviews have changed that. One review found that acupuncture may help people with episodic or chronic tension headaches. The other review found that acupuncture may prevent migraine headaches as well as or better than medications.
The tension headache review looked at 11 studies involving about 2,300 people. In two large studies included in the review, nearly half of people who received acupuncture in addition to their usual headache treatment said their headache days were cut by at least half. Only 16 percent of those who received typical headache treatment, but no acupuncture, reported the same level of headache relief.
The migraine review found evidence that getting regular acupuncture treatments in addition to typical migraine treatments (such as taking painkillers) cut the frequency of migraines. Also, when acupuncture was compared to taking a preventive drug, people who received acupuncture improved more and had fewer side effects than those taking medications.
According to traditional Chinese beliefs, acupuncture works by affecting the flow of energy, called "qi," through pathways that run through the body. The practitioner inserts very fine needles at specific points along these pathways.
Acupuncture has many variations. It typically involves four to 10 needles that are left in place for 10 to 30 minutes. A course of treatment may include six to 12 sessions. Most people report that acupuncture needles cause little or no pain.
Acupuncture is among the most promising of nontraditional headache therapies. The chief downsides are the cost and the time.
If you decide to try acupuncture, do your homework before choosing a practitioner, as licensing requirements vary from state to state. If possible, choose a therapist with a state license. If you live in a state that doesn't require licensing, seek out a practitioner who's certified by the National Certification Commission for Acupuncture and Oriental Medicine.
You may also want to get a referral from your doctor. (In any case, inform your doctor if you are going to try acupuncture.) And make sure that all needles are disposable or are properly sterilized before use.
I think acupuncture is worth a try. Even if it doesn't provide complete relief, it may enable you to cut back on your pain medications.
DEAR READERS: In my column of Dec. 19, I inadvertently spoke of achieving heart benefits by "lowering" HDL ("good") cholesterol. Of course, I meant by "raising" HDL cholesterol, as was clear in the rest of the column. I'm sorry for the lapse. -- Doctor K
(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)