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Acupuncture?
 
Acupuncture 'like migraine pill'

Acupuncture - real or sham - is as good as medication for preventing migraine, a study has suggested.

BBC Online
March 2006

German researchers treated almost 900 patients with either standard drugs, traditional Chinese acupuncture or "fake" acupuncture.

Virtually the same proportion of people in each group found the number of days affected by migraine was halved.

The UK's Migraine Association said the Lancet Neurology study showed there was no "one-size-fits-all" treatment.

'Effectiveness key'

Migraine affects up to 15% of the UK population - around two thirds of sufferers are women.

An attack can last up to 72 hours, and sufferers experience an average of 13 attacks a year.

The results come from acupuncture trials in Germany, where the treatment is commonly used to treat migraine.

The people in the study were given two sessions of either traditional Chinese acupuncture or a "sham" version - where needles were put into areas of the skin not used in traditional practice.

A third group was given standard prophylactic treatment of either beta blockers, calcium channel blockers or antiepileptic drugs.

They were treated over six weeks.

'Very interesting'

The researchers then returned to the patients between 23 and 26 weeks later and checked on whether they had been "migraine free" for 50% of days.

It was found 47% of those receiving traditional acupuncture, 39% of those given sham acupuncture and 40% of those in the drug treatment group had been migraine-free for at least 50% of the time.

Writing in Lancet Neurology, the researchers led by Dr Hans Christoph Diener of the University of Duisberg-Essen, said the results were surprising and the mechanisms unknown.

They were therefore difficult to explain, he added.

He said: "Ultimately, one could argue that the efficacy of a treatment, especially a treatment with almost no adverse events of contra-indications, is more important than the knowledge of the mechanism of action of this particular therapy.

"The decision whether acupuncture should be used in migraine prevention remains with the treating physician."

Ann Turner, director of the UK Migraine Action Association, said: "This is very interesting research.

"Migraine is such an individual and complex condition that not one treatment will work for everyone."
 
Traditional Chinese acupuncture may have no point, research finds

Acupuncture can halve the incidence of headaches among people who are susceptible to them, scientists report today.

The Independent
29 July 2005

But it remains an open question whether traditional acupuncture arried out according to the principles of the ancient Chinese practice is necessary. Researchers found that sticking pins in randomly over the body so they just penetrated the skin was equally effective.

Scientists in Germany who carried out one of the largest studies into the alternative therapy found patients who received acupuncture had seven fewer days with headaches over the four weeks following treatment.

Acupuncturists say there are 365 pressure points that must be stimulated for the therapy to heal. These are said to tap into a dozen body energy channels, or meridians. But patients who had the minimal acupuncture, with randomly placed needles, had 6.6 fewer days with headaches following treatment, an improvement almost equal to that for the traditional acupuncture group.

Both groups received 12 sessions of the therapy over eight weeks. A third group, who received no treatment, had 1.5 fewer days with headaches in the four weeks following the trial.

There were 270 patients in the study in total who had reported suffering tension headaches at least eight days a month.

Writing in the British Medical Journal, the researchers from the Centre for Complementary Medicine Research at the University of Munich say the effectiveness of the "minimal" acupuncture is "intriguing". Even though fewer needles were used and they were inserted less deeply than in traditional acupuncture, their physiological effect cannot be considered "completely inert". Alternatively, the therapy may have produced a placebo effect more
potent than that associated with drugs, they suggest.

The study is the latest to suggest that "minimal" or "sham" acupuncture is as good as the real thing. A study last year of 302 mostly female migraine patients found both methods were equally effective in reducing attacks.

An earlier study, published in the BMJ last year, also found evidence for the effectiveness of acupuncture as a treatment for headaches and migraines. A trial organised by the Royal London Homeopathic hospital involving 400 patients with frequent head-aches found their headaches sharply reduced after 12 sessions of acupuncture.

The patients were mainly women who had been taking three or four paracetamol a day, on average, before the study. A year later, having had 12 acupuncture sessions, they had fewer headaches, made fewer visits to the GP, used less medication and took less time off sick.

But sceptics remain. At least 26 randomised controlled trials had previously been published showing no convincing effect of acupuncture on headaches.

Acupuncture can halve the incidence of headaches among people who are susceptible to them, scientists report today.

But it remains an open question whether traditional acupuncture carried out according to the principles of the ancient Chinese practice is necessary. Researchers found that sticking pins in randomly over the body so they just penetrated the skin was equally effective.

Scientists in Germany who carried out one of the largest studies into the alternative therapy found patients who received acupuncture had seven fewer days with headaches over the four weeks following treatment.

Acupuncturists say there are 365 pressure points that must be stimulated for the therapy to heal. These are said to tap into a dozen body energy channels, or meridians. But patients who had the minimal acupuncture, with randomly placed needles, had 6.6 fewer days with headaches following treatment, an improvement almost equal to that for the traditional acupuncture group.

Both groups received 12 sessions of the therapy over eight weeks. A third group, who received no treatment, had 1.5 fewer days with headaches in the four weeks following the trial.

There were 270 patients in the study in total who had reported suffering tension headaches at least eight days a month.

Writing in the British Medical Journal, the researchers from the Centre for Complementary Medicine Research at the University of Munich say the effectiveness of the "minimal" acupuncture is "intriguing". Even though fewer needles were used and they were inserted less deeply than in traditional acupuncture, their physiological effect cannot be considered "completely inert". Alternatively, the therapy may have produced a placebo effect more
potent than that associated with drugs, they suggest.

The study is the latest to suggest that "minimal" or "sham" acupuncture is as good as the real thing. A study last year of 302 mostly female migraine patients found both methods were equally effective in reducing attacks.

An earlier study, published in the BMJ last year, also found evidence for the effectiveness of acupuncture as a treatment for headaches and migraines. A trial organised by the Royal London Homeopathic hospital involving 400 patients with frequent head-aches found their headaches sharply reduced after 12 sessions of acupuncture.

The patients were mainly women who had been taking three or four paracetamol a day, on average, before the study. A year later, having had 12 acupuncture sessions, they had fewer headaches, made fewer visits to the GP, used less medication and took less time off sick.

But sceptics remain. At least 26 randomised controlled trials had previously been published showing no convincing effect of acupuncture on headaches.
 
Fake acupuncture 'aids migraines'
Fake acupuncture works just as well as the real thing in relieving migraines, scientists have found.

03/05/2005

In a study of more than 300 patients, both genuine and sham acupuncture reduced the intensity of headache compared with no treatment at all.

But real acupuncture was no better than needles placed at non-acupuncture points on the body, the Journal of the American Medical Association reports.

It goes against recent research showing acupuncture works in its own right.

Placebo effect
It has long been debated whether acupuncture works in a unique way or whether any benefits gained are merely down to a person's expectation that the treatment will work.

The latter is called the placebo effect.

To investigate this, Dr Klaus Linde and colleagues randomly assigned 302 people with migraines to one of three groups.

One group received 12 sessions of genuine acupuncture over eight weeks.

Another group received 12 similar sessions of acupuncture, except the needles administered were not placed in parts of the body thought to relieve migraine pain, hence any benefit would likely be placebo rather than real, according to the researchers.

The third group received no treatment but were placed on a waiting list to see a migraine doctor.

Less pain
All of the patients kept diaries about their migraine symptoms.

While the patients on the waiting list continued to have headaches just as often, the ones who received acupuncture - sham or real - had fewer headaches.

The average number of days blighted by a headache went down from about five to two.

This may be due to "non-specific physiological effects of needling, to a powerful placebo effect or a combination of both", said the researchers.

But Dr George Lewith, who recently published work suggesting acupuncture has an effect above and beyond placebo, said although the present study was well conducted, it did not truly test the placebo effect.

"We do not know whether this sham acupuncture is active or not. To test for placebo effect you have to use an intervention that only raises a patient's expectations.

"The authors note themselves that something else could have been going on as well."

The British Acupuncture Council said that using pre-prescribed acupuncture points for all patients might have skewed the results.

"Acupuncture treatment is different for each person. The formulaic treatment part of the study would be inappropriate for some patients. This would reduce the apparent effectiveness in the acupuncture group."

The council said there was good evidence to suggest acupuncture was helpful for treating migraine.

Ann Turner of the Migraine Action Association said: "Acupuncture may be a good treatment option for migraine sufferers to explore."

More than one-in-10 people in the UK experience migraines, two-thirds of whom are women.

Acupuncture 'more than a placebo'
Scientists say they have proof that acupuncture works in its own right.

BBC News 30 April 2005

Sceptics have said that any benefits gained from acupuncture are merely down to a person's expectation that the treatment will work.

But researchers at University College London and Southampton University say they have separated out this placebo effect.

Their findings, based on a series of experiments and brain scan results, are published in the journal NeuroImage.

Dummy treatment
The researchers used positron emission tomography (PET) scans to see what was happening in the brains of people having acupuncture treatment for arthritis pain.

Each of the 14 volunteers underwent each of three interventions in a random order.

In one intervention, patients were touched with blunt needles but were aware that the needle would not pierce the skin and that it did not have any therapeutic value.

Another intervention involved treatment with specially developed "trick" needles that give the impression that the skin was being penetrated even though the needles never actually pierced the skin.

The needles worked like stage daggers, with the tip disappearing into the body of the needle when pressure is applied. This was designed to make the patients believed that the treatment was real.

The third intervention was real acupuncture.

Brain activity
When the researchers analysed the patients' PET scan results they found marked differences between the three interventions.

Only the brain areas associated with the sensation of touch were activated when the volunteers were touched with the blunt needles.

During the trick needle treatment, an area of the brain associated with the production of natural opiates - substances that act in a non-specific way to relieve pain - were activated.

This same area was activated with the real acupuncture but, in addition, another region of the brain, the insular, was excited by the treatment.

This was a pathway known to be associated with acupuncture treatment and thought to be involved in pain modulation.

Sarah Williams of the British Acupuncture Council said: "This is very positive news for acupuncture and this latest research is an exciting illustration of what acupuncturists have known for a long time - that acupuncture works and its effectiveness goes beyond the placebo effect."

Professor Henry McQuay, professor of pain relief at the University of Oxford and member of the Bandolier group that looks at the evidence behind different medical treatments, said: "The great bulk of the randomised controlled trials to date do not provide convincing evidence of pain relief over placebo.

"Some people do report that acupuncture makes them feel better.

"But it is extremely difficult, technically, to study acupuncture and tease out the placebo effect."