Alexander Mauskop, M.D.
Professor of Clinical Neurology
SUNY Downstate Medical Center
Brooklyn, New York
Director, New York Headache Center
New York, New York
This ancient Chinese treatment has been subjected
to hundreds of animal studies, which have established
that acupuncture may exert its effect by causing release
of natural pain-relieving substances such as endorphins
(endogenous morphine). This pain-relieving effect can
be reversed in animals by injecting naloxone, an antidote
given for narcotic overdose. Other possible mechanisms of
action discovered via animal experiments are through the
brain’s serotonin, histamine, and GABA systems.
A very large number of clinical trials have also been
performed in humans. Only a small number of these
trials were rigorous and provided reliable information.
A detailed review of 14 trials of acupuncture used in
the treatment of recurrent headaches was published by
Melchart and his colleagues in the international headache
journal, Cephalalgia, in 1999. This report noted that
the majority of 14 trials comparing true and sham
acupuncture showed at least a trend in favor of true
acupuncture.
A British study, led by Vickers, evaluated the effect of
acupuncture on chronic headaches in 401 patients in a
primary care setting. Patients in the acupuncture group
received 12 weekly treatments and the control group
26
HeadWise™
|
Volume 3, Issue 3 • 2013
received the usual headache treatment. Both groups were
followed for 12 months. The headache score dropped
by 34% in patients receiving acupuncture versus 16%
reduction in the control group. Medication use was 15%
less in the acupuncture group. Several quality of life
measures were better in the acupuncture group who also
reported 25% fewer visits to their general practitioner.
The most significant studies were funded by the
German government. The first study included 302
patients with migraine who were randomly assigned to
one of three groups: a group of patients who were treated
with acupuncture; a group receiving sham acupuncture;
and, a group of patients assigned to a waiting list for 3
months who were subsequently treated by acupuncture.
The study revealed that both in the real and sham
acupuncture groups about 50% of the patients responded.
The responder rate in the waiting list group was only
15%.
The second study was a prospective, randomized,
multicenter, double-blind, parallel-group, controlled,
clinical trial, which is considered the most rigorous and
scientific method. Patients reported 2 to 6 migraine
attacks per month, and were randomly assigned to