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06/10/2005 - Acupuncture is helpful when added to standard medical treatment for headache

News release:

People who received acupuncture in addition to standard medical treatment for chronic daily headache fared better than those who received medical treatment alone, a clinical trial conducted at UNC Hospitals has found.

Results of the study are reported in the October issue of the journal Headache, which is published by the American Headache Society. The study's lead author is Dr. Remy R. Coeytaux, an assistant professor in the University of North Carolina at Chapel Hill School of Medicine's department of family medicine.

"Chronic daily headache is generally very difficult to treat with medications alone," Coeytaux said. "Other studies recently published in the Journal of the American Medical Association and the British Medical Journal had previously demonstrated that acupuncture is effective for treating migraine and tension-type headache; we wanted to find out if acupuncture was also helpful in the treatment of chronic daily headache for people who were getting full-court-press medical care for their headaches."

Seventy-four patients who were already receiving treatment in the Headache Clinic at UNC Hospitals were recruited to participate in the study. To be eligible for the study, a person had to suffer from headaches at least 15 days a month. However, most participants reported that they had headaches nearly every day.

One group of patients in the study continued to receive standard medical care, while a second group was randomly assigned to receive standard medical care, in addition to a course of 10 acupuncture treatments during a six-week period. The acupuncture treatments were administered by UNC's Dr. Wunian Chen, an instructor in the department of family medicine who was trained in China in the use of traditional Chinese acupuncture. These treatments took place in the General Clinical Research Center at UNC Hospitals. Those who received acupuncture were given individualized treatments, depending upon their symptoms, Chen said.

"We think that acupuncture, without giving the body any additional chemicals, might promote the body's healing system and rebalance the body," he said. "Each patient is different, so we treat them individually."

Each day, all of the patients recorded their medication use and headache pain severity, which Coeytaux defined as "the highest level of pain for the worst part of the patient's headache." They also completed standardized questionnaires designed to capture changes in quality-of-life measures such as physical functioning, bodily pain, general health, vitality, social functioning and general mental health.

"At six weeks and at 12 weeks we looked at the outcomes," Coeytaux said. "The results showed that patients who received acupuncture reported significant improvement in many quality-of-life measures. They felt better, and the vast majority who got acupuncture reported that their headaches had improved during the six weeks of treatment."

In fact, the article reports, patients who received acupuncture were 3.7 times more likely to report less suffering from headaches at six weeks. However, the group that received medical treatment alone did not report improvement. Its results remained essentially unchanged during the course of the study.

Additional research is needed, Coeytaux said, to answer questions not addressed by this study, such as whether or not the results might have been influenced by the "placebo effect" - the tendency of some study participants to think they're getting better simply because they're receiving what they think is a new and better treatment. The next step is to conduct a placebo-controlled clinical trial, in which some patients receive genuine acupuncture treatment while others receive what is commonly referred to as "sham" acupuncture, Coeytaux said.

He and his co-authors have submitted a grant application to the National Institutes of Health to conduct such a trial.

In addition to Coeytaux and Chen, UNC co-authors were Drs. William C. Miller, associate professor of infectious diseases in the School of Medicine and of epidemiology in the School of Public Health; Leigh Callahan, associate professor in the medical school's departments of medicine, orthopaedics and social medicine; J. Douglas Mann, professor of neurology in the School of Medicine; and Dr. Jay S. Kaufman, associate professor of epidemiology in the School of Public Health.

Joining them as co-author was Dr. Ted J. Kaptchuk, an assistant professor of medicine at Harvard Medical School, where he is associate director of the Division for Research and Education in Complementary and Integrative Medical Therapies.

Grant funding for the study was provided by the National Institutes of Health and UNC's General Clinical Research Center. In addition, Coeytaux was supported by the Robert Wood Johnson Clinical Scholars Program during the design phase of the study.