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Oct16

Is Acupuncture Effective for Headaches?

David Chu, MD, AQH, CAc

Is Acupuncture Effective for Headaches?

The short, honest answer? It depends.

  1. It depends on the root cause of your headaches, which depends on the accuracy of your medical diagnosis by your medical doctor.
  2. It depends on the education, skills, and clinical experience of your acupuncturist.
  3. It ultimately depends on your own beliefs in medicine and science and what your true expectations are of successful treatment.

I am a Board Certified Headache Medicine Specialist and a Certified Acupuncturist. I have been treating patients in my private practice in New York City and Northern New Jersey for over 10 years. 

Interestingly enough, most of my patients in my midtown Manhattan practice tend to be western or conventional medication-averse. It is nearly impossible to convince some of my patients to consider taking Advil or Tylenol. They would look at me incredulously as if I recommended starting with an alarmingly high dose of Oxycodone. These surprising patient reactions led me to believe that I needed to add alternative treatments to my repertoire, which was why I decided to complement my medical training to become a Certified Acupuncturist (C.Ac.).

Headaches are one of the most common neurologic conditions with almost 50% of the adult population experiencing a headache in the past year. According to the International Classification of Headache Disorders, there are more than 200 different types of headaches, many of which are benign and self-limiting, but some are debilitating and life-threatening. Surprisingly, according to the World Health Organization, the main clinical barrier to adequate treatment is actually the lack of proper education and training of the medical provider. Only four hours of graduate medical education is dedicated to the instruction of headache disorders.

Here are more staggering figures demonstrating the misdiagnosis, under treatment, and mismanagement of headaches:

  1. More than 50% of headache patients have only been treated symptomatically, with no appropriate diagnosis established.
  2. An estimated 60% of women and 70% of men who suffer from migraines have actually never been properly diagnosed with migraines.
  3. Only 10% of patients are properly diagnosed with Medication Overuse Headaches (a frequent cause of headaches which arises when a patient takes an inappropriate amount of ineffective over-the-counter or prescription headache medication).

Many of the patients that I treat were misdiagnosed by their prior medical provider. The most common erroneously diagnosed cases are the patients whose headaches are misdiagnosed as “migraines” or “sinus headaches.” Patients are far too frequently prescribed NSAIDs and triptans (a first line medication such as Imitrex) for the “migraines,” or nasal decongestants and antibiotics for the “sinus headaches.” Since most headaches are benign and self-limiting, patients report the resolution of their pain with these treatments, even though the patient was misdiagnosed and given an inappropriate medication that most likely did little to nothing to treat the root cause of the pain. Sadly, I have diagnosed a few of these chronic “migraine” sufferers with brain tumors that required urgent neurosurgical intervention.

Acupuncture is considered Eastern medicine or Traditional Chinese Medicine. Its foundation and understanding of how our bodies work are very different from what is taught in Western medicine. As I am a Western medicine medical doctor (M.D.) first, in order to advocate for the legitimacy of acupuncture in Western medicine, acupuncture treatment must undergo the same rigorous studies in the same fashion as novel pharmaceutical medications do (evidence-based medicine). A study published in March 2020 compares the outcomes of manual vs. sham acupuncture in patients who suffer from migraines without aura.

 
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The study demonstrated that manual acupuncture showed a statistically significant reduction of migraine days and attacks compared to sham acupuncture and normal treatment. However, this study also illustrated that sham acupuncture produced a statistically significant reduction in the number of migraine attacks as well as compared to normal treatment. Participants in the sham acupuncture group received four non-penetrating, blunt needles in non-acupuncture related points in the head and neck.

This study indicates that the effectiveness of acupuncture correlates with the expertise and clinical experience of the acupuncturist. Acupuncture treatment with needles placed in an incorrect location or depth may not provide the same pain-relieving benefits. Furthermore, the positive outcomes of the sham acupuncture logically can be attributed to both the “placebo effect” and the natural endorphin release that occurs with a slightly uncomfortable procedure such as acupuncture. Natural endorphins can block peripheral pain by binding to opioid mu receptors, which stops the transmission of pain sensations to the brain. Centrally within the brain, natural endorphins also inhibit the release of GABA, an inhibitory neurotransmitter, which then leads directly to the increased production of dopamine, known as the “happy hormone.” Natural endorphin release also occurs with other holistic pain treatment recommendations such as moderate exercise, massage therapy, and meditation.

If you are one of the many headache sufferers researching for headache pain solutions such as acupuncture, my recommendation would be to see a Certified Headache Specialist rather than a primary care physician or even a general neurologist to obtain a clear diagnosis and treatment plan that is tailored to the underlying cause of your headache. If acupuncture is recommended for you, I would advise finding an experienced acupuncturist who specializes in treating headaches. Acupuncture does not always work with all of my patients, just like how medications and other therapeutic procedures do not work the same for every individual. However, there is strong and proven medical evidence that acupuncture is a safe and effective treatment option in headache-suffering patients who are both correctly diagnosed and treated by experienced health professionals.

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