Acupuncture for Migraine May Have Some Benefits but Quality of Studies Lacking, Report Says

A recent overview of systematic reviews (SRs) and meta-analyses (MAs) regarding the effectiveness of acupuncture as a treatment for migraines found the methodological quality of the studies insufficient.

The research aimed to compare the effects of acupuncture, as both a preventative and acute treatment of migraines, to different treatment controls. Though the overview found acupuncture treatment has the advantages of pain improvement and safety, researchers stated the quality of the studies needs to be improved.

The studies did not disclose whether acupuncture was utilized to ease acute attacks or the overall condition, calling into question the significance of collected data. This factor, in addition to the subjective nature of pain evaluation and classification by both patients and doctors, contributed to the overall unreliability of the findings.

In 2016 it was reported that globally, 8.9% of women and 9.8% of men experience migraines.

Common treatments for acute migraines include medications such as aspirin or triptans, while preventative measures include other drugs, cognitive behavioral therapy, and therapeutic treatments.

By searching relevant studies published by 8 sources, the researchers found 15 SR/MAs that fit the criteria for the overview.

To be considered, the studies must have been randomized controlled trials with control groups treated with other blank controls, placebos, drug treatments, or other Traditional Chinese Medicine (TCM) treatments. Participants must have also been diagnosed by internationally accepted clinical guidelines. Studies that were not available in Chinese and English were excluded.

Of the 15 SR/MAs collected:

• 6 concluded acupuncture is superior to drugs
• 4 concluded acupuncture is superior to sham acupuncture and drugs
• 3 concluded acupuncture is superior to sham acupuncture
• 1 concluded acupuncture is superior to drugs and other TCM treatments
• 1 concluded acupuncture is superior in treating migraines, but did not list a control group

Though the results were positive, the overview emphasized that the absence of classifying data regarding patients’ conditions may “affect the heterogeneity of results provided by SR/MAs and reduce the certainty of their studies.”

The researchers suggest future studies on the efficacy of acupuncture as a treatment for migraines utilize universally consistent terminology and quantifiers.

“The core reason of low methodological quality of SR/MAs may be that a large portion of researchers of SR/MAs in acupuncture for migraine may not receive standard evidence-based medical education,” the researchers wrote. This could lead to inconsistent results due to communication errors. Authors suggest an improvement in continuing education of TCM practitioners may strengthen the reliability of results.

Reference

Zhang X, Li X, Zhao C, et al. An overview of systematic reviews of randomized controlled trials on acupuncture treating migraine [published online October 29, 2019]. Pain Res Manag. doi: 10.1155/2019/5930627.