Acupuncture for migraine headache

Migraines: Types and Symptoms

Migraines are a common type of headache characterised by intense, throbbing pain, typically on one side of the head. They can last from a few hours to several days and often come with symptoms like nausea, vomiting, and sensitivity to light and sound. Migraines can be classified into several types:

• Migraine without Aura: The most common form, without sensory disturbances before the headache.
• Migraine with Aura: Involves visual or sensory disturbances before the headache.
• Chronic Migraine: Occurs more than 15 days a month.
• Hemiplegic Migraine: Causes temporary paralysis or sensory changes on one side of the body.
• Retinal Migraine: Causes visual disturbances or loss in one eye. Diagnosing migraines in Australia typically involves consultations with a GP, maintaining a headache diary, and sometimes referrals to a neurologist, taking approximately 6-12 weeks.

Comparing Migraines with Other Headaches

Migraines differ significantly from other common types of headaches. Here are the main differences in symptoms between migraines and other common headaches:

• Migraine Symptoms:
  • Pain: Intense, throbbing pain, typically on one side of the head.
  • Duration: Can last from a few hours to several days.
  • Associated Symptoms: Nausea, vomiting, sensitivity to light and sound.

Differences from Tension Headaches:

• Pain Type: Tension headaches cause dull, aching pain.
• Location: Pain is on both sides of the head.
• Associated Symptoms: Lack of nausea and sensory sensitivity.

Differences from Cluster Headaches:

• Pain Type: Cluster headaches cause severe, piercing pain.
• Location: Pain is around one eye.
• Occurrence: Happen in clusters over weeks or months.
• Associated Symptoms: Often involve tearing and nasal congestion.

Differences from Sinus Headaches:

• Pain Type: Sinus headaches cause deep, constant pain.
• Location: Pain is in the forehead, cheekbones, or bridge of the nose.
• Associated Symptoms: Often linked to sinus infections, with nasal congestion and runny nose.

Common PBS Medications for Migraines

In Australia, several medications are commonly prescribed to treat migraines. These medications include:

• Acute Treatments:

  • Triptans: Sumatriptan, Rizatriptan (effective in relieving migraine symptoms).
  • NSAIDs: Ibuprofen, Naproxen (help reduce inflammation and pain).
  • Anti-emetics: Metoclopramide, Prochlorperazine (manage nausea associated with migraines).

• Preventive Treatments:

  • Beta-Blockers: Propranolol (used to prevent migraine attacks).
  • Anticonvulsants: Topiramate (helps reduce the frequency and severity of migraines).
  • CGRP Inhibitors: Erenumab, Fremanezumab (newer treatments that block the calcitonin gene-related peptide pathway involved in migraine).

Research Findings on Acupuncture for Migraine Treatment

There is a growing body of scientific literature suggesting that acupuncture may be effective for treating migraine headaches. Key findings include:

• Cochrane Review (Linde et al., 2016): Acupuncture can reduce the frequency of migraines and may be at least as effective as, or possibly more effective than, prophylactic drug treatment, with fewer adverse effects.
• Meta-Analysis (Vickers et al., 2012): Reviewed randomised controlled trials and found that acupuncture is effective for chronic pain, including migraines, and provides a safe alternative to conventional drug therapies.
• Review by Endres et al. (2007): This review suggests that acupuncture should be integrated into existing migraine therapy protocols (Endres, Diener, & Molsberger, 2007).
• Study by Diener et al. (2012): Published in “Headache,” this study showed that acupuncture effectively reduced the frequency and severity of migraines in a primary care setting, with sustained benefits over six months. Diener et al. also highlighted the benefits of a multidisciplinary approach to migraine management, integrating acupuncture with other treatments.

It is important to note that the findings are not entirely conclusive due to limitations such as sample size and other methodological considerations.

Headaches and Chinese Medicine

In Chinese Medicine diagnosis framework, headaches can be attributed to imbalances in the body’s organ systems. There are at least 11 different patterns of headache, each with its specific underlying cause and treatment approach. These imbalances can result from emotional stress, everyday wear and tear, sleep disturbances, dietary issues, or hormonal fluctuations. Specifically, we look at the five Zang (Yin) and six Fu (Yang) organs. The Zang organs include the Liver, Spleen, Kidney, Heart, and Lung, while the Fu organs consist of the Stomach, Small Intestine, Large Intestine, Gallbladder, Bladder, and San Jiao. Each organ’s imbalance can manifest as different headache patterns. Our treatment focuses on restoring balance and harmony within these systems to alleviate the headache and address the underlying cause. 

References

• Diener, H. C., Kronfeld, K., Boewing, G., Lungenhausen, M., Maier, C., Mueck-Weymann, M., … & Willich, S. N. (2012). Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomised controlled clinical trial. Headache: The Journal of Head and Face Pain, 52(5), 582-591. https://doi.org/10.1111/j.1526-4610.2012.02133.x
• Endres, H. G., Diener, H. C., & Molsberger, A. (2007). Role of acupuncture in the treatment of migraine. Expert Review of Neurotherapeutics, 7(9), 1121-1133. https://pubmed.ncbi.nlm.nih.gov/17868011/
• Linde, K., Allais, G., Brinkhaus, B., Manheimer, E., Vickers, A., White, A. R. (2016). Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews, (6). https://doi.org/10.1002/14651858.CD001218.pub3
• Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., MacPherson, H., Foster, N. E., … & Linde, K. (2012). Acupuncture for chronic pain: Individual patient data meta-analysis. JAMA Internal Medicine, 172(19), 1444-1453. https://doi.org/10.1001/archinternmed.2012.3654