Re: Electroacupuncture Helpful for Tension-Type Headache

May 4, 2004

In a message dated 5/4/2004 19:14:02 PM Pacific Daylight Time, mike@...

writes:

they are able to measure and quantify their results

**************

Hey, you never know ... maybe it will move into mainstream!

Well, some time anyway.

Debbi

May 4, 2004

In a message dated 5/4/2004 19:14:02 PM Pacific Daylight Time, mike@...

writes:

they are able to measure and quantify their results

**************

Hey, you never know ... maybe it will move into mainstream!

Well, some time anyway.

Debbi

May 4, 2004

It is encouraging to see more and more studies come out like this in

mainstream medicine. By doing the studies with the electroapuncture

unit they are able to measure and quantify their results. Much

easier to do it this way than with individuals doing self-

acupressure.

At least it is another " scientific " validation in the mainstream.

May 4, 2004

It is encouraging to see more and more studies come out like this in

mainstream medicine. By doing the studies with the electroapuncture

unit they are able to measure and quantify their results. Much

easier to do it this way than with individuals doing self-

acupressure.

At least it is another " scientific " validation in the mainstream.

May 5, 2004

I've used electroacupuncture for headaches for just over 2 years. It

also can work for sinus headaches amoung other things.

I use the Stimplus that was discussed a couple weeks ago on the board.

I find that it works sometimes and sometimes it doesn't. It appears

to works only if you I relax enough of the muscles before they start

to contract again. I find I'm often just chasing the muscles around

in a vicous circle. So if you can catch it at the begining there is

a better chance of eliminating the headache. However, I haven't

documented any of this. Also, I think sometimes the tension headache

has a source that I'm not addressing with the acupuncture points I

choose - so then of course it doesn't work either.

I really need to do more investigation (and documentation) into this

area -

I find it very interesting that the western medical community is

finally catching up with the alternative community - this is old news

there. I'm very glad that so many people are being more open minded

and checking out various things. Not that I think all alternative

treatments are great - many are shams - but a lot of them are more

useful than conventional western medicine. " Mainstream " is a-

changing!

> http://www.medscape.com/viewarticle/474713?src=mp

>

> News Author: Laurie Barclay, MD

> CME Author: Vega, MD, FAAFP

> Authors and http://www.medscape.com/viewarticle/474713_author>

Disclosures

>

> To earn CME credit, read the news brief, the paragraphs that

follow, and

> answer the questions below.

>

> Release Date: April 29, 2004; Valid for credit through April 29,

2005

>

> Credits Available

>

> Physicians - up to 0.25 AMA PRA category 1 credit(s)

>

> April 29, 2004 — Electroacupuncture to distal points alone is

effective for

> the treatment of tension-type headache (TTH), according to the

results of a

> randomized trial published in the April issue of Headache.

>

> " Electroacupuncture is commonly used for tension-type headache, but

when

> applied to distal acupoints only, evidence of its efficacy [has

been]

> lacking, " write Charlie Changli Xue, PhD, from RMIT University in

Bundoora,

> , Australia, and colleagues. " To the best of our knowledge,

the

> current study is the first of its kind using distal acupoints only

for

> treating TTH. "

>

> This single-blinded, sham-controlled, crossover trial had five

stages:

> baseline for two weeks; phases I and II, each four weeks; washout

period for

> two weeks; and follow-up for three months after phase II. Of 40

patients

> randomized to receive real electroacupuncture during phase I, then

sham

> electroacupuncture in phase II, or to receiving the treatments in

reverse

> order, 37 patients completed the trial. Both groups were similar at

> baseline.

>

> After phase I, the group receiving real electroacupuncture had

significant

> improvements in mean headache frequency (3.0 ± 0.3 per month vs.

12.0 ± 1.7

> per month, duration, 13.3 ± 3.5 hours vs. 32.0 ± 6.2 hours), pain

intensity

> using a visual analog scale (32.8 ± 4.1 mm vs. 47.5 ± 2.7 mm),

mechanical

> pain threshold, headache disability score (6.0 ± 1.0 vs. 16.3 ±

1.6), and

> sickness impact score (288.7 ± 48.0 vs. 687.1 ± 77.2).

>

> For each parameter, both groups also had significant differences

between

> baseline and phase II, and between baseline and follow-up. At the

end of

> follow-up, there were no significant differences between groups.

>

> Study limitations include possibly insufficient length of washout,

because

> there was no regression to baseline during the washout period.

>

> " Electroacupuncture to distal points alone is effective for short-

term

> symptomatic relief of tension-type headache, " the authors

write. " The

> treatment is relatively safe, as no side effects were reported

throughout

> the study. "

>

> The authors recommend additional research on the long-term effect

of distal

> acupuncture by repeated measurements during follow-up, and on the

methods

> employed for acupoint selection.

>

> Headache. 2004;44(4):333-341

>

> Learning Objectives

>

> Upon completion of this activity, participants will be able to:

>

> * List treatments available for tension headache.

> * Describe the efficacy of electroacupuncture in the management

of

> tension headache.

>

> Clinical Context

>

> Tension headache is a common condition that can be difficult to

treat.

> According to the authors of the current study, first-line

medications such

> as aspirin and ibuprofen may be effective but can have deleterious

effects

> on the gastric mucosa. Other treatments, including biofeedback-

assisted

> relaxation and cognitive therapy, have fewer adverse effects but

can require

> considerable time and expense.

>

> Acupuncture has a mixed record in treating tension headache. In a

study of

> 69 patients diagnosed with tension headache, Karst and colleagues

noted no

> difference in frequency or severity of headaches between groups

treated with

> either acupuncture or sham acupuncture. The results of their study,

> published in the July 2001 issue of Cephalalgia, also showed that

> quality-of-life scores improved somewhat in the acupuncture group

compared

> with placebo.

>

> The Karst study used needles producing pressure without breaking

the skin as

> their placebo treatment. The current study used misplaced needles

and lower

> levels of electric current to create a placebo treatment and

compare it with

> standard electroacupuncture.

>

> Study Highlights

>

> * Study subjects were recruited to a research clinic in

Australia. All

> participants fulfilled the International Headache Society criteria

for

> episodic or chronic tension headache. Those with a history of

migraine

> headache, hypertension, eye problems related to headache, or

pregnancy were

> excluded from participation.

> * A 2-week evaluation was performed at baseline to judge

headache

> intensity, frequency, and duration. A mechanical pain threshold was

also

> conducted, as were measures of the headaches' impact on quality of

life. All

> of these values constituted the main outcomes of the trial.

> * The study was conducted as a double-crossover trial. One

group of

> participants underwent active treatment twice a week for 4 weeks,

while

> another received placebo treatment. After a 2-week washout period,

the 2

> groups switched treatments for another 4 weeks.

> * Both real and sham electroacupuncture were applied only to

distal

> sites on the upper and lower limbs. Continuous electrical

stimulation, with

> frequencies ranging from 2 to 100 Hz and 0.2 to 1.5 volts, was

applied in

> the active treatment group at every other visit to prevent

tolerance to the

> therapy. In the sham treatment group, needles were applied 5 to 10

mm away

> from the correct insertion point, and lower levels of current were

applied.

> * Outcomes were measured at baseline, after both treatment

periods,

> and at 3 months after treatment.

> * 40 patients entered the study, and 3 left the trial. Baseline

data

> from both treatment groups were similar. The average age of study

subjects

> was 42 years. There were nearly twice as many women as men in the

study

> cohort, and the mean frequency of headaches was 12.9 per month.

There were

> no data available on the mean or total amount of current applied

between the

> 2 groups.

> * After the first treatment phase, electroacupuncture produced

an

> 88.3% reduction in headache frequency compared with a 4% reduction

for sham

> treatment. After crossover of treatment, both groups had similarly

reduced

> frequencies of headache. At 3 months, both groups had reduced

headache

> frequency compared with baseline, but headache incidence had

increased since

> the last treatment.

> * Duration of headache was also improved with electroacupuncture

> compared with sham treatment and also was reduced by up to 86.1%

compared

> with baseline values. Again, at 3 months after treatment, both

groups

> experienced trends approaching their baseline values for headache

duration.

> * Headache intensity also improved with active treatment over

placebo,

> with scores again worsening 3 months after therapy compared with

scores

> immediately following the treatment periods.

> * The mechanical pain threshold was significantly improved in

the

> first group to undergo electroacupuncture compared with the placebo

group

> after both treatment periods.

> * Quality-of-life scores were also improved with active

treatment

> compared with placebo after the first phase of treatment.

Improvement was

> similar between the 2 groups after both treatment periods. Quality-

of-life

> scores appeared to be approaching baseline values at the 3-month

follow-up

> visit.

>

> Pearls for Practice

>

> * Several treatment options are available for tension

headaches.

> * Electroacupuncture is an effective means to manage tension

headaches

> for at least two months. However, it does not appear to produce a

lasting

> salutary effect if stopped following this treatment period.

>

> Love Lana 0 :-)

>

May 5, 2004