Welcome to my blog, discover acupuncture with Dr Maggie Ju

Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Thursday, 21 July 2022

How to get rid of your migraines?

Migraine is a very painful headache. Migraines is characterized by recurrent episodes of severe headaches that are often unilateral and are often accompanied by symptoms of autonomic nervous system dysfunction, such as nausea, vomiting, photophobia, and phonophobia. It is recurrent and it affects sufferer’s quality of life. It occurs in more than 10% of the world's population, afflicting more women than men by a ratio 3:1, and inflicts significant personal and socioeconomic costs. A WHO survey showed that migraine was ranked as the seventh highest cause of disability in the world, accounting for 2.9% of all years of life lost to disability.

Migraine is featured as moderate or severe pulsating pain only on one side of the head which is deliberated by physical activity. It is recurring headache with duration 4-72 hours. It could accompany other symptoms including nausea, vomiting and increased sensitivity to light or noise. The diagnosis is based on clinical history and exclusion of other kind of headache, because there is no specific test for migraine. The cause of migraine is not fully understood. The current accepted theory of migraine is that the brain chemical called serotonin level is changing; this leads to blood vessels in brain contracting and then dilating, as a result, it causes symptoms of migraine. Migraine attach could be triggered by many factors, such as stress, tension, depression, not sleep well, tiredness, poor posture, neck or shoulder tension, hunger, caffeine products (coffee, tea), bright light, loud noise etc. Apart from headache, there could be other symptoms present, such as nausea, vomiting, fatigue, dizziness, blurred vision etc. Pain killers and anti-inflammatory drugs are mainly used to treat migraine attacks. Beta-blockers (e.g., propranolol, originally developed to treat high blood pressure), anti-seizure drugs (e.g., topiramate), or tricyclic antidepressants (e.g., amitriptyline), in combination with behavioral therapy or lifestyle adjustments are used to prevent migraine attack. Mauskop A from New York Headache Center USA summarised therapies proven (to various degrees) to be effective for migraine. These include aerobic exercise; other forms of relaxation training; dognitive therapies; acupuncture; and supplementation with magnesium, CoQ10, riboflavin, butterbur, feverfew and cyanocobalamin with folate and pyridoxine.

The migraines management is still challenging due to ineffectiveness of medication and side effects of drugs. People turn to complementary and alternative methods to help.

Acupuncture reduces migraine effectively

Recent research showed that acupuncture has effect to treat migraine. For example, Wang et al studied the effect of acupuncture in patients with migraine. This was a randomized controlled trial involving in 150 patients with migraine. They found that acupuncture has significantly better effect in relieving pain and reducing acute migraine attack than sham acupuncture. They also conducted another trial in 140 patients in 5 hospitals in China. They compared the effect of acupuncture with that of flunarizine, a drug used for migraine treatment. They found that acupuncture is more efficient in decreasing days of migraine attacks than flunarizine; acupuncture has similar effect as flunarizine in reducing pain and improving patient’s quality of life.

Another recent research studied the effectiveness of acupuncture for migraine. In this study 91 patients aged from 18-70 with a history of migraine for at least 12 months and a mimimum 4 days migraine per 4 weeks attending the neurology outpatient clinic at the University Hospital Hradec Kralove.

The treatment period is 12 weeks with 14 acupuncture treatments: twice a week in the first 4 weeks, once a week during weeks 5–8 and once every 14 days during the last month.

The result has shown that after 12 weeks of acupuncture treatments and 6 months follow-up the number of migraine days was reduced significantly more compared with control group. The number of responders to the treatment was also greater in acupuncture group. The intake of medication was reduced significantly in acupuncture group at the end of the treatment and 6 month follow-up.

Could you respond to acupuncture with your migraines?

Acupuncture is used to treat migaraines and achieved good effects, but not everyone responds to the treatment. Why is that? A study solved this mystery.

Forty-one patients with migraines were recruited and offered 4 weeks of acupuncture treatment and two brain imaging sessions at the Beijing Traditional Chinese Medicine Hospital affiliated with Capital Medical University. Patients were asked to keep a headache diary for 4 weeks before treatment and during acupuncture treatment. Those with at least a 50% reduction in the number of migraine days were defined as responders.

Results showed that after 4 weeks of acupuncture, 19 patients were responded to acupuncture treatments. 10 brain areas changed to the treatments include the frontal, temporal, parietal, precuneus, and cuneus gyri. The reduction in the number of migraine days was correlated with baseline brain gray matter volume in the cuneus, parietal, and frontal gyri in all patients. Moreover, the left cuneus showed a longitudinal increase in GM volume in responders. The results suggest that pre-treatment brain structure could be a novel predictor of the outcome of acupuncture in the treatment of migraines. Imaging features could be a useful tool for the prediction of acupuncture efficacy, which would enable the development of a personalized medicine strategy.

New research confirmed that acupuncture is effective for migraines

Acupuncture is effectively used to treat migraines. There is a new research adding more data to this subject. In this study, 147 patients with episodic migraine without aura completed the study. 20 sessions of acupuncture were offered over 8 weeks. Result has shown that there is a significantly greater reduction in migraine days at weeks 13 to 20 and a significantly greater reduction in migraine attacks at weeks 17 to 20 in acupuncture group compared to the control group. Their result support to use acupuncture to treat migraines in the future.

Acupuncture is as good as conventional medication for migraines.

Popularity of acupuncture is increasing for variety of conditions. Acupuncture is an alternative treatment to conventional prophylactic drug treatment used to reduce the frequency, duration, and intensity of migraine attacks. A review verified the efficacy of conventional migraine drugs and compared it with acupuncture. They found high-quality evidence suggesting that prophylactic drug treatment, at the treatment dosage ranges used in Linde et al.'s 2016 review, reduced headache frequency at a 3-month follow-up, compared to placebo. Acupuncture also reduced headache frequency at a 3-month follow-up. The efficacy is equivalent to the medication.

Acupuncture has better effect than medication for migraines

Migraine is very common type of headaches and acupuncture is very effective for it. This review summarized current data with high quality trials. They found high quality of evidence indicating that the effective rate of acupuncture was superior to western medicine in treatment of migraine. acupuncture reduced more headache days and the times of using painkiller and was more effective in reducing the frequency and degree of headache than western medicine.

Propranolol is recommended for preventing migraine attacks and acupuncture can be used to treat migraines effectively. A new study compared acupuncture or propranolol with sham acupuncture, placebo, waiting-list control or usual care. The analysis showed that acupuncture had a significant advantage over propranolol in reducing migraine episodes over a 4-week period. Acupuncture also had a significant advantage over waiting-list control in decreasing migraine frequency. Acupuncture caused fewer adverse events than propranolol.

A review analyzed recent studies of acupuncture on migraines. There were 62 studies involved 4,947 participants. The treatment duration varied from 1 month to 6 months. Result has shown that Acupuncture was more effective for short-term treatment compared with no treatment. Compared with medication, manual acupuncture resulted in better efficacy or safety, especially at follow-up times of up to 3 months after treatment.

Acupuncture reduces head and neck myofascial pain.

Persistent head and neck myofascial pain is among the most common pain complaints. Acupuncture is one of the least invasive and effective methods to release the pain. A recent review provided the evidence for the effectiveness of acupuncture in the management of localized persistent myofascial head and neck pain. This review analysed six randomized controlled clinical trials (RCTs). All included studies reported reduction in pain intensity scores in the groups receiving acupuncture when compared to sham needling/no intervention. They suggest that acupuncture may be an effective and safe method in relieving persistent head and neck myofascial pain.

Acupuncture reduces migraines and associated depression and anxiety

Migraine is a common condition affecting about 1/10 of the human population, with an especially dominant prevalence in females, students, and urban residents. Depression and anxiety are the most frequent psychiatric disorders associated with migraine.

Acupuncture was shown to be an effective therapy for reducing pain severity in acute migraine attack or prevention of frequent and chronic migraine. A study assessed the effectiveness of acupuncture on reducing migraine medical cost and risk of depression and anxiety development in Taiwan using the NHIRD information.

In this study all patients diagnosed with migraine were from January 1, 2000 to December 31, 2012. The 1:1 propensity score method by sex, age, income, urbanization, occupation, baseline comorbidities, conventional medicine used, and diagnosis year of migraine and index year was used to match an equal number of patients in both cohorts. 1,948 patients were selected in the acupuncture group and non-acupuncture group separately.

Result has shown that acupuncture may reduce the frequency and severity of a migraine attack and bring rapid, safe, effective pain relief, and patients with migraine could reduce medication usage. Acupuncture users had significantly lower total medical expenditures compared with non-users within a year.

The mean follow-up periods for depression were 5.50 and 4.03 years for the acupuncture group and non-acupuncture group, respectively. The mean follow-up periods for anxiety were 4.78 and 2.60 years for the acupuncture group and non-acupuncture group, respectively. The conclusion is that migraine patients receiving acupuncture treatment were less likely to develop both depression and anxiety compared to those not receiving acupuncture treatment during the 13-year follow-up period.
Acupuncture is for migraine prevention
Acupuncture is used for migraine prevention. The effectiveness has been reviewed recently. Twenty-two trials including 4985 participants were analysed. Migraine frequency (migraine days, attacks or headache days if migraine days not measured/reported) was measured before and after treatment and at follow-up. The response (at least 50% frequency reduction) was also measured. Comparison with no acupuncture, acupuncture was associated with a moderate reduction of headache frequency over no acupuncture after treatment. After treatment headache frequency at least halved was found in 41% of participants receiving acupuncture comparing to 17% with no acupuncture. There is one trial with post-treatment follow-up found a small but significant benefit 12 months after treatment. Comparison with prophylactic drug treatment, acupuncture reduced migraine frequency significantly more than drug prophylaxis after treatment. Trial participants receiving acupuncture were less likely to drop out due to adverse effects than participants receiving prophylactic drugs. The conclusion from this study is that the available evidence suggests that adding acupuncture to symptomatic treatment of attacks reduces the frequency of headaches. The available trials also suggest that acupuncture may be at least similarly effective as treatment with prophylactic drugs. Acupuncture can be considered a treatment option for patients willing to undergo this treatment.

Acupuncture is effective for the treatment or prevention of migraine, tension-type headache

Recently a study summarizes the current evidence that evaluates the effectiveness of acupuncture for the treatment or prevention of migraine, tension-type headache, and chronic headache disorders. It demonstrate that acupuncture is associated with improved clinical outcomes compared to routine care only, medical management, and sham acupuncture 2 months after randomization. Cost effectiveness analyses conducted in the United Kingdom and Germany suggested that acupuncture is a cost-effective treatment option in those countries.

How can acupuncture help in the treatment of migraines?

According to the Migraine Trust, migraine is the third most common disease in the world, affecting about one in seven people. A chronic migraine affects approximately 2% of the world population and three times as many women as men get migraines. Research suggests that there are more than 190,000 migraine attacks every day in the UK. There is a large body of evidence to suggest that acupuncture is effective in the treatment of a migraine.Research supports acupuncture for a migraine. A review involved 4,985 participants in 25 randomised controlled trials, found that adding acupuncture to symptomatic treatment of attacks reduces the frequency of headaches. It also showed that the available trials also suggested that acupuncture may be at least similarly effective as treatment with prophylactic drugs. Acupuncture can be considered an option for patients willing to undergo this treatment, the review concluded. NICE recommends acupuncture for a migraine. 10 sessions acupuncture could be offered for migraine prevention. Acupuncture is considered very safe treatment, well, of course, for well trained acupuncturists.

It became commonly knowledge that acupuncture stimulates body releasing endogenous pain relief substances such as beta-endorphin. Recent research has shown that acupuncture can change response of the blood vessels in the brain. In migraine patients, their artery blood flow in the brain is increased excessively during migraine attack. After acupuncture treatments, the artery blood flow in the brain became normal. The reduction of blood flow reflexes the intensity of the headache.

7 reasons why acupuncture is good for a migraine based on the research

It provides pain relief – by stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurohumoral factors and changes the processing of pain in the brain and spinal cord (Zhao 2008, Pomeranz, 2001)

It reduces inflammation- increasingly there is evidence that inflammation is associated with a migraine. Acupuncture promotes the release of vascular and immunomodulatory factors that can counter this (Kim, 2008; Kavoussi, 2007; Zijlstra, 2003).

It reduces the degree of cortical spreading depression – This is an electrical wave in the brain associated with a migraine. (Shi, 2010).

It reduces plasma levels of calcitonin gene-related peptide and substance – These are pain-signaling neuropeptides that may be implicated in the pathophysiology of a migraine. (Shi, 2010).

It modulates extracranial and intracranial blood flow – changes in cranial blood flow don’t necessarily initiate migraine pain but may contribute to it. (Park, 2009)

It affects serotonin levels in the brain – serotonin may be linked both to the initiation of migraines and to the relief of acute attacks (through triptans, drugs that promote seretonin levels). (Zhong, 2007)

It increases local microcirculation – This aids the dispersal of swelling. (Komori, 2009)



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