Acupuncture for recurrent headaches: a systematic review of randomized controlled trials

Objective: To assess whether there is evidence that acupuncture is effectiv e in the treatment of recurrent headaches. Design: Systematic review. Study selection: Randomized or quasi-randomized clinical trials comparing acupun cture with any type of control intervention for the treatment of recurrent headaches. Data sources: Electronic databases (Medline, Embase, Cochrane Fi eld for Complementary Medicine, Cochrane Controlled Trials Register), perso nal communications and bibliographies. Data collection and analysis: Inform ation on patients, interventions, methods, and results were extracted by at least two independent reviewers using a pretested form. A pooled estimate of the responder rate ratio (responder rate in treatment group/responder ra te in control group) was calculated as a crude indicator of trial results a s meta analysis of more specific outcome data was impossible due to heterog eneity and insufficient reporting. Results: Twenty-two trials, including a total of 1042 patients (median 36, range 10-150), met the inclusion criteri a. Fifteen trials were in migraine patients, six in tension-headache patien ts, and in one trial patients with various headaches were included. The maj ority of the 14 trials comparing true and sham acupuncture showed at least a trend in favor of true acupuncture. The pooled responder rate ratio was 1 .53 (95% confidence interval 1.11 to 2.11). The eight trials comparing acup uncture and other treatment forms had contradictory results. Conclusions: O verall, the existing evidence suggests that acupuncture has a role in the t reatment of recurrent headaches. However, the quality and amount of evidenc e is not fully convincing. There is urgent need for well-planned, large-sca le studies to assess effectiveness and efficiency of acupuncture under real life conditions.