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.