Acupuncture in headache: A critical review

Twenty-seven clinical trials that evaluated the efficacy of acupuncture in the treatment of primary headaches (migraine headache, tension-type headach e, and mixed forms) were reviewed. In the majority of the trials (23 of the 27 trials), it was concluded that acupuncture offers benefits in the treat ment of headaches. Conversely, the evaluation of physical forms of treatmen t, including acupuncture, has special difficulties, and certain parameters in the study design need consideration. Acupuncture methods need individual ization, a carefully selected placebo ("minimal acupuncture" seems to be be st), and the crossover design must have adequate time between the two treat ment periods. Clinical trials that evaluate acupuncture frequently are char acterized by several inadequacies (including some from these evaluating hea daches), but it seems that additional clinical research is necessary to con firm its efficacy and to clarify its indications.