title: Acupuncture for the management of chronic headache: a systematic review.
abstract: OBJECTIVE
  The objective of this review was to evaluate the efficacy of acupuncture for treatment of chronic headache.
  
  
  METHODS
  We searched the databases of Medline (1966-2007), CINAHL, The Cochrane Central Register of Controlled Trials (2006), and Scopus for randomized controlled trials investigating the use of acupuncture for chronic headache. Studies were included in which adults with chronic headache, including migraine, tension-type headache or both, were randomized to receive needling acupuncture treatment or control consisting of sham acupuncture, medication therapy, and other nonpharmacological treatments. We extracted the data on headache intensity, headache frequency, and response rate assessed at early and late follow-up periods.
  
  
  RESULTS
  Thirty-one studies were included in this review. The majority of included trials comparing true acupuncture and sham acupuncture showed a trend in favor of acupuncture. The combined response rate in the acupuncture group was significantly higher compared with sham acupuncture either at the early follow-up period (risk ratio [RR]: 1.19, 95% confidence interval [CI]: 1.08, 1.30) or late follow-up period (RR: 1.22, 95% CI: 1.04, 1.43). Combined data also showed acupuncture was superior to medication therapy for headache intensity (weighted mean difference: -8.54 mm, 95% CI: -15.52, -1.57), headache frequency (standard mean difference: -0.70, 95% CI: -1.38, -0.02), physical function (weighted mean difference: 4.16, 95% CI: 1.33, 6.98), and response rate (RR: 1.49, 95% CI: 1.02, 2.17).
  
  
  CONCLUSIONS
  Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate.
authors.affiliation: Duke University Medical Center, Department of Anesthesiology, Box 3094, Durham, NC 27710, USA.
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Sun
authors.forename: Tong J
authors.initials: TJ
authors.lastname: Gan
mesh_terms: D015667:Acupuncture Analgesia / Q000009:adverse effects; D020773:Headache Disorders / Q000628:therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic