Traditional and Evidence-Based Acupuncture in Headache Management: Theory, Mechanism, and Practice

Chong-hao Zhao, MD, PhD, DABMA; Mark J. Stillman, MD; Todd D. Rozen, MD

Disclosures

Headache. 2005;45(6):716-730. 

In This Article

Abstract and Introduction

Acupuncture, traditional Chinese needle therapy, has become widely used for the relief of headache. The history of the practice of acupuncture in the United States and the theoretical framework for acupuncture in Chinese medicine are reviewed. The basic scientific background and clinical application of acupuncture in the headache management are discussed.

About one million of American patients receive alternative medicine treatment, an estimated 10 millions visits each year.[1] In response to this growth, many US medical schools have created alternative medicine curricula and begun to form academic departments of alternative medicine.[2]

Acupuncture, probably the most celebrated example of alternative medicine, is an important therapy in China, Japan, and Korea. In recent years, with the growth of interest in alternative medicine, acupuncture has become more popular in the United States as a treatment option. Despite the fact that more scientific studies are needed to confirm the efficacy of acupuncture, the National Institutes of Health Consensus Development Panel (NIHCDP) issued a report in November 1997 stating "acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program."[3] This statement will be discussed below.

There are an estimated 10 000 acupuncturists in the United States, including approximately 3000 physician acupuncturists.[1] The practice of acupuncture is regulated by individual states,[2] whose medical boards disseminate clear guidelines for education and certification of physicians. For those licensed physicians who are interested in obtaining board certification as DABMA (Diplomate, American Board of Medical Acupuncture), the American Academy of Medical Acupuncture requires 200 hours of didactic and clinical training as a prerequisite for taking the board exam. Both passing the board exam and clinical experience of at least 500 medical acupuncture treatments are required for the application of diplomat status in the American Board of Medical Acupuncture.[4] Nonphysicians can be trained in acupuncture in 16 schools accredited by the US Government to give 4-year courses in acupuncture or oriental medicine.[2]

To western thinking, it is difficult to understand how acupuncture relieves headache by placing needles in the scalp and neck, or, by treating points in the hands and feet. This essay briefly reviews the historical and theoretical framework for acupuncture, the scientific evidence for its mechanism, efficacy in headache relief, safety profile, and potential difficulty in the clinical acupuncture research.

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