Dry Needling for the Treatment of Chronic Headaches

 

The prevalence of self-reported migraines and severe headaches in the US adult population is roughly 1 out of every 6 Americans and 1 in 5 women. In 2013, migraines were globally ranked as the 7th highest cause of disability. An article published in Therapeutic Advances in Chronic Disease states that many patients with chronic migraines also have medication overuse. This is defined as using a compound analgesic, opioid, triptan or ergot derivative at least 10 days per month due to migraine symptoms. The current best treatment offered for individuals suffering from chronic migraines is lifestyle modification, simple analgesics, and triptans. Other treatments, if the aforementioned are ineffective, include tricyclics, beta blockers, and anticonvulsant medication.

 

Dry needling, a form of western acupuncture performed by physical therapists, is a viable and effective option supported by literature in the treatment of chronic migraines and severe headaches. This treatment is under prescribed by practitioners and underutilized by patients. Dry needling is the process of inserting thin monofilament needles into muscles, tendons, joints, fascia, scar tissue, skin, and perineural tissue. The insertion and stimulation of needles creates local and systemic neuromuscular changes leading to pain reduction and tissue repair. Despite differing theoretical constructs or rationale for treatment, the methods and procedures of dry needling and acupuncture are quite similar. For this reason, research regarding acupuncture for the treatment of neuro-musculoskeletal conditions is used to support the use of dry needling for the same conditions. 

 

SUPPORTING EVIDENCE 

A study by Coeytaux et al. in 2005 looked at the effectiveness of medical management of headaches by a neurologist versus medical management by a neurologist plus acupuncture. The acupuncture group received 10 treatments over the course of 10 weeks. Up to 30 needles were used on each patient and were placed according to individual needs/symptoms. Daily pain improved in both groups. Significant improvement on the headache impact scale was seen in the group that received acupuncture. The patients that received acupuncture were 3.7 times more likely to report less suffering from headaches compared to the patients who did not receive acupuncture.

 

 

In 2002 Allias et al. studied 160 women with chronic migraines over the course of 6 months. One group received medical management with flunarizine, a common drug used to treat migraines. The other group received acupuncture. The drug treatment group received 10 mg of Flunarizine daily for the first 2 months and 20 days per month for the next 4 months. The acupuncture group received 1 treatment per week for the first 2 months and 1 treatment a month for the next 4 months.

Before I reveal the results of the study, recognize how the frequency of the drug treatment is significantly greater than the frequency of acupuncture treatment.

2-month follow up:

  • both groups reported decreased pain intensity
  • number of headaches was significantly less in the acupuncture group
  • symptomatic drug use was significantly less in the acupuncture group

 

4-month follow up:

  • pain intensity and symptomatic drug use were less in both groups 
  • number of headaches was significantly less in the acupuncture group

 

6-month follow up:

  • number of headaches and symptomatic drug use were less in both groups
  • pain intensity was significantly lower in the acupuncture group
  • treatment side effects were significantly lower in acupuncture group

 

At all 3 follow up periods, acupuncture out performed standard drug therapy for treating chronic migraine headaches.

 

 

In 2003 Vickers et al. studied the effects of “usual care” versus acupuncture for the treatment of chronic headaches in 401 patients. The study found that the patients who received acupuncture experienced 22 less days of headaches per year, reported a significant reduction in disability on the SF-36 outcome measure, reported 15% reduction in use of headache medication, and reported 34% reduction in daily headache score diary.

 

In a 2011 Cochrane review for the treatment of migraine headaches, including 4419 patients across 22 randomized control trials, it was concluded that acupuncture should be considered a treatment option.

 

In 2001, a Cochrane review of Cochrane reviews concluded that acupuncture is effective for treating migraines and tension type headaches.

 


If you experience chronic migraines or headaches, it may be time to expand your treatment options. To learn more about dry needling and how it can help relieve your headache symptoms, contact our team to speak with a qualified Doctor of Physical Therapy.   954-256-9052

 

Written by Hannah Sweitzer, DPT, OCS, Cert. DN

 

References

  1. Coeytaux RR, Kaufman JS, Kaptchuk TJ, Chen W, Miller WC, Callahan LF, Mann JD. A randomized, controlled trial of acupuncture for chronic daily headache. Headache. 2005 Oct;45(9):1113-23. doi: 10.1111/j.1526-4610.2005.00235.x. PMID: 16178942.
  2. Allais G, De Lorenzo C, Quirico PE, Airola G, Tolardo G, Mana O, Benedetto C. Acupuncture in the prophylactic treatment of migraine without aura: a comparison with flunarizine. Headache. 2002 Oct;42(9):855-61. doi: 10.1046/j.1526-4610.2002.02203.x. PMID: 12390610.
  3. Vickers AJ, Rees RW, Zollman CE, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ. 2004;328(7442):744. doi:10.1136/bmj.38029.421863.EB
  4. Burch R, Rizzoli P, Loder E. The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies. Headache. 2018 Apr;58(4):496-505. doi: 10.1111/head.13281. Epub 2018 Mar 12. PMID: 29527677.
  5. Steiner TJ, Stovner LJ, Birbeck GL. Migraine: the seventh disabler. J Headache Pain. 2013;14(1):1. Published 2013 Jan 10. doi:10.1186/1129-2377-14-1
  6. Weatherall MW. The diagnosis and treatment of chronic migraine. Ther Adv Chronic Dis. 2015;6(3):115-123. doi:10.1177/2040622315579627
  1. Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, Vickers A, White AR. Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews 2016, Issue 6. Art. No.: CD001218. DOI: 10.1002/14651858.CD001218.pub3.
  2. Lee MS, Ernst E. Acupuncture for pain: an overview of Cochrane reviews. Chin J Integr Med. 2011 Mar;17(3):187-9. doi: 10.1007/s11655-011-0665-7. Epub 2011 Feb 27. PMID: 21359919.

 

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