J Headache Pain. 2012 Feb 26;

Authors: Autret A, Valade D, Debiais S

Abstract
We present a theory according which a headache treatment acts through a specific biological effect (when it exists), a placebo effect linked to both expectancy and repetition of its administration (conditioning), and a non-specific psychological effect. The respective part of these components varies with the treatments and the clinical situations. During antiquity, suggestions and beliefs were the mainstays of headache treatment.

The word placebo appeared at the beginning of the eighteenth century. Controversies about its effect came from an excessive interpretation due to methodological bias, inadequate consideration of the variation of the measure (regression to the mean) and of the natural course of the disease. Several powerful studies on placebo effect showed that the nature of the treatment, the associated announce, the patients’ expectancy, and the repetition of the procedures are of paramount importance. The placebo expectancy is associated with an activation of pre-frontal, anterior cingular, accumbens, and periacqueducal grey opioidergic neurons possibly triggered by the dopaminergic meso-limbic system.

In randomized control trials, several arms design could theoretically give information concerning the respective part of the different component of the outcome and control the natural course of the disease. However, for migraine and tension type headache attacks treatment, no three arm (verum, placebo, and natural course) trial is available in the literature. Indirect evidence of a placebo effect in migraine attack treatment, comes from the high amplitude of the improvement observed in the placebo arms (28% of the patients). This figure is lower (6%) when using the harder criterium of pain free at 2 h. But these data disregard the effect of the natural course. For prophylactic treatment with oral medication, the trials performed in the last decades report an improvement in 21% of the patients in the placebo arms. However, in these studies the duration of administration was limited, the control of attacks uncertain as well as the evolution of the co-morbid psycho-pathology.

Considering the reviews and meta-analysis of complex prophylactic procedures, it must be concluded that their effect is mostly linked to a placebo and non-specific psychological effects. Acupuncture may have a slight specific effect on tension type headache, but not on migraine. Manual therapy studies do not exhibit difference between manipulation, mobilization, and controls; touch has no proven specific effect. A comprehensive efficacy review of biofeedback studies concludes to a small specific effect on tension type headache but not on migraine. A review of behavioral treatment conclude to an interesting mean improvement but did not demonstrated a specific effect with the exception of a four arm study including a pseudo meditation control group.

Expectation-linked placebo, conditioning, and non-specific psychological effects vary according clinical situations and psychological context; likely low in RCT, high after anempathic medical contact, and at its maximum with a desired charismatic healer. The announcements of doctors strongly influence the beliefs of patients, and in consequence their pain and anxiety sensibilities; this modulates the amplitude of the placebo and the non-specific psychological effects and is therefore a major determinant of the therapeutic success. Furthermore, any repetitive contact, even through a placebo, may interfere positively with the psychopathological co-morbidity. One has to keep in mind that the non-specific psychological interactions play a major role in the improvement of the majority of the headache sufferers.

PMID: 22367630 [PubMed - as supplied by publisher]

Using acupuncture to manage severe pain in horses and other animals is not a novel concept, but veterinarians have been hard at work lately combing research studies to better understand this complementary therapys usefulness, efficacy, and safety. During a presentation at the 2011 American Association of Equine Practitioners convention, held Nov. 18-22 in San Antonio, Texas, James Kenney, DVM, an equine practitioner from Clarksburg, N.J., presented an overview of acupuncture and equine pain.”According to the World Health Organization, the effectiveness of acupuncture has been established in controlled clinical trials in humans, and the use of acupuncture to control chronic pain is comparable with morphine without the risk of drug dependence and other adverse side effects,” Kenney explained.After an in-depth discussion of the physiologic mechanisms behind acupuncture and pain control, Kenney discussed clinical research on the use of acupuncture in animals.

via The Horse | Acupuncture and Managing Pain in Horses AAEP 2011.

At school, 8-year-old Alex Karaszi couldn’t focus his attention and sit still. Soon, his grades began to suffer. At home, he had mood swings and threw tantrums. “I was grumpy at night,” the second-grader explained. The family doctor diagnosed mild to moderate attention deficit hyperactivity disorder and prescribed medication. Beata Karaszi, Alex’s mother, was reluctant, but went ahead at the urging of her husband and the boy’s teachers. She stopped it after a week. “He got horrible nightmares, became very sensitive, very emotional. It was horrible,” she said. Then she read about another option: acupuncture.

Acupuncture has been an integral part of Chinese medicine for more than 2,000 years. It is based on the theory that the body’s energy, called Qi (pronounced chee), flows freely when you are well, but can become blocked or weak. Inserting hair-thin needles into the skin at specific treatment points on the body can restore a healthy energy flow, practitioners say.

Read more via Parents say acupuncture has alleviated boy’s ADHD – Tampa Bay Times.

The latest issue of the journal Medical Acupuncture reveals that the United States Armed Forces is incorporating acupuncture, one of the oldest healing practices in the world, to assist in the medical care of its personnel.

First recorded in the Yellow Emperor’s Inner Canon (黄帝内经), an ancient Chinese medical text written more than two millennia ago, acupuncture is a traditional Chinese method of encouraging the body to promote natural healing and to improve functioning by inserting needles and applying heat or electrical stimulation at very precise acupuncture points.

Before the 1990s, the U.S. military hardly used acupuncture in its treatment of military personnel. In 2001, however, Dr. Richard C. Niemtzow, Editor-in-Chief of Medical Acupuncture and Director of the USAF Acupuncture Center in Maryland, developed an acupuncture technique designed for military use.

Battlefield acupuncture (BFA), as it is called, …

Read more via Use Of Acupuncture By The U.S. Military To Treat Battlefield Injuries, PTSD.

Traditional Chinese medicine has long been used to ease pain and treat disease.

Now researchers have found it can also boost fertility if used in combination with fertility treatments.

A team led by Dr Shahar Levi-Ari from Tel Aviv University compared the success rates of couples using intrauterine insemination (IUI) both with and without Chinese herbal and acupuncture therapies.

IUI involves a laboratory procedure to separate fast moving sperm from more sluggish sperm.

The fast moving sperm are then placed into the woman’s womb close to the time of ovulation when the egg is released from the ovary in the middle of the monthly cycle.

The results, which have been published in the Journal of Integrative Medicine, show a significant increase in fertility when the therapies are administered side-by-side.

Read more via Traditional Chinese medicine ‘makes fertility treatments more effective’ | Mail Online.

The addition of acupuncture to best medical care for chemotherapy-induced peripheral neuropathy (CIPN) may have a positive effect, according to a pilot study published online Dec. 5 in Acupuncture in Medicine.

Sven Schroeder, Ph.D., from the HanseMerkur Centre for Traditional Chinese Medicine at the University Medical Center in Hamburg, Germany, and colleagues evaluated the therapeutic effect of acupuncture on CIPN by measuring the changes in nerve conduction studies. Six patients were treated with acupuncture for 10 weeks, along with best medical care, and five patients were given best medical care with no specific treatment for CIPN (control group).

The investigators found an improvement in the nerve conduction study after treatment in five of the six patients treated with acupuncture. In the control group, one patient showed improvement, one showed impairment, and three showed no difference in the nerve conduction study.

“The data suggest that acupuncture has a positive effect on CIPN as measured by objective parameters nerve conduction study,” the authors write. “This pilot study shows encouraging results for the application of acupuncture in CIPN, justifying a randomized controlled trial.

Read more via Acupuncture May Help Chemo-Induced Peripheral Neuropathy –Doctors Lounge.

An ancient therapy could prove effective at relieving a common side effect of cancer treatment, a small, new study shows.

Acupuncture was able to reduce dry mouth in people who were receiving radiation therapy to treat their head and neck cancers, reported researchers from the University of Texas MD Anderson Cancer Center and the Fudan University Shanghai Cancer Center.

Dry mouth, also known as xerostomia, occurs when there is not enough saliva in the mouth.

Read more via Acupuncture Treats Dry Mouth In Cancer Patients, Study Shows.

Acupuncture helps reduce days with migraines and may have lasting effects, according to a new study published in the Canadian Medical Association Journal.

In the study, almost 500 adults were treated with either traditional Chinese acupuncture or a sham treatment in which acupuncture needles were inserted in nonspecific points. The acupuncture treatment points were previously used to study migraine. Participants did not know which type of acupuncture treatment they were receiving during the four-week study.

Read more via Acupuncture May Be Effective for Migraines.