RxPG News : Headache

Treating chronic migraine with Botox

Tue, 30 Aug 2011 11:44:46 PST

( from http://www.rxpgnews.com ) The anti-ageing drug Botox was until now an answer to your beauty concerns, but now the treatment can also benefit sufferers of chronic migraine, a neurological disorder characterised by severe headaches, say experts.

Chronic migraine can leave sufferers in pain for at least half of every month. The World Health Organization - ranks migraine as the 19th most disabling disease and notes that a day lived with severe migraine can be more disabling than blindness, paraplegia, angina or rheumatoid arthritis. Although these debilitating headaches occur in both men and women, women are believed to be three times more likely than men to suffer from migraines.

Patients of migraine often experience anxiety and depression along with the headaches. Stress, dietary, sleeping and other inappropriate lifestyle habits are known to influence the state of chronic migraine sufferers. Now studies and clinical trials have revealed that when injected in labelled doses and in the recommended locations in the head and neck, Botox is expected to produce results lasting up to three months depending on the individual patient.

'Since using Botox for chronic migraines is a relatively new treatment on the block, many people are still not aware of it and most do not understand it well, but the response that I have received from my patients has been very good. This will surely pick up in years to come,' Sumit Singh, senior consultant, headache & movement disorder, Medanta - The Medicity, Gurgaon, told IANS on the phone.

'Botox treatment is just evolving in our country. At this moment, there is not enough data on the number of patients being treated with it for their condition. However, it surely seems to be catching up and is well-received by our patients. The treatment will become popular in coming years,' echoed Rajashekar Reddi, senior consultant neurologist, Max Hospitals, New Delhi.

For the treatment of chronic migraine, measured doses of Botox are injected at 29-32 sites in a patient. These sites include six-seven on the forehead, eight on the temples and six each on the back of the head, the neck and the shoulders. It takes 10-15 minutes to administer the dosage. Besides, two additional sites - the temples or the back of the head on each side - can also be injected, depending upon whether extreme pain is felt by the patient at these sites.

Although there aren't any major side effects of the treatment, patients may feel slight pain around the injected areas.

'When the drug is injected by an expert, the chances of any side-effects are negligible. Usually, there occurs slight pain and bruising at the site of injection,' said Charulata Sankhla, senior consultant, neurology, Hinduja Hospital, Mumbai.

'There are mild and transient side-effects such as drooping of eyelids that is observed when the wrong or an overenthusiastic dose of Botox is administered to the patient,' added Reddi.

Although the treatment lasts for up to three months, it doesn't come very cheap. Including the procedural fee and the drug costs, the price of this treatment is about Rs.25,000.

The treatment is already making its mark in big cities like Mumbai, Bangalore, Delhi and Kolkata but is yet to find a following in the smaller ones.

'It is available in all the bigger medical centres/hospitals in major cities, including the metros. Patients in Tier-2 cities are yet to be sensitised about this treatment as it is not available there,' revealed Reddi.

The treatment is suitable for chronic migraine sufferers in the 18-80 years age group.

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Genes linked to migraine discovered - TRPM8, LRP1 and PRDM16

Mon, 13 Jun 2011 01:10:13 PST

( from http://www.rxpgnews.com ) US scientists have discovered three gene variants linked to migraine, a move that could help understand the cause of severe headaches.

Inheriting any one of the three gene variants raises risk of severe headaches by 10 to 15 percent, the researchers said in a study published online by the journal Nature Genetics.

The three genes are TRPM8, LRP1 and PRDM16. The first plays a role in sensitivity to cold and pain, while the second is involved in the transmission of signals between neurons, Xinhua reported quoting the study Sunday.

'While migraine remains incompletely understood and its underlying causes difficult to pin down, identifying these three genetic variants helps shed light on the biological roots for this common and debilitating condition,' said lead author of the study, Daniel Chasman, assistant professor in the preventive medicine division at Brigham and Women's Hospital and Harvard Medical School.

The researchers based their findings on analysis of genetic data from more than 23,000 women, including over 5,000 migraine sufferers.

Although the researchers said the findings are encouraging, they noted that more research is needed to better understand exactly how each of these genes is associated with migraine.

Migraine headache, an abnormality in the response of nerve cells to stimuli, is characterized by recurring severe headaches, which often result in nausea as well as sensitivity to light and sound.

Repeated migraines and headaches do not increase the risk of cognitive decline

Wed, 19 Jan 2011 17:22:03 PST

( from http://www.rxpgnews.com ) Previous work, in particular the CAMERA study, has used MRI to study the brains of migraine sufferers and has shown that a higher proportion of these patients exhibit lesions of the brain microvessels than the rest of the population.

Lesions of the brain microvessels, visible on cerebral MRI images, can be of various kinds: white-matter hyperintensities and, more rarely, silent infarcts leading to loss of white-matter tissue.

They result from a deterioration of the small cerebral arteries that supply blood to the brain's white matter, the material which ensures, among other things, the passage of information between different parts of the brain.

These lesions are observed in almost all elderly people. However, their severity varies greatly from one individual to the next. Moreover, it has been shown that they are more severe among hypertension sufferers and diabetics.

A large quantity of hyperintensities leads to many cerebral complications: cognitive deterioration, increased risk of Alzheimer's disease, depression, movement disorders and increased risk of stroke.

Moreover, according to several studies, the presence of a large quantity of this type of brain lesion increases the risk of cognitive deterioration (reasoning, memory, etc.) and of Alzheimer's disease. This is why the research team coordinated by Christophe Tzourio, director of the Inserm-Université Pierre et Marie Curie Mixed Research Unit 708 "Neuroepidemiology", advanced the hypothesis that migraines could "damage" the brain.

To test this hypothesis, the researchers evaluated the impact of migraine on cognitive function. The team used the EVA study-group of individuals aged over 65 years, recruited from the general population in Nantes, and monitored them over a 10-year period. Cerebral MRI was performed on more than 800 of the participants and these individuals were also questioned about their headaches by a neurologist. "The advantage of this cohort is that it involves relatively elderly individuals. However, since migraine often begins before age 30, if it did indeed have a deleterious and cumulative effect on the brain, then we should observe cerebral damage and a higher level of cognitive decline among the migraine sufferers", explains Christophe Tzourio.

The cognitive tests performed, involved an evaluation of the volunteers orientation in time and space, their short-term memory and their capacity and speed to correctly carry out specific tasks.

The results show that 21% of people suffer or have suffered from severe headaches over the course of their lives. For more than 70% of these, this involves migraines, some of which are with aura (see box below). The MRI scans for those participants having severe headaches confirm that they are twice as likely to have a large quantity of microvascular brain lesions as subjects without headaches.

In contrast, the cognitive scores were identical for individuals with or without severe headaches and for those having or not having cerebral microvascular lesions.

Among participants having a migraine with aura (2% of the total sample), a specific increase in silent cerebral infarcts and certain lesions was observed, hence confirming previous studies, but without detectable cognitive harm.

"This is a very reassuring result for the many people who suffer from migraine. In spite of the increased presence of lesions of the brain microvessels, this disorder does not increase the risk of cognitive decline. Therefore, we have not observed negative consequences of migraine on the brain ", concludes Tobias Kurth, lead author of the study, who designed and carried out these analyses.

Headaches (or cephalgias) are very common among the general population. This is particularly the case for migraine, a very painful, chronic and debilitating variety of headaches. It is estimated that around 12% of adults and 5 to 10% of children are afflicted, which represents 11 million migraine sufferers in France. There are two types of migraine, migraine without aura, by far the most frequent, and migraine with aura (15% of migraines). Migraine aura involves the appearance of, often visual, phenomena (zigzag lines of light, the impression of viewing the world through frosted glass, etc) in the minutes preceding the appearance of the headache.

The mechanisms of migraine and migraine aura are still largely unknown. However, it is suspected that a transitory contraction of the blood vessels could be responsible for a reduction of blood flow in the brain promoting the appearance of migraine aura. Much research elsewhere has shown that people suffering from migraine with aura have an increased risk of cerebral infarction (or strokes). Extremely fortunately, this risk remains low among migraine sufferers. However, the research confirms the existence of a link between migraine and blood vessels in the brain.

New visual pathway linked to photophobia in migraines identified

Sun, 10 Jan 2010 14:42:07 PST

( from http://www.rxpgnews.com ) Ask anyone who suffers from migraine headaches what they do when they're having an attack, and you're likely to hear "go into a dark room." And although it's long been known that light makes migraines worse, the reason why has been unclear.

Now scientists at Beth Israel Deaconess Medical Center (BIDMC) have identified a new visual pathway that underlies sensitivity to light during migraine in both blind individuals and in individuals with normal eyesight. The findings, which appear today in the Advance On-line issue of Nature Neuroscience, help explain the mechanism behind this widespread condition.

A one-sided, throbbing headache associated with a number of symptoms, including nausea, vomiting, and fatigue, migraines are notoriously debilitating and surprisingly widespread, affecting more than 30 million individuals in the U.S. alone. Migraine pain is believed to develop when the meninges, the system of membranes surrounding the brain and central nervous system, becomes irritated, which stimulates pain receptors and triggers a series of events that lead to the prolonged activation of groups of sensory neurons.

"This explains the throbbing headache and accompanying scalp and neck-muscle tenderness experienced by many migraine patients," explains the study's senior author Rami Burstein, PhD, Professor of Anesthesia and Critical Care Medicine at BIDMC and Harvard Medical School.

In addition, for reasons that were unknown, nearly 85 percent of migraine patients are also extremely sensitive to light, a condition known as photophobia.

"Migraine patients may wear sunglasses, even at night," he notes, adding that the dimmest of light can make migraine pain worse. Extremely disabling, photophobia prevents patients from such routine activities as reading, writing, working or driving.

It was the observation that even blind individuals who suffer from migraines were experiencing photophobia that led Burstein and first author Rodrigo Noseda, PhD, to hypothesize that signals transmitted from the retina via the optic nerve were somehow triggering the intensification of pain.

The investigators studied two groups of blind individuals who suffer migraine headaches. Patients in the first group were totally blind due to eye diseases such as retinal cancer and glaucoma; they were unable to see images or to sense light and therefore could not maintain normal sleep-wake cycles. Patients in the second group were legally blind due to retinal degenerative diseases such as retinitis pigmentosa; although they were unable to perceive images, they could detect the presence of light and maintain normal sleep-wake cycles.

"While the patients in the first group did not experience any worsening of their headaches from light exposure, the patients in the second group clearly described intensified pain when they were exposed to light, in particular blue or gray wavelengths," explains Burstein. "This suggested to us that the mechanism of photophobia must involve the optic nerve, because in totally blind individuals, the optic nerve does not carry light signals to the brain.

"We also suspected that a group of recently discovered retinal cells containing melanopsin photoreceptors [which help control biological functions including sleep and wakefulness] is critically involved in this process, because these are the only functioning light receptors left among patients who are legally blind."

The scientists took these ideas to the laboratory, where they performed a series of experiments in an animal model of migraine. After injecting dyes into the eye, they traced the path of the melanopsin retinal cells through the optic nerve to the brain, where they found a group of neurons that become electrically active during migraine.

"When small electrodes were inserted into these 'migraine neurons,' we discovered that light was triggering a flow of electrical signals that was converging on these very cells," says Burstein. "This increased their activity within seconds."

And even when the light was removed, he notes, these neurons remained activated. "This helps explain why patients say that their headache intensifies within seconds after exposure to light, and improves 20 to 30 minutes after being in the dark."

The discovery of this pathway provides scientists with a new avenue to follow in working to address the problem of photophobia.

"Clinically, this research sets the stage for identifying ways to block the pathway so that migraine patients can endure light without pain," adds Burstein.

Tai Chi may help alleviate tension headaches

Sat, 28 Apr 2007 12:18:56 PST

( from http://www.rxpgnews.com ) FINDINGS: Researchers found that Tai Chi, a traditional Chinese low-impact mind-body exercise, provided significant health benefits for adults suffering from tension headaches. Compared with a control group, patients who participated in a 15-week Tai Chi program were helped not only with headache pain, but also perceived improvement in other areas, reporting increased energy, emotional well-being, social functioning and improved mental health.

IMPACT: According to researchers, Tai Chiâs emphasis on relaxation, breathing and coordination may address stress, the underlying cause of the pain associated with tension headaches. The patients who participated in the Tai Chi program showed improvement on a quality-of-life based measurement called SF-36 and also on a test called HIT-6TM designed to capture the effect of headaches.

AUTHORS: Ryan B. Abbott, M.T.O.M, L.Ac., UCLA Center for East-West Medicine and Dr. Ka-Kit Hui, Wallis Annenberg Professor in Integrative East-West Medicine and director of the UCLA Center for East-West Medicine are available for interviews.

FUNDING: The study was funded in part by the National Institutes of Health and various foundations.

JOURNAL: The research appears in the March 2007 issue of the journal, Evidence-based Complementary and Alternative Medicine (eCAM).

RAMP - the protein implicated in causing migraines

Thu, 08 Mar 2007 14:26:10 PST

( from http://www.rxpgnews.com ) A University of Iowa study may provide an explanation for why some people get migraine headaches while others do not. The researchers found that too much of a small protein called RAMP1 appears to "turn up the volume" of a nerve cell receptor's response to a neuropeptide thought to cause migraines.

The neuropeptide is called CGRP (calcitonin gene-related peptide) and studies have shown that it plays a key role in migraine headaches. In particular, CGRP levels are elevated in the blood during migraine, and drugs that either reduce the levels of CGRP or block its action significantly reduce the pain of migraine headaches. Also, if CGRP is injected into people who are susceptible to migraines, they get a severe headache or a full migraine.

The UI study findings are published in the March 7 issue of the Journal of Neuroscience.

"We have shown that this RAMP protein is a key regulator for the action of CGRP," said Andrew Russo, Ph.D., UI professor of molecular physiology and biophysics. "Our study suggests that people who get migraines may have higher levels of RAMP1 than people who don't get migraines."

RAMP1 is a normal, required subunit of the CGRP receptor. Russo and his colleagues found that overexpression of RAMP1 protein in nerve cells increased the sensitivity and responsiveness of CGRP receptors to the neuropeptide -- more RAMP1 made CGRP receptors react to much lower concentrations of CGRP than usual and caused the receptors to respond more vigorously to the neuropeptide.

The UI team also engineered mice to express human RAMP1 in their nervous system in addition to the normal mouse version of the protein. These mice had double the amount of inflammation in response to CGRP than did normal mice. Nerve-induced inflammation is one of the effects associated with migraine headache.

Russo explained that his study raises the possibility that people who have migraines may have subtle genetic differences in the RAMP1 gene that result in increased levels of RAMP1 protein.

"There is clearly a genetic difference between people who get migraines and those who do not, and we think that difference could be RAMP1. Our studies provide a reason to look for variations in the DNA that encodes RAMP1 in humans," he said.

The study also suggests that the mice engineered to produce elevated levels of RAMP1 protein may be a good model for studying migraine and specifically trying to understand how the neuropeptide, CGRP, is working.

The UI team investigated CGRP receptors in the trigeminal nerve, which is responsible for relaying almost all sensory perception, including pain and touch, for the front of the head. The UI findings reinforce the emerging view that CGRP receptors in the trigeminal nerve play a key role in migraine headache.

However, there are other CGRP receptors throughout the body, and elevated CGRP levels are implicated in other types of pain, including arthritis. Russo predicts that his group's findings about RAMP1 will have implications for pain research beyond migraine headaches.

Migraine dealings for the women

Thu, 07 Sep 2006 00:54:00 PST

( from http://www.rxpgnews.com ) Migraines are more common in the United States than diabetes, osteoarthritis or asthma. Of the 28 million people who experience migraines in this country, 18 million are women. Although prevention is very effective in managing this disorder, only 3 percent to 5 percent of women seek preventive therapy.

To better understand this issue and provide guidance for physicians treating female migraine patients, Mayo Clinic in Arizona Women's Health Internal Medicine physicians reviewed all the major studies on the disorder published in the past five years. They compiled study results into a concise review for clinicians, published in the August 2006 issue of the Mayo Clinic Proceedings.

"Most people with migraines first seek help from their primary care provider instead of a neurologist or a specialist. The purpose of our paper is to provide more information for primary care physicians who typically manage these cases," says Beverly Tozer, M.D., who led the review.

The review emphasized preventive therapies for migraines at different stages of a female's life. According to Dr. Tozer, strong evidence suggests that hormonal changes effect migraine development, with migraines being most prevalent during the reproductive years.

"Almost one-fourth of women in their reproductive years experience migraines," Dr. Tozer says. "During these years, women are building both their families and their careers. The predominance of this disorder in women with its associated social, functional and economic consequences makes migraine an important issue in women's health."

Approaching the issue with regard to hormonal causes, the Mayo authors tracked migraine development and treatment for women from childhood to menopause.

Childhood and Adolescence:

Research found that in children ages 4 to 7, girls are less likely than boys to have migraines. However, by puberty, girls are three times more likely than boys to have migraines. Stress is a major migraine trigger for children and adolescents, and stress management techniques have helped children as young as 8 years.

If other therapies and lifestyle changes fail to reduce migraines, researchers have found that cyproheptadine is a useful medication for children under 6, with several other preventive medications available to older children. As many as one-third of all pediatric migraine patients require periodic courses of daily preventive medication.

Reproductive Years:

Menstrual migraine -- Migraines increase substantially after menarche. Menstruation is one of the most common migraine triggers. Menstrual migraines are typically migraines without aura (bright flashing lights that may precede migraine) that occur predictably around the menses. They are caused, studies suggest, by the decline in estrogen levels before menstruation. Menstrual migraines may be prevented by taking medication only during the vulnerable period when migraines are expected to occur.

Medications used in the prevention of menstrual migraine include nonsteroidal anti-inflammatory drugs, ergots, alkaloids and triptans. Medications used in the prevention of other migraines also are effective in preventing menstrual migraine. In some patients, menstrual migraines also may be managed with hormonal manipulation using oral contraceptives. However, reviewers emphasized that oral contraceptives should not be prescribed in migraine patients who smoke because of the dramatic increased risk of stroke.

Pregnancy -- Pregnant women with migraines often have fewer attacks by the end of the first trimester. According to the studies, 50 percent to 80 percent of women noted a decrease in attacks, while a smaller percentage experienced a worsening or onset of attacks. The reviewers noted that pregnant women should avoid using medication except in severe cases.

If it is determined that the benefits of the preventive therapy outweigh the risks to both mother and fetus, medications such as propranolol hydrochloride, verapamil hydrochloride and topiramate may be used. However, valproic acid, divalproex sodium and ergot derivatives should never be prescribed to pregnant patients.

Menopause:

Early menopause -- Changing hormone levels make the menopausal transition challenging for many women with migraines. Studies found that hormonal manipulation and long cycle usage of low-dose oral contraceptives have been useful in managing these migraines.

Late menopause -- Migraines beginning after age 65 is extremely uncommon and warrants further evaluation. Physicians should be aware that as many as one-third of all headaches in elderly women are due to secondary causes. Doctors recommend lower doses of all preventive medicine for this group to avoid side-effects. Medication also should be selected with consideration to other health conditions.

Electronic TMS Device Zaps Migraine

Fri, 23 Jun 2006 00:52:00 PST

( from http://www.rxpgnews.com ) Results of a study found that the experimental device appears to be effective in eliminating the headache when administered during the onset of the migraine. The device, called TMS, interrupts the aura phase of the migraine, often described as electrical storms in the brain, before they lead to headaches. Auras are neural disturbances that signal the onset of migraine headaches. People who suffer from migraine headaches often describe seeing showers of shooting stars, zigzagging lines and flashing lights, and experiencing loss of vision, weakness, tingling or confusion. What typically follows these initial symptoms is intense throbbing head pain, nausea and vomiting.

Yousef Mohammad, a neurologist at OSU Medical Center who presented the results, says that the patients in this study reported a significant reduction in nausea, noise and light sensitivity post treatment.

"Work functioning also improved, and there were no side effects reported, Mohammad said.

Yousef Mohammad

This magnetic pulse, when held against a person's head, creates an electric current in the neurons of the brain, interrupting the aura before it results in a throbbing headache.

The device's pulses are painless. In our study sample, 69 percent of the TMS-related headaches reported to have either no or mild pain at the two-hour post-treatment point compared to 48 percent of the placebo group. In addition, 42 percent of the TMS-treated patients graded their headache response, without symptoms, as very good or excellent compared to 26 percent for the placebo group. These are very encouraging results.

It was previously believed that migraine headaches start with vascular constriction, which results in an aura, followed by vascular dilation that will lead to a throbbing headache. This new understanding of the migraine mechanism has assisted with the development of the TMS device.

More than 26 million Americans suffer from the neurologic disorder of migraine, according to the American Medical Association. No medical test exists for migraine, so the diagnosis is based on having some or all of the following symptoms: a moderate to severe throbbing pain for four to 72 hours that is frequently on one side of the head (the word migraine comes from the Greek hemicranios, meaning half a head), nausea, with or without vomiting, sensitivity to light and sound.

According to FDA website, about 15 to 20 percent of migraine sufferers experience visual and other disturbances about 15 minutes before the head pain. These symptoms, collectively known as "aura," may include flashing lights, zig-zag lines, bright spots, loss of part of one's field of vision, or numbness or tingling in the hand, tongue, or side of the face. Migraines preceded by an aura are called classic migraines; all others are referred to as common migraines. According to news reports, the Broncos' Davis experienced an aura during the Super Bowl, allowing him to get early treatment to prevent a full-blown migraine.

Migraines strike some people about two or three times a year and others as frequently as twice a week or more. They appear to have a genetic link. According to the American Council for Headache Education, up to 90 percent of people with migraine have a family history of the condition.

Tension Headache May Actually Be TMJD

Mon, 15 May 2006 17:29:00 PST

( from http://www.rxpgnews.com ) People whose recurrent headaches have been diagnosed as tension-related actually may be suffering from temporomandibular muscle and joint disorder, or TMJD, a study headed by a researcher from the University at Buffalo's School of Dental Medicine has shown.

Results showed that examiners could replicate tension-headache symptoms in 82 percent of subjects by performing the clinical examination of the temporalis muscle, which is involved in TMJD.

Richard Ohrbach, D.D.S., Ph.D., UB associate professor in the Department of Oral Diagnostic Sciences, presented the study results at the American Association of Dental Research meeting held recently in Orlando, Fla.

The temporalis muscle is responsible for closing the jaw and is involved in chewing, but these core functions of that pair of muscles often are ignored when the presenting complaint is "headache," as opposed to jaw pain, Ohrbach said.

"Because headache is so incredibly common, it often is regarded as inevitable, and if sufferers label the pain as 'headache,' they may not seek help," he said. "Or if they do seek help, the label of 'headache' typically will propel the individual to a physician or neurologist for consultation.

"Knowledge about the intersection between jaw pain and headache is not well established, and consequently, jaw pain may be ignored in the differential diagnosis," Ohrbach added. "This can be most unfortunate for the individual, because TMJD can be very treatable, but if a jaw disorder is ignored, then treatment for the headache may not address all of the factors contributing to the headache."

The current study is part of an $8 million project to establish valid and reliable TMJD diagnostic criteria. Results will advance the field of TMJD research and aid clinicians in their practices.

Researchers at the University of Minnesota and the University of Washington, in addition to UB, are involved in the project.

An estimated 5-10 percent of the U.S. population suffer from TMJD severe enough to warrant treatment. These patients experience debilitating pain that can destroy quality of life. Diagnosing the disorder is problematic, however, due to overlap with other conditions, Ohrbach said.

TMJD usually involves more than a single symptom, rarely has a single cause and frequently involves multiple factors, including behavioral and emotional responses. Lacking a firm set of diagnostic tools, physicians and dentists often depend on their individual judgment to decide if a patient does or does not have the disorder, he noted.

The diagnostic criteria for TMJD being tested in this project are part of the established Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Headache diagnosis is based on the International Headache Society (IHS) guidelines. All examiners were been trained to use the "gold-standard" criteria for tension-type headache established by the IHS.

The study compared the diagnostic procedures for pain and the reproduction of "pain" vs. "headache" during the clinical examination. Procedures included a range of functional and orthopedic tests and standard pain sensitivity to pressure applied to the muscles associated with headache. The types of headaches considered included sub-clinical headaches, tension-type headaches and headaches exhibiting more symptoms than are accepted for tension-type headaches, such as the "mixed headache," migraine or "migraine-type" headaches

The study involved 583 participants -- 82.3 percent female and 17.7 percent male -- who were recruited as cases from the community based on the presence of symptoms clearly associated with TMJD. Based on IHS criteria, 31.5 percent, or 152 participants, were diagnosed with tension-type headache by the examiners.

Tension headaches - Don't ignore this differential diagnosis

Sun, 14 May 2006 18:43:00 PST

Acupuncture cuts tension headache rates by almost half

Fri, 29 Jul 2005 14:45:00 PST

( from http://www.rxpgnews.com ) Acupuncture is an effective treatment for tension headache, cutting rates for sufferers by almost half, shows a study on bmj.com this week.

And a minimal acupuncture course works almost as well as traditional Chinese therapy, say the researchers.

In a randomised controlled trial - the gold standard of clinical trials - researchers in Germany divided 270 patients with a similar severity of tension headache into three groups.

Over an eight week period one set were treated with traditional acupuncture, one with minimal acupuncture (needles inserted only superficially into the skin, at non-acupuncture points), and one group had neither treatment (control group).

Those receiving traditional acupuncture care saw their headache rates drop by almost half - suffering 7 days less headaches over the four weeks following the treatment. Those receiving minimal acupuncture had 6.6 less days of headaches. While the control group experienced 1.5 less days of headaches - a drop of just a tenth.

Improvements to headache rates continued for months after the acupuncture treatment, though they began to rise slightly as time went on.

Those in the no treatment group were subsequently given acupuncture for eight weeks after the main study period. These patients also improved significantly after the treatment, though not to the same level as those given acupuncture initially.

Of the 195 patients in the acupuncture groups, 37 reported some side effects - the most common being dizziness, other headaches and bruising.

Such a small difference in results between traditional and minimal acupuncture treatments seems to indicate that the location of acupuncture points and other aspects of traditional Chinese acupuncture do not make a major difference for tension headache, say the authors.

Acupuncture treatments are sometimes associated with strong placebo effects, caution the authors. But these findings show that acupuncture produces just as good improvements for tension headache sufferers as treatments already accepted, they conclude.