The Acupuncture Randomised Trial (Art) for Tension-Type Headache - Details of the Treatment

2005 ◽  
Vol 23 (4) ◽  
pp. 157-165 ◽  
Author(s):  
Dieter Melchart ◽  
Andrea Streng ◽  
Andrea Hoppe ◽  
Benno Brinkhaus ◽  
Claudia Becker-Witt ◽  
...  
Keyword(s):  
Randomised Trial ◽  
Treatment Strategies ◽  
Tension Type Headache ◽  
Waiting List ◽  
Acupuncture Points ◽  
Individual Choice ◽  
Consensus Process ◽  
Funding Agencies ◽  
Superficial Needling ◽  
Type Headache

Objective The goal of this paper is to describe the characteristics of physicians and their interventions in a large, multicentre randomised trial of acupuncture for tension-type headache known as ARTTTH, in order to enable acupuncturists to assess the study interventions. Methods Participating physicians were recruited whose qualifications met or surpassed those of physicians currently accredited for providing acupuncture by state health funding agencies in Germany. Semi-standardised treatment strategies for acupuncture and minimal acupuncture were developed in a consensus process with acupuncture experts. A total of 270 patients suffering from episodic or chronic tension-type headache were randomised to 12 sessions of semi-standardised acupuncture (three predefined ‘basic’ points, recommendations for additional points given, but individual choice of additional points possible), standardised minimal acupuncture (superficial needling of at least 5 of 10 predefined, bilateral, distant non-acupuncture points) or a waiting list. Forty two physicians, trained and experienced in acupuncture, from 28 centres in Germany participated in the trial. Results The median duration of acupuncture training of trial physicians was 500 hours (range 140 to 1350 hours). Physicians had 10 (<1 to 25) years acupuncture experience. The three ‘basic’ points (GB20, GB21 and LR3) were treated in 96%, 82% and 97% of sessions, respectively. Frequently treated optional points included LI4 (67%), SP6 (50%) and ST36 (46%). Ten of the 42 physicians stated that they would have treated patients differently outside the trial. The trial found a significant effect of acupuncture over waiting list but not over minimal acupuncture. Conclusions In general, trial physicians complied well with the predefined interventions. A relevant minority of participating trial physicians stated that they would have treated patients differently outside the trial.

scholarly journals Acupuncture for tension-type headache: a multicentre, sham-controlled, patient-and observer-blinded, randomised trial

2007 ◽  
Vol 8 (5) ◽  
pp. 306-314 ◽  
Author(s):  
Heinz G. Endres ◽  
Gabriele Böwing ◽  
Hans-Christoph Diener ◽  
Stefan Lange ◽  
Christoph Maier ◽  
...  
Keyword(s):  
Randomised Trial ◽  
Tension Type Headache ◽  
Type Headache

scholarly journals Use of Laser Acupuncture in Chronic Tensional Headache: Randomized Clinical Trial

2021 ◽  
Vol 23 (2) ◽  
pp. 141-144
Author(s):  
Rafaela Gulhak Moretto ◽  
Thais Schemberger Favarin ◽  
Morgana Neves ◽  
Paula Renata Olegini Vasconcellos ◽  
Gladson Ricardo Flor Bertolini
Keyword(s):  
Impact Test ◽  
Intervention Group ◽  
Tension Headache ◽  
Pain Scale ◽  
Tension Type Headache ◽  
Laser Acupuncture ◽  
Control Group ◽  
Acupuncture Points ◽  
Type Headache ◽  
Headache Impact

AbstractSince tension headache, besides being highly prevalent, has a deleterious effect on daily activities, the search for therapeutic resources is interesting. Thus, the objective of this study was to verify the effect of laser acupuncture in individuals with chronic tensional headache. The sample consisted of 14 volunteers with chronic tensional headache, separated into a control group (placebo) and an intervention group (laser acupuncture, 660nm, 10 J/cm²), in both groups the pen was positioned for 20 seconds in each of the six acupuncture points. There were three therapies on alternate days, and at the end there was previous evaluation by both the Visual Analog Pain Scale and the Headache Impact Test questionnaire. In both forms of evaluation there were significant differences in the comparison between evaluations, with reduction of values (p<0.001), but without differences between groups or interaction (p>0.05). It was concluded that the acupuncture laser showed no greater effectiveness than the placebo. Keywords: Tension-Type Headache. Acupuncture Points. Meridians. Resumo Visto que a cefaleia tensional, além de apresentar alta prevalência, tem um efeito deletério sobre as atividades diárias, apresenta-se interessante a busca por recursos terapêuticos. Desta forma, o objetivo deste estudo foi verificar o efeito do laser acupuntura em indivíduos com cefaleia tensional crônica. A amostra foi composta por 14 voluntários, com cefaleia tensional crônica, separados em grupo controle (placebo) e grupo intervenção (laser acupuntura, 660nm, 10 J/cm²), em ambos os grupos a caneta foi posicionada por 20 segundos em cada um dos seis pontos de acupuntura. Foram três terapias em dias alternados, sendo que houve avaliação prévia e ao final delas tanto pela Escala Visual Analógica de Dor quanto pelo questionário Headache Impact Test. Em ambas as formas de avaliação houve diferenças significativas na comparação entre avaliações, com redução dos valores (p<0,001), porém sem diferenças entre os grupos ou interação (p>0,05). Conclui-se que o laser acupuntura não mostrou eficácia superior ao placebo. Palavras-chave: Cefaleia do Tipo Tensional. Pontos de Acupuntura. Meridianos.

CGRP in human models of primary headaches

Cephalalgia ◽  
2016 ◽  
Vol 38 (2) ◽  
pp. 353-360 ◽  
Author(s):  
Håkan Ashina ◽  
Henrik Winther Schytz ◽  
Messoud Ashina
Keyword(s):  
Treatment Strategies ◽  
Primary Headache ◽  
Experimental Models ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Human Models ◽  
New Treatment ◽  
Type Headache ◽  
Methodological Aspects

Objective To review the role of CGRP in human models of primary headaches and to discuss methodological aspects and future directions. Discussion Provocation experiments demonstrated a heterogeneous CGRP migraine response in migraine patients. Conflicting CGRP plasma results in the provocation experiments are likely due to assay variation; therefore, proper validation and standardization of an assay is needed. To what extent CGRP is involved in tension-type headache and cluster headache is unknown. Conclusion Human models of primary headaches have elucidated the role of CGRP in headache pathophysiology and sparked great interest in developing new treatment strategies using CGRP antagonists and antibodies. Future studies applying more refined human experimental models should identify biomarkers of CGRP-induced primary headache and reveal whether CGRP provocation experiments could be used to predict efficacy of CGRP antagonists in migraine patients.

Peripheral and Central Mechanisms in Tension-Type Headache: an Update

Cephalalgia ◽  
2003 ◽  
Vol 23 (1_suppl) ◽  
pp. 49-52 ◽  
Author(s):  
R Jensen
Keyword(s):  
Central Sensitization ◽  
Treatment Strategies ◽  
Tension Type Headache ◽  
Effective Prevention ◽  
Future Treatment ◽  
Type Headache ◽  
Underlying Pathophysiology

Despite the tremendous socoeconomic impact of tension-type headache surprisingly little is known about the underlying pathophysiology and treatment. Existing evidence and theories about the relation between central and peripheral mechanisms are discussed. Central sensitization is probably the most important key to understand this widespread disorder. An effective prevention or reversal of this central sensitization will probably be of major importance in future treatment strategies.

Are Headache and Temporomandibular Disorders Related? A Blinded Study

Cephalalgia ◽  
2008 ◽  
Vol 28 (8) ◽  
pp. 832-841 ◽  
Author(s):  
V Ballegaard ◽  
P Thede-Schmidt-Hansen ◽  
P Svensson ◽  
R Jensen
Keyword(s):  
Temporomandibular Disorders ◽  
Treatment Strategies ◽  
Severe Depression ◽  
Tension Type Headache ◽  
Psychosocial Dysfunction ◽  
Headache Centre ◽  
Significant Disability ◽  
Masticatory System ◽  
Type Headache ◽  
Headache Patients

To investigate overlaps between headache and temporomandibular disorders (TMD) in a clinical headache population and to describe the prevalence of TMD in headache patients, 99 patients referred to a specialized headache centre were diagnosed according to Research Diagnostic Criteria for TMD (RDC/TMD) and classified in headache groups according to the International Classification of Headache Disorders, second edition for headache diagnoses in a blinded design. The prevalence of TMD in the headache population was 56.1%. Psychosocial dysfunction caused by TMD pain was observed in 40.4%. No significant differences in TMD prevalence were revealed between headache groups, although TMD prevalence tended to be higher in patients with combined migraine and tension-type headache. Moderate to severe depression was experienced by 54.5% of patients. Patients with coexistent TMD had a significantly higher prevalence of depression—most markedly in patients with combined migraine and tension-type headache. Our studies indicate that a high proportion of headache patients have significant disability because of ongoing chronic TMD pain. The trend to a higher prevalence of TMD in patients with combined migraine and tension-type headache suggests that this could be a risk factor for TMD development. A need for screening procedures and treatment strategies concerning depression in headache patients with coexistent TMD is underlined by the overrepresentation of depression in this group. Our findings emphasize the importance of examination of the masticatory system in headache sufferers and underline the necessity of a multidimensional approach in chronic headache patients.

Predictors of outcome of the treatment programme in a multidisciplinary headache centre

Cephalalgia ◽  
2010 ◽  
Vol 30 (10) ◽  
pp. 1214-1224 ◽  
Author(s):  
Rigmor Jensen ◽  
Peter Zeeberg ◽  
Christian Dehlendorff ◽  
Jes Olesen
Keyword(s):  
Treatment Strategies ◽  
Specific Treatment ◽  
Female Gender ◽  
Tension Type Headache ◽  
Female Ratio ◽  
Headache Centre ◽  
Male Female Ratio ◽  
Absence Rate ◽  
Triptan Overuse ◽  
Type Headache

Introduction: Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. The objective was to characterise patients and treatment results in a tertiary headache centre. Subjects and methods: A systematic review of all referred patients in the Danish Headache Centre in a 2-year period. Outcome results were analysed with respect to diagnoses and sociodemographics. Results: A total of 1326 patients with a mean age of 43.7 years and male : female ratio of 3 : 7 were included. In total, frequency and absence rate from work were reduced from 20 to 11 days ( P < 0.001) and 5 to 2 days/month ( P < 0.001), respectively. Predictors for good outcome were female gender, migraine, triptan overuse and a frequency of 10 days/month, whereas tension-type headache and overuse of simple analgesics predicted a poor outcome. Conclusions: The present analysis provided support for a multidisciplinary approach in a tertiary headache centre. Further evaluation of specific treatment strategies and outcome predictors are important for future planning.

Tension-type headache in patients with concomitant musculoskeletal disorders

2020 ◽  
pp. 72-79
Author(s):  
Yu. O. Novikov ◽  
I. E. Salakhov
Keyword(s):  
Cervical Spine ◽  
Drug Therapy ◽  
Drug Treatment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Tension Type Headache ◽  
World Health ◽  
Standard Drug ◽  
Rehabilitation Treatment ◽  
Type Headache

Introduction. According to the defi nition of the World Health Organization (WHO), tension-type headache (TTH) is the most common type of primary headache. Rehabilitation of patients with chronic tension-type headache continues to be an important socio-medical problem. Its main goal is the most complete restoration of the functions of the musculoskeletal system of the neck, the correction of vascular and psychoemotional problems, and the patient′s return to his everyday life and work. As a rule, the main emphasis in the treatment of such patients is placed primarily on drug therapy. At the same time, practitioners are faced with a number of problems — the low effectiveness of the treatment, the nonpersistency of the results, allergic reactions, polypharmacy and others. All this suggests that there is a need for differentiated rehabilitation treatment of patients with tension-type headache with the use of various non-pharaceutical methods. The goal of research — to evaluate the clinical effi cacy of complex non-drug therapy in patients with tension-type headache.Materials and methods. The prospective controlled randomized study, which was conducted from October 2017 to March 2019 at the Department of Medical Rehabilitation of the Bashkir State Medical University, included 110 patients with TTH from the age of 20 to 45 years. All patients, depending on the treatment methodology used, were randomly divided into two groups of 55 people. Patients of the main group received complex rehabilitation treatment with the use of non-drug methods: osteopathic correction, acupuncture and exercise therapy. Patients in the control group received treatment in accordance with the standard of medical care for TTH (analgesics, non-steroidal antiinfl ammatory drugs, antidepressants, vasoactive and nootropic drugs). The study of the clinical effectiveness of the therapy included: an assessment of the severity of pain with the use of a visual analogue scale and a tensoalgimeter, a goniometric study with an assessment of the volume of active movements in the cervical spine, transcranial ultrasound dopplerography with an assessment of quantitative indicators in the system of the middle cerebral artery.Results. The use of complex non-drug therapy in patients with TTH compared with standard drug therapy leads to a signifi cantly more important decrease in the severity of pain, an increase in pain threshold, an increase in the volume of active movements in the cervical spine. The effect of non-drug treatment methods on blood fl ow in the system of the middle cerebral artery is comparable in its effectiveness with the use of pharmaceutical drugs.Conclusion. The proposed complex rehabilitation treatment of patients with TTH with the use of non-drug methods has shown clinical effi cacy which is comparable, and in a number of indicators, superior to the effectiveness of conventional medical treatment. All this determines the necessity of wider implementation of multidisciplinary non-drug treatment of patients with this pathology.

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