Health Problem: Headache is a common neurological condition characterized by aching or pain that occurs in 1 or more areas of the head, face, mouth, or neck. Headaches may be primary or secondary. Familiar types of primary headaches include tension-type (TTH), migraine, and cluster. Twenty percent of women and 9.7% of men in the United States report having had a severe headache or migraine in the previous 3 months.

Technology Description: The technique of acupuncture involves percutaneous insertion of very fine needles to a depth of approximately 10 to 15 millimeters at prescribed acupoints. In some cases, low-voltage current is applied to the needles; this is referred to as electroacupuncture.

Controversy: Concerns regarding the opioid epidemic have fueled considerable interest in nonpharmacological strategies, including acupuncture, for pain management in recent years. Numerous federal regulatory agencies have advised or mandated that nonpharmacologic options for pain be offered by healthcare systems and providers. Acupuncture is controversial in the United States because of lack of clear mechanisms for efficacy, inconsistent findings in studies in the peer-reviewed literature, and heterogeneity in techniques and treatment administration.

Key Questions:

  • Does acupuncture therapy improve patient outcomes for adult patients with chronic or episodic TTH or episodic migraine?
  • Is acupuncture safe for treating chronic or episodic TTH or episodic migraine in adult patients?
  • How do the efficacy and safety of acupuncture compare with treatment as usual, or other common active interventions, for adult patients with chronic or episodic TTH or episodic migraine?
  • Have definitive patient selection criteria been identified for acupuncture for treatment of chronic or episodic TTH or episodic migraine?

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