Electroacupuncture

Dilara Onan et al. (2025) · Journal of oral & facial pain and headache

Chronic tension-type headache (CTTH) -- headaches on 15 or more days a month for at least three months -- is thought to involve tight, tender muscles in the head, neck, and face, though scientists are not fully certain why it happens. This systematic review and meta-analysis pulled together randomized trials testing physiotherapy-style treatments -- things like massage, exercise, acupuncture, and relaxation training -- to see whether they actually ease CTTH symptoms. The researchers followed a pre-registered research plan and searched two major databases through mid-2024, aiming to answer a focused question: do these hands-on and movement-based approaches beat sham treatment, no treatment, or medication alone? Two physiotherapist researchers with PhD degrees independently screened 237 studies and settled on nine randomized trials -- ranging from 25 to 169 patients each, mostly women, treated for 3 to 12 weeks. The approaches tested included trigger point massage, electroacupuncture, relaxation with muscle-tension biofeedback, yoga, and neck-and-shoulder strengthening exercises, among others. Seven of the nine trials had comparable enough data to combine mathematically (meta-analysis), and each study's methodological rigor was scored using a standard 11-item checklist. When the researchers pooled the numbers, physiotherapy approaches meaningfully reduced headache intensity compared to control (a large, statistically significant effect), cut the number of headache days per month by more than one day on average, and shortened how long headaches lasted -- all statistically significant improvements. A fourth measure, day-to-day headache impact on daily life, trended in favor of physiotherapy but did not reach statistical significance. Looking at individual studies: electroacupuncture beat sham treatment for headache intensity; combining a hands-on release technique with ibuprofen worked better than ibuprofen alone; and yoga added to standard medical care outperformed medical care by itself on several measures. Importantly, though, the researchers rated their overall confidence in these pooled results as low to very low -- the studies were small, methods varied a lot between them, and most carried some risk of bias. No serious side effects were reported in any trial. The takeaway is cautiously encouraging: physiotherapy-based approaches -- especially those combining exercise, hands-on techniques, or relaxation training with standard care -- show a real signal for easing CTTH symptoms, and they appear safe. But because the underlying evidence is still thin and inconsistent, these findings should not be read as proof that any one specific technique is the best choice. The authors call for larger, more consistently designed trials before physiotherapy can be confidently recommended as a primary CTTH treatment, though the current evidence supports trying it as a reasonable, low-risk complement to standard care.

Min He et al. (2022) · European journal of medical research

This systematic review and meta-analysis combined 30 randomised controlled trials with 4,413 participants to test whether acupuncture helps allergic rhinitis — the sneezing, congestion and runny nose caused by an allergic reaction in the lining of the nose. What sets it apart is that the authors then stress-tested their own findings using trial sequential analysis, a method that asks whether enough participants have been studied for a pooled result to be trusted rather than treated as a chance finding. Trials came mostly from China (22 of 30), with others from Germany, Australia, South Korea and Sweden, ranging from 24 to 981 participants and lasting between two and twelve weeks. Three needling approaches were used: standard needle acupuncture, electroacupuncture, and warm needling, in which mugwort is burned on the needle to heat it. Acupuncture was compared against no treatment, against sham needling at non-acupuncture points, and against antihistamines including cetirizine and loratadine. Symptoms were scored with the Total Nasal Symptom Score and quality of life with the Rhinoconjunctivitis Quality of Life Questionnaire. Against no treatment, acupuncture improved both nasal symptoms and quality of life in adults. Against sham needling it also came out ahead, improving nasal symptoms (mean difference -0.60, 95% CI -1.16 to -0.04, from 489 participants) and quality of life (mean difference -8.47, 95% CI -14.91 to -2.03, from 248 participants) — both statistically significant, since neither confidence interval crosses zero. Against cetirizine or loratadine no clear difference appeared, suggesting acupuncture performs about as well as standard antihistamines. But the trial sequential analysis failed to confirm any of these results, meaning the pooled evidence has not yet accumulated enough participants to be considered reliable. Effects in children and adolescents could not be determined at all. The honest summary is a promising signal that has not yet been confirmed. Performance and attrition bias were serious in most of the included trials, and the authors' own robustness check contradicted their own positive findings. For an adult who would rather not take daily antihistamines, acupuncture is a defensible option on current evidence; it is not yet a demonstrated one. Larger and better-conducted trials, especially in children, are what would settle the question.

He Chen et al. (2024) · Current pain and headache reports

Does acupuncture keep helping knee osteoarthritis after the needles stop? A 2024 systematic review and meta-analysis in Current Pain and Headache Reports pooled 10 randomized controlled trials with 3,221 participants to answer exactly that, and found benefits lasting roughly 3 to 6 months after the final session. The durability depended on the comparison. Against sham acupuncture, real acupuncture kept function measurably better for 4.5 months after treatment ended, and overall pain stayed lower through 4.5 months as well. Against usual care, both pain relief and functional improvement remained large enough to matter clinically for 5 months. One trial comparing dry needling with the anti-inflammatory drug diclofenac found relief persisting 6 months after treatment ended. Not every comparison favored acupuncture. When it was added on top of exercise-based physical therapy, it added nothing measurable for up to 11 months — exercise appears to occupy much of the same therapeutic ground. And two no-treatment-controlled trials disagreed, one showing 3 months of persistence and the other showing benefits only at end of treatment. Safety was consistently good across trials, with no significant excess of adverse events. For the estimated one in five adults over 40 living with knee osteoarthritis, the practical takeaway is that a 4-to-12-week course of acupuncture (typically 1–3 sessions weekly) can deliver relief that outlasts treatment by months — something NSAIDs and steroid injections generally cannot claim. It works best as its own treatment or alongside routine care, not stacked on structured exercise therapy, and results should be weighed knowing each individual comparison rested on relatively few trials.

Jun J Mao et al. (2021) · JAMA oncology

This randomized clinical trial with 360 cancer survivors asked a practical question: for people who finished cancer treatment but still live with chronic musculoskeletal pain, does acupuncture work better than usual care — and which kind of acupuncture is better? The PEACE trial, run across six sites in New York and New Jersey and published in JAMA Oncology, compared electroacupuncture (electrical stimulation through needles placed in the body) with auricular acupuncture (needles placed at standardized points on the ear). Participants — mean age 62, about 70% women — had a prior cancer diagnosis, no current disease, and pain of at least three months. They were randomized to ten weekly sessions of electroacupuncture (145 people), ear acupuncture (143), or usual care (72), with pain scored on the Brief Pain Inventory, a 0-to-10 scale. Electroacupuncture points were tailored to where each person hurt, while ear acupuncture used the same standardized points for everyone — a deliberately pragmatic design reflecting how each style is really practiced. Nearly everyone (94.4%) completed the twelve-week assessment, unusually high retention for a pain trial in this population. Both acupuncture styles delivered real relief. Electroacupuncture reduced pain by 1.9 points more than usual care (97.5% CI 1.4–2.4, p<0.001 — roughly a one-third drop from the average starting pain of 5.2), and auricular acupuncture by 1.6 points more (97.5% CI 1.0–2.1, p<0.001). But ear acupuncture failed to prove itself as good as electroacupuncture, and it was harder to tolerate: 10.5% of ear-acupuncture patients stopped because of side effects — mostly ear discomfort — versus just 0.7% with electroacupuncture. For cancer survivors seeking alternatives to long-term pain medication, this trial makes electroacupuncture the stronger evidence-backed choice, with ear acupuncture as a workable fallback when body needling isn't practical. The design was pragmatic and the analysis blinded, though there was no sham-needle arm, so expectation effects can't be fully separated — and follow-up ended at 24 weeks, leaving durability an open question.