Electroacupuncture for tension-type headache on distal acupoints only: a randomized, controlled, crossover trial.

OBJECTIVE: To investigate the efficacy of electroacupuncture, applied to distal acupoints only, for tension-type headache. BACKGROUND: Electroacupuncture is commonly used for tension-type headache, but when applied to distal acupoints only, evidence of its efficacy is lacking. DESIGN: A randomized, single-blinded, sham-controlled, crossover clinical trial. Methods.-The trial had 5 stages: baseline (2 weeks), phases I and II (each 4 weeks), washout period (2 weeks), and follow-up (3 months after phase II). Forty patients were randomly assigned to either group A or group B. Group A received real electroacupuncture during phase I, then sham electroacupuncture in phase II. Group B received the treatments in reverse order. Outcome measures were headache frequency and duration, pain intensity using a visual analog scale, mechanical pain threshold, headache disability, and sickness impact. Data were analyzed by univariate 2-way analysis of variance. RESULTS: Thirty-seven patients completed the trial. There were no significant differences between the 2 groups at baseline. At the end of phase I, group A, but not group B, demonstrated significant improvement in mean (standard error of the mean [SEM]) headache frequency (3.0 per month [0.3] versus 12.0 per month [1.7]), duration (13.3 hours [3.5] versus 32.0 hours [6.2]), pain intensity (32.8 mm [4.1] versus 47.5 mm [2.7]), pain threshold (right side, 2.9 kg/second [0.1] versus 0.9 kg/second [0.1]; left side, 2.4 kg/second [0.1] versus 1.1 kg/second [0.1]), headache disability score (6.0 [1.0] versus 16.3 [1.6]), and sickness impact score (288.7 [48.0] versus 687.1 [77.2]). For each parameter, significant differences also were demonstrated for both groups between baseline and phase II, and baseline and follow-up. There were no significant differences between the groups at the end of follow-up (P >.05). CONCLUSION: Electroacupuncture to distal points alone is effective for short-term symptomatic relief of tension-type headache.

The frequency of positive common spinal clinical examination findings in a sample of premenstrual syndrome sufferers.

OBJECTIVE: As part of a randomized clinical trial to determine the efficacy of chiropractic therapy on premenstrual syndrome (PMS), subjects were evaluated for initial underlying spinal dysfunction. SUBJECTS: Fifty-four subjects with diagnosed PMS (using a Moos PMS questionnaire plus daily symptom monitoring) and 30 subjects with no diagnosable PMS were recruited by newspaper advertising and referrals. DESIGN: All subjects underwent a full history and physical and chiropractic examination carried out by 1 of 2 fully qualified and registered chiropractors, each with a minimum of 10 years experience. The results of the assessment for the PMS group were compared with those of the non-PMS group. SETTING: RMIT teaching clinics. DATA ANALYSIS: The data collected were entered into a spread sheet and contingency tables were created. The data were analyzed by use of chi-squared tests, with the statistical significance being set at P < .05. RESULTS: The PMS group had a higher percentage of positive responses for each of 12 measured spinal dysfunction indexes except for range of motion of the low back. The indexes where the increase was statistically significant (P < .05) were cervical, thoracic, and low back tenderness, low back orthopedic testing, low back muscle weakness, and the neck disability index. An average of 5.4 of the 12 indexes were positive for the PMS group compared with 3.0 for the non-PMS group. CONCLUSIONS: A relatively high incidence of spinal dysfunction exists in PMS sufferers compared with a comparable group of non-PMS sufferers. This is suggestive that spinal dysfunction could be a causative factor in PMS and that chiropractic manipulative therapy may offer an alternative therapeutic approach for PMS sufferers.

A randomized, placebo-controlled clinical trial on the efficacy of chiropractic therapy on premenstrual syndrome.

OBJECTIVE: To evaluate the efficacy of chiropractic therapy on the treatment of symptoms associated with premenstrual syndrome. DESIGN: A prospective, randomized, placebo-controlled, crossover clinical trial. SETTING: Multicenter private clinics. SUBJECTS: Twenty-five subjects with diagnosed premenstrual syndrome (with a Moos premenstrual syndrome questionnaire plus daily symptom monitoring). INTERVENTION: After randomization, 16 of the subjects received high-velocity, low-amplitude spinal manipulation plus soft tissue therapy 2 to 3 times in the week before menses for at least 3 cycles. The remaining 9 subjects received a placebo treatment with a spring-loaded adjusting instrument wound down for minimum force. After a 1-cycle washout, the 2 groups changed over. OUTCOME MEASURE: Daily rating of symptom level, comparing total scores for premenstrual week with baseline for treatment and placebo phases. DATA ANALYSIS: The data were analyzed with paired Student t tests and Wilcoxon signed rank tests, with the statistical significance set at P < .05. RESULTS: There was a significant decrease in scores after treatment compared with baseline scores (P = .00001) and a statistically significant decrease in scores for the treatment phase compared with the placebo (P = .006). For group 1 (n = 16), there was a significant decrease in scores after treatment compared with baseline scores (P = .0001) and a statistically significant decrease in scores for the treatment phase compared with the placebo (P = .041). For group 2 (n = 9), there was a significant decrease in scores during treatment compared with the baseline (P = .01); however, there was no difference at the P = .05 level between treatment and placebo scores. CONCLUSIONS: Within the limitations of the study, the results support the hypothesis that the symptoms associated with PMS can generally be reduced by chiropractic treatment consisting of adjustments and soft-tissue therapy. However, the role of a placebo effect needs further elucidation, given that the group receiving the placebo first, although improving over the baseline, showed no further improvement when they had actual treatment.